HomeMy WebLinkAboutFYFE BLK E LT 5GREATER ANCHORAGE AREA BOROUGH
Department of Environmental (duality
3500 Tudor Road, Anchorage, Alaska 99507 279-8696
Date Received ! - <-2.-�) j 5
Time of Insoection /L?, , `,
Date of Insoection 7 =�
REQUEST FOR APrjRO jAL OF
TM1VIDUAI. SEINER & NATER FACILITIES
FOR
i
1. Aoproval Requested 13,1:
Address: Phone: '% /--17e/G,
2. Prooerty Owner:- /�t �`C <<1�z�n� Phone.-- a L 5
3. Legal Description:_S"�� E�L,'/--c-
4. Location. AL-
i
5. Type of Facility to be Inspected: �-
U
Number of -Bedrooms: /
6. (Nell Data:
A. Tvoe B. Depth
C. Construction D. Bacterial Analysi"
7. Sewage Disposal System: C'
A. Installed COL'v
C. Septic Tank: 1..
D. Seepage Pit: I.
E. Disposal Field:
9. Distances:
9. Install�
r
Size 2 ,�-n facturer`" 1
Size !' �2. Matt /
Total Length of Lines
A. Well To: Septic Tank.__A Absorption Area Sewer Lines
Nearest Lot Line 3 Othir Contamination 41&t •
B. Foundation to Septic Tank Absorption Area ;-�ci4
f
C, Absorption Area to Nearest Lot Line %�'
Reque . `or Approval of „, ividual Sewer & 'water Faciliti�.
Page Two
9. Comments:
—
Approved
T
Approval Valid for One Year From Date Sinned
Greater Anchorage Area Borough, Derartment of Environmental Quality
DTAGRAM OF SYSTE-W
I certify that the information contained in this request for approval to be a true
and accurate representation of the srabiact sewer and water facilities located at:
Signed Date
HOME OFFICE
235 EAST 5TH AVE
ANCHORAGE, ALA�SKA
L
PHONE ® 1� A 2-4643
P. 0. BOX 721
01
t
7
cam'
151
FL3-177�
Percolation Test
FAIRBANKS OFFICE
N
PHONE
�G!bp Li J
l4.
P. O. BOX 1480
Test Location: Lot -:!5- Blcck 2�-' Subd.
Test Date:
Requested by : ..wiz.-/c'��c2� ;Ie: -
Test Hole Log Test Hole Location
4
lst. Filling:
Bottom of hole
to drain out.
end. Filling:
Bottom of hole
Lc-i-;�de-. ii
approximate slope
filled with of water and allowed
filled with 4; �5 of water and test run.
Percolation Rate: / ���� ! min./in.
Remarks: `� //�'y lr
These results are only the visual soil conditions and theoretical
percolation rate on this date for this test hole®