HomeMy WebLinkAboutTURNAGAIN #2 BLK 2 LT 3
TURNAGAIN #2
Block 2
Lot 3
#016-131-18
GR- --TER ANCHORAGE AREA BOROU"H
�NJ HEALTH DEPARTMENT I No 180
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
MAILING
NAME ��%%�/�� S✓��5/r/f/ ADDRESS f/'-�D.f/��i%i� C� PHONE,,2,^e
�t_T1T' Clot= �
LEGAL DESCRIPTION�T��',.r,�'�. TeJ„�.�✓.(/��,�3�s✓/Pl��
SEPTIC TANK:
. NUMBER OF
DISTANCE FROM WELL �' MATERIAL �'-E�.�E=Ac��?- COMPARTMENTS✓
_ �.%:d/✓OJ'% %tea-����v�-'✓' /` �rJ
LIQUID CAPACITY ��� -S 2 GALLONS. INSIDE LENGTH �-D
!:—'INSIDE WIDTH ���EEPTH �—
PAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS / OUTSIDE DIAMETER OR WIDTH LENGTH ✓-�� DEPTH
LINING MATERIAL DISTANCE . DISTANCE FROM WELL BUILDING FOUNDATION -U /,
i
NEAREST LOT LINE '�� TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) // SQ. FT. 2; -
TILE DRAIN FIELD:
DISTANCE FROM
NUMBER OF
LINES
SQ. FT. LENGTHNQF EACH LI
NEAREST LOT
TOTAL LENGTH
Dr-t4,JES ,
EFFECTIVE
'DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE
WELL: DISTANCE FROM �,�-- WATER
.DEPTH , � '� ��o ,BUILDING FOUNDATION. SAMPLE �., NEAREST
NEAREST SEPTIC ✓ SEEPAGE ANOTHER
LOT LINE SEWER LINE,TANK %� ,SYSTEM �a� ,CESSPOOL—, SOURCES
DISTANCES:
0
DIAGRAM OF SYSTEM
DATE /� sG
GAAB-HD-2
GREATE1LIANCHORAGE AREA LOROUGH
HEALTH DEPARTMENT
327 Eagle St. Anchorage, Alaska 99501
rO.
Case No.
279-2511 I 'f �Y' 'I
f;
g1'(1�'
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
NAME OF APPLICANT�tsl�in�rlid ''/1i MAILING ADDRESS. <7 C /pHONENO.����/- ��/�
RESIDENCE ADDRESS I_V — LOCATION OF INSTALLATION Jc� Loa
LEGAL DESCRIPTION_ Zy! 3 31 -ii a lei '//V
APPLICATION TO INSTALL: SEPTIC TANK , SEEPAGE PIT , DRAIN FIELD , OTHER
TO SERVE THE FOLLOWING FACILITY_ c IS171;b-� T 1Z l 1 L E 2
FINANCED THROUGH e L F TO BE INSTALLED BY P L
PERCOLATION TEST RESULTS C%C% i' ANTICIPATED DATE OF COMPLETION_ ZI %r Ain rlt
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
THIS IS TO SERVE AS
dem r
DISTANCES:
,PERMIT TO INSTALL A
AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED �
h�
SEPTIC TANK SIZE TYPE 2 )J SEEPAGE AREA 00 STYPE
?_ O CL I&LL- 5� DIAGRAM OF SYSTEM 11
-6 !
HEALTH AUTHORITY
OR
LICENSED DESIGNER
IO2 V
I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the
above described system is in accordance with said code.
DATE Z APPLICANTS SIGNATU . �> ��