HomeMy WebLinkAboutZODIAK MANOR ALASKA BLK 8 LT 10Zodiak Manor
Block 8
Lot 10
#015-042-19
Gli~TER ANCHORAGE AREA BOROI~H
DEI~ARTMENT OF ENVIRONMENTAL QUALI"J"~
3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCATION
SEPTIC TANK:
DISTANCE FROM WELL
LIQUID CAPACITY /~0~'~) GALLONS.
MATERIAL ~ ~,~4,/~',~_~ NUMBER OF
COMPARTMENTS
INSIDE LENGTH ~ INSIDE WIDTH~DEPTH
SEEPAGE SYSTEM: SEEPAGE PIT: ~-/~'~'-~
NUMBER OF PITS / _OUTSIDE DIAMETER. ~ .OR WIDTH
LINING MATERIAl .~ ~---~)/~/~ ~/~/~--J~ DISTANCE FROM WELl
/
NEAREST L'QT LINE ~"~,~--~ TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)
, LENGTH '-~4~-' , DEPTH
BUILDING FOUNDATION
~' ~--~ ~::~ SQ. FT.
TILE DRAIN FIELD:
DISTANCE FROM WELL .~Ji~;DAT:O~'; _ ,NEAREST LOT LINE
NUMBER OF LINES DISTANCE BETWEEN LINES H WIDTH
ABSORP_~N AREA SQ, FT. LENGTH OF EACH LINE ~
TOTAL LENGTH
. OF LINES
IN. TOTAL EFFECTIVE
DEPTH: TOP OF TILE TO FINISH GRADE
.DEPTH OF FILTER MATERIAL BENEATH TILE
IN. ABOVE TILE
WELL:.~,~z~.f~-- ~//,~/.~..~ ~,¢~,~.~..~. ~/.~-.z;. DISTANCE FROM
TYPP~/~/-~' DEPTH , BUILDING FOUNDATION.
NEAREST ~,~ SEPTIC / SEEPAGE
LOT LINE /~ /_/__ . SEWER LINF~, ~-, TANK ~7 , SYSTEM
DISTANCES:
DIAGRAM OF SYSTEM
DATE
G.A.A.B.
GAAB-H D.-2
GREATEI ANCHORAGE AREA OROUGH
HEALTH DEPARTMENT
327 Eagle St. Anchorage, Alaska 99501 279-2511
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
Case No.~
NAME OF APPUCANT/ e,,, £.
RESIDENCE ADDRESS
LEGAL DESCRIPTION L~-
APPLICATION TO INSTALL: SEPTIC TANK
TO SERVE THE FOLLOWING FACILITY -~
FINANCED THROUGH /~H/q
PERCOLATION TEST RESULTS 5'o// '~.~1
THIS IS TO SERVE AS
/0
MAILING ADDRESS/~/-Z~- P ~-~.
LOCATION OF INSTALLATION
PHONE N0.,'~ 77'O~5~
. SEEPAGE PIT /~ . DRAIN FIELD , OTHER
TO BE INSTALLED BY
ANTICIPATEB DATE OF COMPLETION
BELOW TO BE FILLED DDT BY HEALTH DEPARTMENT
)t~/~ (~/'~45 , PERMIT TO INSTALL A
AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED
· SEPTIC TANK SIZE /3-~,~ TYPE ~ SEEPAGE AREA ~'~ ~' TYPES~-,v,~ ~'t/'
<; ,/<.~/ / !
DIAGRAM OF SYSTEM
DISTANCES:
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. - - ~/L r
3~7 LA...~,~L %Ti<EET
Feet . Soil Charactepistics I,oc~tion Sketch
c/ . ' //~/I '= "
,6, ~ ,, i .. .-''
~- ' b: ~. ,_,~, .~
; ..... /' f "*/~-/ '.f :'..,; E' :" '
/
Del;Ch Of Inlet '~i
GREATER ANCHORAGE AREA BOROUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3500 TUDOR ROAD
ANCHORAGE, ALASKA 99507
279-8686
DATE RECEIVED:
9-a3-71
INSPECT:
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER AND WATER FACILITIES
FOR
PHONE:
2. PROPERTY OUNER: ~Z/ Z,~'r?' P,ONE:
NUMBER OF BEDROOMS: ~
WELL DATA:
DEPTH
C. SIZE
D. CONSTRUCTION
SEWAGE DISPOSAL SYSTEM:
A. SEPTIC TANK (IF HOMEMADE,
~. SIZE /~0
2. AGE /77/
SHOW DIAGRAM ON BACK)
3. MANUFACTURER
INSTA ER
APPROVAL REQUEST FOR SEWER & WATER FACILITIES
PAGE TWO
SEEPAGE PIT
,. size ~ ~: z ~ '.,.".7~'~i~..;~
2. LINING
C. DISPOSAL FIELD
1. NUMBER~F LINES
2. TOTAL LEAH_
7. REQUIRED MEASUREMENTS
A. WELL TO SEPTIC TANK
B. WELL TO SEEPAGE PIT
C. WELL TO SEWER LINE
D. WELL TO PROPERTY LINE
E. WELL TO OTHER
F. FOUNDATION TO
G. FOUNDATION TO
H. SEEPAGE
POSSIBLE CONTAMINATION
SEPTIC TAN~ ~-'±
PIT TO PROPERTY LINE
8. COMMENTS:
APPROVED:-,~ ,/~ ~'- ~, ¥'~DIsAPPROVED:
DATE: ( ct , DATE:
APPROVAL VALID FOR YEAR FROM DATE SIGNED.
GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY
