HomeMy WebLinkAboutELMRICH VILLAS #4 Block 1 Lot 6 Public Information
GJO ATER ANCHORAGE AREA BORO~
HEALTH DEPART~AENT
327 EAGL~ S]'. ANCHORAGE, ALASKA 9950] 279-2511 _
INSPECTION R~PORT ON-SITE SEWAGE DISPOSAL SYSTEM
MAll lNG ~ ~- ' / /'~ ~'~
"¢ ,, f' i /['/~" LEGAL DES(-RiPFiON,~'~/~:, /''/~
SEPTIC TANK:
MATERIAL ~ ¢>. ~,/~ :i¢: ~-x::z~: : COMPARTMENTS._
SEEPAGE SYSTEM:
NUMBER OF PIIS
LINING MATERIAL
NEARES1 LO1 lINE
TILE DRAIN FIELD:
SEEPAGE PI[:
// OUFSIDE I)IAMFTER _ .OR WlDrlt : . ' , LENGFlt ,'"J'. [' ~ , DEPTtt ¢~': .,
.*' z %~ ,% ..I)ISTANCE FROM WElL(
{~i,, ., BUILDING I:OUNDAflON_ ' _,
. ' .. TOTAL EFFECTIVE ABSORPIlON AREA (WAIL ARI,{A) " ] ,;! SQ. FT.
DISTANCE FROM WELl. _: , FOUNDATION , NEAREST LOT lINE
NUMB~t,~.OF LINES _ - DISTANCE BETWEEN L~NES. TRENCH WIDTH
ABSORPTION AREA_ SQ. FT. iENGIH OF EACH LINE _
FOTAL LENGTH
, OF LINES.
IN. TOTAL EFFECTIVE
DEPTH: fOP OF TIlE TO FINISFt GRADE_ _ DEPTH OF FILTER MATERIAl BENEA1H 'I'IIE IN. ABOVE TILE
· ~,_// ' ' "' , DISTANCE FROM " WATER
WELL: TYPE~. ';_,,, ~.j~ .' ', DEPTH _1' ___,BUILDING FOUNDATION. ::'" SAMPLE. '(, ., NEAREST
NEAREST SEPTIC SEEPAGE OTHER
LOT LINE , SEWER LINE. ' " _,TANK. ' ' *' , SYSTEM_ , CESSPOOL .... SOURCES
DISTAN ZES:
//
DIAGRAM OF SYSTEM
GREATE
327 Eagle St.
HEALIII D~J ARIMI~N
Am:horag% Alaska 99501 279-2o
F ,: : / PHONE NO..'
NAME OF APPLICANT (D'i ·
RESIDENCE ADDRESS
APPLICATION TO INSTALL: SEPTIC TANK ...... ~: _ .,SEEPAGE PIT. ~" .,DHAIN FIELD ........... OTHER
TO SERVE THE FOLLOWING - . ........ .
FINANCED THROUGH ~:_ ( JLLL EJ,:~
PERCOLATION TEST RESULTS ........................ ANTICIPATI3~ DATI~ DF
AS DESCRIBED BEI.OW. SIZE OF IINI'I'
SEPTIC TANK SIZE
DIAGRAM OF SYSTEM
DISTANCES:
,'L
I certify that I am familiar with thc requirements oi' (;r0a tm- Anchorage Area Ilorottgh ()rdinancc No. 28-68/and that thc
above described system is in accordance with said code.
DATE_ ; ' ( APPI.IfiANTS
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3500 Tudor Road, Anchorage, Alaska 99507 279-8686
Date Received
Time of Inspection
.... 4 ..... F FOR AP~RO~rAL OP
~.~!" IN.r,.'r,.,IDUAL '3E~'IER 8 WATER FACILITIES
2. P~ooertv ~,ner: --/'~'" ' ~.-s't ~'Z.-~-~'"~ Phone
3 Legal I}escription: ~'
5. Type o-f Facility to he Im~uect. ed: :(~( 'l ~ ~-
....... %T
Number of' Bedrooms: ~') ~~'~'
5. ?~el. Data: ,
!3. Depth
A. Type
C. Construction D. Bacterial Analysis
7. Sewage Disposal ov,;t, em: ~'~/-
A. ~nsta lled -,: /~) B. Instal ] er
C. Septic Tank: 1, 5ize.2/(~).~_2. ~anufacturer~'Z"~a~
D, Seepage Pit:
~, Disposal F~eld: Total !.eng~h off Lines
8. Distances:
A. Well To: Septic T~nP , Absorption Area , Sewer Lines
, Neare, sl: Lot Line , Other Contamination ..
B. Foundatior! tc~ ~.er~t' c Wor, k '~ AbSorotion Area
/
~,. Absorotion Arsa to ' ' I,ot Line ~0 ?
~ Rec~]e~t for App~ovat c
~'vage Two ~
Disaporoved
// // /
f. Appr~'a] Valid for One Y~ar F-,co~ Date SiGned
Greater Anchorage Are3 Borouqh, DeF-artmer~t of .F:nvf..ron~,enta] Quality
DYAGRAM OF SYSTEM
I certify that the information contained in this request for approval to be a true
and accurate ~ ~
representa~,.,oa of the subiect sewer and water facilities located at: