HomeMy WebLinkAboutLot 04 - 07
G?'~TER ANCHORAGE AREA BORO~'~H
HEALTH DEPARTMENT
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
N? 760
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCATION ,.'~:--
SEPTIC TANK:
MAILING
ADDRESS/'
LEGAL DESCRIPTION
DISTANCE FROM WELL ~ ~'"
LIQUID CAPACITY
GALLONS.
NUMBER OF
MATERIAL _,~ ~.-'--~" ~--Z~f.-. COMPARTMENTS
.~-..>-.~.~:.~ .... ~_~--Z~.;:.'_/'/ ,:, : ?/ 1/,_/~ ..~..C~..~.~,~>*~
INSIDE LENGTH ~ INSIDE WIDTH
LIQUID
DEPTH ':-"
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS / OUTSIDE DIAMETER
LINING MATERIA[,~- ~" '~'~
OR WIDTH "~ LENGTH - ' , DEPTH
DISTANCE FROM WELl
NEAREST LOT LINE
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)
BUILDING FOUNDATION.__
..~J-')-C:~ ~'--~"..'~.-"-~ -
SQ. FT.
TILE DRAIN FIELD:
DISTANCE FROM WELL j/~.~!D.CTLOJxL ~
NUMBER OF LINES// DISTANCE BETWEEN LIN
EACH
ABSORPTI A SQ. FT. LENGTH O LIN~
NEAREST LOT LINE.
TRENCH WIDTH
TOTAL LENGTH
OF LINES
IN. TOTAL EFFECTIVE
DEPTH: TOP OF TILE TO FINISH GRADE
DEPTH OF FILTER MATERIAL BENEATH TILE
IN. ABOVE TILE.~
WELL:
LOT LINE
TYPE ~e:~Sz:x~c'-'~'-~:'z- ' DEPTH.
-/,4~'" NEAREST /'~:"./~"~-'~.. SEPTIC
SEWER LINE /'/&' -~</ TANK
DISTANCE FROM
BUILDING FOUNDATION.
x SEEPAGE
-J~ , SYSTEM
WATER
SAMPLE
, CESSPOOL,,,4-'~ ~
NEAREST
OTHER
SOURCES
DISTANCES:
.~c~: ,
DIAGRAM OF SYSTEM
I I
DATE
APPROVED
HEALTH AUTHORITY
GAA.;.~-:. GREATEr'ANCHORAGE AREA OROUGH
'~, HEALTH DEPARTMENT
· ~* - 327 Eagle St. Anchorage, Alaska 99501 279-2511
No./;' P£
SEWAGE DIP SAL SY TEM - APPLIC TI N ,& PERMIT
NAME OF APPLICANT/~ ~ ¢~-I/' P-" e C~ ~i_l~'J__.~iLl. G ~ODRESS f~_ ~ ~ ~4,~";~[ NO.
RESIDENCE ADDRESS ~ ~~ ,~u~ LOCATION 0F INSTAL[ATION
LE6ALDESCRIPTION ~0~ % %~,~/~/~
APPLICATION T0 INSTALL: SE~IC TANK ~ ,SEEPAGE PIT. ~ . DRAIN FIELD . OTHER
To SE.YE ~.E FOLL0W~.. F*C~m~ ~ ~C ~
FINANCED THROUGH C~k ~, TO BE INSTALLE0 BY
PERCOLATION TEST RESULTS A;/¢¢Sf ANTICIPATE0 DATE OF C0,PLETI0,
aE~0W ~0 e~ m~E0 OUT SY HEALT. DE.A.mEmT
THIS IS TO SERVE AS '7);P O~/vrC ~ ~$ ,PERMIT TO INSTALL A -~-~/l~'~:I~/~_LL~? ',..~
..... AS DESCRIBED BELOW. SIZE 0F UNIT T0 BE SERVED I ~ ~
DIAGRAM OF ~YSTEM
HEALTH AUTHORITY
OR
LI CEHSED DESIGNER
I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the
~o~ ~.~d ~.~m ~ ~ ~=rda=~ wi~ ~d ~od~. ~~ ~*n: ¢%~~~/~
Performed For Church of the Na.zar~_~e :)ate ?'erfor:,;ed ~/?~/71 . .
Le~..=~ Dcscz,:.o~ot~"[~~' ~i~?Y'!,:,~:: A1 Cross
Th.ks Fcrm Reports ~.: So~I,<: :m.:,, _ X ~ t-er, c-i,:a~.:on Tes':,
,Lots 4,5,6 & 7
Depth
Feet Soil
....... i'" t gray ;il:tY'-gravel, slightly
2-i. i sandy (GM)
4 --1 I ~ray sandy §ravel (~W)
/ f and silty sandy gravel (GM)
6 in seams and lenses
becomes silty at 12.0'
8---
~0---
12I
I
Was Ground Water Encountez'ed? no
if Yes, At 1,!hat Depth .....
Readlng
!,ocation Sketch
Oross 7]me
Depzh Of :Inlet .... be:',t:: To S~'~~.t C'r Trench'_ _
('o~f'~ ~',~: .... _ .......
155 s~~~na~e area ~s rgqu~r~__~er bodroom.
Test' Performed
Dsta Certified By: National Testing. Sg~vices, Inc.
Date: