HomeMy WebLinkAboutSAND LAKE #2 This lot has been subdivided into Block 2 of Sand Lake S/DSE.c.
~.,~' '~lr'K /&I~.I'I~K/-~I~ AKI:P. §URU' ,11
HEALTH DEPARTMENT
327 EAGLE 51'. ANCHORAGE, ALASKA 99501 279-2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
DISTANCE EROM WELL_
LIQUID CAPACITY
MATERIAL C~/~/
____GALLONS. INSIDE LENGTH
NUMBER OF t
COMPARTMENTS
___INSIDE WIDTEI
LIQUID
DEPTH
SEEPAGE SYSTEM:
NUMBER OF PITS
LJNING MATERIAL
NEAREST LOT LINE
SEEPAGE PIT:
OUTSIDE DIAMEIER
,LENGTH I 7 ~
, DEPTH
BU~LmNO FOUNDAnON
FT.
· '~'TILE Di~AIN FIELD:
DISTANCE FROM WELl.
NUMBER OF LINES
· FOUNDATION___ . NEAREST LOT LINE
DISTANCE BETWEEN LINES ' TRENCH WIDTH
TOTAL LENGTH
OF LINES
IN, TOTAL EFFECTIVE
ABSORPTION AREA
SQ. FT. LENGTH OF EACH LINE
DEPTH: TOP OF TILE TO FINISH GRADE
DEPTH OF FILTER MATERIAL BENEATH TILE
IN. ABOVE TILE__
WELL:
LOT LINE
TYPE . DEPTH
NEAREST
, SEWER LINE.
SEPTIC
· TANK
WATER
SAMPLE
DISTANCE FROM
, BUILDING FOUNDATION
SEEPAGE
, SYSTEM , CESSPOOL
DIAGRAM OF SYSTEM
NEAREST
OTHER
SOURCES
DISTANCES:
DATE
APPROVED
GA LD-2 Case No.--~
GREATEr._. ANCHORAGE AREA
ILEAL 11t DEl AR FMI,N T
327 Eagle St. Anchorage, Alaska 99501
279-2511
SEWAGE DISPOSAl. SYSTEM - APPLICATION & PERMIT
NAME OF APPLICANT
RESIDENCE ADDRESS
LEGAL DESCRIPTION
APPLICATION TO INSTALL: SEPTIC TANK
I-"/' ., SEEPAGE PIT ~/ , DRAIN FIELD
1'[) BE INSTALLED BY.
ANTICIPATED DATE OF COMPLETION.
TO SERVE THE FOLLOWING FACILITY
FINANCED THROUGH ~(? L ~"
L~'J:::~ I L_
'~-P ER~OI.~+,T-!8 N-:F-E S T RESULTS
~ Cq - ¢~y%~ ¢ BELOW TO lie FILLED OUT BY HEALTH DEPARTMENT
THIS IS -ro SERVE AS /'v.}/~ _ "~> L~ I~ ~)~, PERMIT TO INSTALL A
_As DESCm,E~ ,ELOW. S~ZE o" D,IT 1-0 ,E SERVE~___ '~ ~J~'.'~_
. SEPTIC TANK SIZE. '7 ,~'~_TYPE ~'/ '¢' ¢ c/` SEEPAGE AREA TYPE
DIAGRAM OF SYSTEM
DISTANCES:
Health Authority
I certify that I am familiar with the requkements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the
above describ~.~sYVn is 7ccordance with said c°de,