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HomeMy WebLinkAboutT12N R3W SEC 13 Lot 28D - Lot No Longer Exists .o'T GR~^,TER ANCHORAGE AREA BOROUr'~H HEALTH DEPARTMFNT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM LOCATION~ SEPTIC TANK: ~--- / NUMBER OF / DISTANCE FROM WELL ,~ ~ MATERIAl ~ ~"~..7-- COMPARTMENTS_ / LI©UID CARACHY ~,z.:~ GALL©NS. INSIDE LENGTH_ ~"-'~I~SIDE WIDT~ DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS / OUTSIDE DIAMETER NEAREST LOT LINE / OR WIDTH .-~' ~) , LENGTH .~.A;~ , DEPTH ~'$ / DISTANCE FROM WELL .,~,~) Z~ BUILDING FOUNDATION -~'~.~ TOTAL EFFECTIVE ABSORPTION AREA {WALL AREA} SQ. FT. TILE DRAIN FIELD: DISTANCE FROM WELL AB~LI.L.L.L.L.L.L.L.L.~NUMBER OFAREA DEPTH: TOP OF TILE TO FINISH GRADE TOTAL LENGTH FOUNDATION_ _ , N~T LOT LINE , OF LINES ., DISTANCE BETWEEN LINES .~'~ TJ~JzNCH WIDTH / IN, TOTAL EFFECTIVE DEPTH OF FILLER MATERIAL BENEATH TILE IN. ABOVE TILE WELL: ~ TYPE /)~//~-~/~ , DEPTH _ NEAREST ~,....~ SEPTIC LOT LINE ,/~J / ~ , SEWER LINE , TANK DISTANCE FROM · WATER BUILDING FOLJNDAIlON ./~) ~ SAMPLE_/'~/~'~' NEAREST ~-¢ .~ SEEPAGE . ~ ~ OTHER , SYSTEM ~ ~ CESSPOOt ~, SOURCES DIAGRAM OF SYSTEM DISTANCES: DAlE APPROVED GREATEIF 327 Eagle St. ANCHORAGE AREA .... 'OROUGH IIEALTIt DEPARTMENT Anchorage, Alaska 99501 SEWAGE DISPOSAl. SYSTEM - APPLICA?ION NAME OF APPLICANT· RESIDENCE ADDRESS LEGAL DESCRIPTION MAILING ADDRESS '7~-~],,[~,, /~,'/ PHONE NO. LOCATION OF INSTALLATION ~.,¢~(~-t~,/ APPLICATION TO INSTALL: SEPTIC TANK TO SERVE THE FOLLOWING FACILITY. FINANCED THROUGH PERCOLATION TEST RESULTS ,~ , SEEPAGE PIT_~___, DRAIN FIELD TO BE INSTALLEO BY... , OTHER. ANTICIPATED DATE OF COMPLETION_ BELOW TO RE FILLED OUT BY HEALTH DFPARTMENT THIS IS TO SERVE A8 .~g/~&~¢.- , PERMIT TO INSTALL A -'"~'~z'"f'X~'4 -'~'~-~ _AS DESCRIBED BELOW. SIZE OF UNIT TO'BE SERVED ~'~ SEPTIC TANK SIZE ~_TYPE ~ SEEPAGE AREA __TYPE OlAORAM 0F SYSTEM DISTANCES: [ certify that I am familiar with the requirements o£ Greater Anchorage Area Ordinance No. 28-68 and ~hat the above described system is in accordance with said code. GATE '~/ APPLICANTS SIGNATURE .~ , ]REATER ANCHORAGE AREA BOROUGH HEALTH DEPARTMENT CASE 327 EAGLE STREET /~.~[~NCHORAGE, ALA~,KA 99501 ~ >~ ¢[ ~ ' Date Performed ~/~ Perform,~d Forego ~d . L O~O~ ............... 3~ Le~a] Descz, iptzon Lot R ~DBloc~~on D~.f~dm ~ '~ Tnzs Form Repomrs a: So~ls Log .... ~~emc<~{ ...... Depth Feet Soil Characteristics Was Ground Water Encountered? ' 0 Ii': Yes, At ~;hat Depth Readb g Gross Time Location Sketch -- I Date Net D~op Net Time Depth To H20