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GP" ;TER ANCHORAGE AREA BOROV'
HEALTH DEPARTMENT
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
INSPECTION REPORT ON-SiTE SEWAGE DISPOSAL SYSTEM
OCAT'ON
SEPTIC TANK:
D~STANCE FROM WELL_
BQUID CAPACITY__ ~7..;~,~-~y
MAILING
LEGAL DESCR~P TIO ~'~' '
NUMBER OF /'
MATERIAL d'~ ~'~dt~'"~ '%~:" ~ COMPARTMENTS-
~ /~ //~:?~ ~' ~ /~--~'~ LIQUID
~GALLONS. INSIDE LENGTH ~-- _~- INSIDE WIDTH_ -- DEPTH~
SEEPAGE SYSTEM: SEEPAGE PiT:
NUMBER OF PITS /_____OUTSIDE DIAMETER.
/
DISTANCE FROM WELl._
TOTAl. EIZFECTIVE ABSORPTION AREA (WALL AREA)
--, DEPTH.
BUILDING FOUNDATION~''
sa. FT.
TOTAL LENGTH
__IN. TOTAL EFFECTIVE
IN. ABOVE TILE_--.
TILE DRAIN FIELD:
DISTANCE FROM WELl. OUNDATION-- .OT LINE_
NUMBER OF LIN BETWEEN LINES TRE CH WIDTH__
OEI~HH: TOP OF TILE 10 FINISH GRADE__-- ____DEPTH OF FILTER MATERIAL BENEATH TILE_
WELL: T y p E ~'?~-~6--~'~ DEPTH~ ----- BUILDING FOUNDATION._ ~ SAMPLE NEAREST
SEEPAGE SOURCES__
NEAREST SEPTIC .~ ------ CESSPOOL
LOT LINE '~'~__, SEWER LINE _~ TANK_ SYSTEM_
DIAGRAM OF SYSTEM _ _
DISTANCES:
DATE
, M
APPROVED _- HEALIH AUIHORIIY
GAAB-H D-2
GREATEK
327 Ea~le St.
ANCHORAGE AREA
IIEALTH DEPARTMENT
Anchorage, Alaska 99501
.)ROUGH
279-2511
Case N 0.9'~__~2Z_
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
" ' ' , _. -[ PHONE NO. E:zcT~_~-/
RESIDENCE ADDRESS
LEGAL DESCRIPTION.
APPt. ICATION TO INSTALL: SEPTIC TANK.
TO SERVE THE FOLLOWING FACILITY.
FINANCED THROUGH__
PERCOLATION TEST RESULTS
INSTALLATION
LOCATION OF .....
, SEEPAGE PIT /~'/" , ORAIN FIELD_ __, OTHER__
ANTICIPATEO DATE OP COMPLETION.
BELOW TO BE FIt. LED OUT BY HEALTH DEPARTMENT
THIS IS TO SERVE AS ---~-! S ~$ ,~ ~ ~'IA) d"" n'~, PEflMIT T0 INSTALL A
._AS DESCmREO ~ELOW. S~ZE OF UN~,T TO ~E SE,VEO
SEPTIC TANK SIZE. "78'~ TYPE '-S_ ~"~SEEPAGE AREA-- TYPE_LO..~--~- ..
· ' ~'7~.¢~,.~.~-). DIAl;RAM OF SYSTEM
DISTANCES:
';REATER ANCHORAGE AREA BOROUGH
ItEALT}t DEPARTMENT
32? EAGLE STREET
ANCHORAGE~ ALASKA g9501
Performed For Lamb Bros. Cons. Co ._[In~= ~ .Date Performed __;7_~14~/7~0 -~
. _ · .--~- .,~.~-~'o~n~^,.~ ,ubdiv~sion Sec 27 T 12 NR
Le[~aJ. u ~ P ~- · c~;~.o. ~ ~colat~on Test
This Por,m KepoP~s a ........ ~ ............... ~ .... ~ -
Soil Characteristics
Brown
Gray poorly graded Sand (SP)
Silt and Silty Fine Sand (ML)
Depth
Feet
Location Sketch
12---
Was Ground Water Eneoantered?__~___~._~NO ~o
If Yes, At W~at Depth ......
Reading [ Pate
Time
Net Time
Depth To H20
Net Dmop
Proposed Installa~::~on*~:'-Seepage Pit Drain Field
Depth Of Inlet ])ep~~o'~'"~'~it Or Trenc]~'
COMMENTS :__, Nec~.~_._~es~~~.e~ area i~____~s 27_.~5_squar_e f~et p~p~~~
Test Perfomrned By: R.E. Carlisle
Data Certified By: National Testing Services
Date: