HomeMy WebLinkAboutSONNEY VIEW LT 120AOnsite File
"' GREATER ANCHORAGE AREA BOROIJGI
~¢~ HEALTH DEPART/,~ENT
i ,:.~'~ 327 EAGLE STREET
X" ANCHORAGE, ALASKA 99S01
~9':'~ ) ~ ~ ~ INDIVIDUAL SELVAGE AND IqATER FACILITIES
~ ,~ 5' ~ :, ~: ~! FOR
1. Approval Requested By ~/
Phono ~ ~ 7- /S~>
2. Property Owner q ~ ~::'x ~ Phone
3, Legal Description [~,~ /~0
4, ~pe o~ Facility to be Inspected _~~:__
Number oY Bedrooms
Nell Data:
D. Construction
E. Bacterial Analysis
6. Sewage Disposal System:
show diagram on back)
Septic Tank (If homemade,
1. Size
3. Manufacturer
4. Installer-/~
Approval Request for Se ge ~ Water Facilities
Page Two
B. Seepage Pit
1. Size
2. Lining
C. Disposal Field
1. Number of Lines
2. Total Length
Required Measurements
A. Well to Septic Tank
B. Well to Seepage Pit_...~
C. Well to Sm~er Line
D. Well to Property Line
lVell to Other Possible Contaminatioa
F. Foundation to Septic Taak
G. Foundation to Seepage Pit
ti. Seepage Pit to Property Line
8. COMMENTS:
APPROVED:
DATE:_ /
AFPROVAL YA~
~ f' ~ ____~DISAPPROVED:
ti 1 71
DATE:
FOR ONE YEAR FROH DATE SIGNED.
GREATER ANCHORAGE AREA BOROUGH HEALTH DEPARTMENT
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