HomeMy WebLinkAboutLot 08, 093q
GAAB-HD-J
G~q,'-"~.TER ANCHORAGE AREA BOROJ'~H
" HEALTH DEPARTMENT '
,. 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
,; " INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCAT,ON P'~r fo ~-~k/3 ~ ~ ~ ~6~t ~ESC~,~.o~ ~ ~ ~ .x~
DISTANCE FROM WELl MATERIAL COMPARTMENTS
LIQUID
LlaUID CAPACITY~~ GALLONS. INSIDE LENGTH INSID[ WIDTH DEPTH
SEEPAGE SYSTEM:
NUMBER OF PITS
LINING MATERIAL
NEAREST LOT LINE
SEEPAGE PIT:
OUTSIDE DIAMETER
OR WIDTH
. DISTANCE FROM WELL.
TOTAL EEFECTIVE ABSORPTION AREA (WALL AREA)
, LENGTH , DEPTH
BUILDING FOUNDATION
SQ. FT.
TILE DRAIN FIELD:
DISTANCE FROM WELL
NUMBER OF LINES
ABSORPTION AREA
FOUNDATION
DISTANCE BETWEEN · NES
SQ F[. _ENGTH OF EACH LINE
DEPTH: TOP OF TILE TO ClNISH GRADE
NEAREST LOT LINE
[RENCH WIDTH
TOTAL LENGTH
OF LINES
iN. TOTAL EFFECTIVE
DEPTH OF FILTER MATERIAL BENEATH TILE_
ABOVE TILE
WELL:
LOT LINE
--/NEAREST / SEPTIC
/-~ SEWER LINE ,//~ , TANK
. BU LDING FOUNDATION.
SEEPAGE .
· SYSTEM
WATER
SAMPLE
· CESSPOOL.
NEAREST
'
DISTANCES:
DATE
DIAGRAM OF SYSTEM
·
I
GREATEr. ANCHORAGE AREA
HEALTH DEPARTMENT
327 Eagle St. Anchorage, Alaska 99501
~!'3ROUGH
279-2511
Casa No. '~
APPLICATION TO INSTALL: SEPTIC TANK
TO SERVE THE FOLLOWING FACILITY
FINANCED THROUGH
PERCOLATION TEST RESULTS
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
NAME OF APPLICANT ~l~,.~z,-; -~,,~ MAILING ADDRESS PHONE NO.
RESIDENCE ADDRESS LOCATION OF INSTALLATION~'~-¢7"'
LEGAL DESCRIPTION~
, SEEPAGE PiT , DRAIN FIELD ' , DTF~ER
TO BE INSTALLED BY ~..~
ANTICIPATED DATE OF COMPLETION
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
TH,S,STO SERVE AS ,PERM,TTO'NSTALLA
,~ /~SoDES~._R.I~ED BELOW. SIZE OF UNIT T.O BE SERVED ~'f
· ~~ /~'~ TYPE -~ SEEPAGE AREA
DIAGRAM OF SYSTEM
DISTANCES:
TYPE
Health Authority
I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the
above described system is in accordance with said code. ~-