HomeMy WebLinkAboutT13N R3W SEC 32 Parcels 1-4 & 1-5
GAAB-HD-I
GPJ~6.TER ANCHORAGE AREA BORO,pL~H
HEALTH DEPARTMENT ~
279-2511
327 EAGLE ST. ANCHORAGE, ALASKA 99501
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCATION
/
SEPTIC TANK:
DISTANCE FROM WELL_
LIQUID CAPACITY
GALLONS.
MATERIAL
INSIDE LENGTH
ADDRESSMAILING; ~';/~/.~ ~-~ t.~ PHONE
LEGAL i ~ ~
NUMBER OF
INSIDE WIDTH DEPTH
SEEPAGE SYSTEM:
NUMBER OF PITS
LINING MATERIAl
NEARES'I LOT LINE
SEEPAGE PIT:
OUTSIDE DIAMETER
OR WIDIH. , LENGIH , DEPTH
DISTANCE FROM WELL_ BUILDING FOUNDATION
TOTAl EFFECTIVE ABSORPTION AREA (WALL AREA) SQ. FT.
TILE DRAIN FIELD:
DISTANCE FROM WELL.
NUMBER OF LINES
ABSORPTION AREA
FOUNDATION
DISTANCE BETWEEN LINES
SQ. FT. LENGTH OF EACH LINE
, NEAREST LOT LINE
TRENCH WIDTH
DEPTH: TOP OF TILE TO FINISH GRADE
DEPTH OF FILTER MATERIAL BENEATH TILE.
TOTAL LENGTH
· OF LINES
IN. TOTAL EFFECTIVE
IN. ABOVE TILE
WELL:
LOT LINE
TYPF
DISTANCE FROM WATER
, DEPJH , BUILDING FOUNDATION. . SAMPLE NEAREST
NEAREST SEPTIC SEEPAGE OTHER
SEWER LINE , TANK SYSTEM , CESSPOOl , SOURCES
DISTANCES:
DIAGRAM OF SYSTEM
GAAB-H D-2
GREATE 'ANCHORAGE AREA _OROUGH
HEALTH DEPARTMENT
327 Eagle St. Anchor.age, Alaska 99501 ~- 279-2511
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
MAILING ADDRESS . ~'~,4~
Case No.,
PHONE NO.
TO SERVE THE FOLLOWING FACILITY
FINANCED THROUGH '-
PERCOLATION TEST RESULTS
RESIDENCE ADDRESS~'/~'5'"'/~"~~'g'~'~'/~/''~-- LOCATION OF INSTALLATION
.... LEGAL DESCRIPTION ~;.~ ~/
APPLICATION TO INSTAL~~NK ,SEEPAGE PIT ,DRAIN FIELD ,OTHER
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT/~
DISTANCES:
~- · · . AS DESCRIBED BELOW. SIZE OF .U,~? TO BE SERVED
~~",JK SIZE ~:,:~-5 ~ YPE, SEEPABE AREA
TYPE
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. ~
DATE APPLICANTS SIGNATURE