HomeMy WebLinkAboutT13N R3W SEC 22 LT 27
G~ :TLR ANCHORAGE AREA BOROi' /H
DEPARTMENT OF ENVIRONMENTAL 0. UALI/?
3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCATION J'~)~ ~:~- ,.~('~/'ZCs~
SEPTIC TANK:
MAILING
ADDRESS ~-¢ ~*1 '] J~,Nl~/~p PHONE
LEGAL DESCRIPTION~, ~ '~
DISTANCE FROM WELL _~
LIQUID CAPACITY
GALLONS.
MATERIAL_ .~'~,~ / NUMBER OF
COMPARTMENTS ~
.¢~/1~.~-(.')'[~. /~'~r.u~, LIQUID
INSIDE LENGTH INSIDE WIDTH DEPTH
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS / OUTSIDE DIAMETER
LINING MATERIAl ~
NEAREST LOT LINF
OR W~DTH_ ! ~'~
. DISTANCE FROM WELl /(~ /
~ ~) ~' '~ ~ TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)
LENGTH /'~? . DEPTH
, BUILDING FOUNDATION
~ ~'~ SQ. FT.
TILE DRAIN FIELD:
DISIANCE FROM WELL N ., NEAREST LOl LINE
NUMBER OF LINES DISTANCE BETWEEN LI~.~ - ~
ABSORPTION AREA SQ. FT. LENGTH OF EACH LINE
//~1 [ LENGTH
NES
IN. TOTAL EEFECTIVE
DEPTH: TOP OF TILE TO FINISH GRADE
DEPTH OF FILTER MATERIAL BENEATH TILE_
IN. ABOVE fILE.--
WELL:
LOT LINE
TYPE /~/~'/J/~/~ DEPTH l~J~I DISTANCE FROM ,~_~ ! WATER /j/¢~/~., NEAREST
· , . BUILDING FOUNDATION. SAMPLE
, ~ , . NEAREST SEPTIC ~l SEEPAGE , OTHER
'.~ J~ ~/~-~';SEWER LINF '~ , TANK , SYSTEM /~J..9 I . CESSPOOL ~ , SOURCES--
DISTANCES:
DIAGRAM OF SYSTEM
GREATEF ANCHORAGE AREA
x 327 Eagle St. Anchorage Alaska 99501
SEWAGE DISPOSAL SYSTEM - APPLICON & PERMIT ~.~
RESIDENCE ADDRESS ,q~3;e. LOCATION OF INSTALLATION
APPLICAT ON TO INSTALL: SEPTIC TANK~,.SEEP~E PIT ~, DRAIN FIELD , OTHER
FI ANCEO THROUGH ,_)~z / TO BE INST~LEO. B
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT:
THIS IS TO SERVE AS ::~':.'~ ,PERMITTO INSTALL
I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance ~o. 28-68 and that the
ab°ye des.~be~f system ~in acc°rdance with said c°de'¢/z~//~: '- ~ f4d:~'/'~ ~(//~/// h ~)~ O~L ~-/Y~
GRF~ER ANCHORAGE AREA BOROUGH'
DEPAR,IqENT OF EHVIRONMENTAL QUAL;
3500 TUDOR ROAD
ANCHORAGE, ALASKA 99502
CASE #
Performed For George Powell
Legal Description: Lot Block__
This Form Reports Soils~g x
Lot 27 TS13N R3W Sec 22
Date Performed 9/27/71
Subdivision
~ion Test
Depth
Feet Soil Characteristics
· Gray sandy gravel with cobbles
WAs Ground Water Encountered? no
If Yes, At What Depth?
Reading Date
Percolation Rate
Proposed
Depth Of
COMMENTS:
Gross Time Net
Installation:
Inlet
Time Depth to H20
Net Dro
85 square feet of drainage area is required, per bedroom. This gravel may be used
as backfill.
Test Performed By R. ~. C~rlisle Data Cert'i Fi'ed By National Testing Svs. Inc.
Date:
Minute
Seepage Pit x Drain Field
Depth To Bottom Of Pit Or Trench