HomeMy WebLinkAboutT13N R3W SEC 19 LT 5 PTN MULCAHY PARK
ANCHORAGE AREA BORq'~"~3H
Anchorage, Alaska 99507
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME L(?~'~
LOCATION
MAILING ADDRESS ~ ~ ~/~/'~/)4~']"2 ~./-~(~'PHONE ,2' 7.-=2 .~c/~
LEGAL DESCmPT~ON (?//~'~:~- ~'~ ~0~ ~Om~/~
~DEI~FFC-TA N K:
DISTANCE
FROM WELl
INSIDE LENGTH
NUMBER OF
MANUFACTURER ~/~e~/~AZ (}0 · MATERIAL ~Z~ /~-~- COMPARTMENTS
INSIDE WIDTH
LIQUID DEPTH
LIQUID CAPACITY 1'.~0 GALLONS.
SEEPAGE PIT:
NUMBER OF PITS -- DIAMETER _ OR WIDTH LENGTH DEPTH
LINING MATERIAL CRIB SIZE: ~~PTH
DISTANCE
FROM:
WELL
/ TOTAL EFFECTIVE
BUILDING FOUNDATION ,/NE'~REST LOT LINE ABSORPTION AREA (WALL AREA)
ADD ITl O~.D$~R~
SQ. FT.
WELL:
TYPE CONSTRUCTION
BUILDING NEAREST
FOUNDATION __ LOT LINE
CESSPOOL OTHER SOURCES
APPROVED DISAPPROVED
NEAREST
SEWER LINE
REMARKS
DEPTH DISTANCE FROM:
SEPTIC SEEPAGE
TANK __ SYSTEM
DISTANCES:
INSTALLED BY:
PIPE MATERIAL:
LOT SLOPE:
REMARKS:
DIAGRAM OF SYSTEM
Form PW-026
DATE ~J~' '~. [~TZ
APPROVED
G.A.A.B.
GREATER ANCHORAGE AREA BOROUGH
SEWAGE DISPOSAL SYSTEM APPLICATION AND P~EltMIT/C//~IJ,'(:
-- d,~ ~ .f x.l ~, ~ "', .
SOIL TEST RESUbT~ '-' NOTE: THIS PERMIT I$ NOT VALID WITHOUT ~IL
pF~fT VAI T~ ~NF YFAR
FINAL INSPECTION~ 24 HOUR NOTI~ REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY
HEALTH DEPARTMENT AUTHORI~ WILL BE SUBJECT TO PROSECUTION.
5 f~.
FOUNDATION TO SEEPAGE PIT 20 ltl DRAIN FIELD 10
SEPTIC TANK. 25 ft. SEEPAGE P'T 100 f%'.. DRAm r,ELO 50 ft* .
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
TYPE
DIAGRAM OF SYSTEM
CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE /~REA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE