HomeMy WebLinkAboutT13N R3W SEC 24 Parcel 1 City Greenhouse
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GP,-~-ATER ANCHORAGE AREA BORO~><~H
" HEALTH DEPARTMENT ]
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
~L.~ j~j~/~ MAILING
SEPTIC TANK:
DISTANCE FROM WELL
L, ID CAPAC,TY
MATERIAl
GALLONS.
,' PHONE
NUMBER OF /
~ ~'~-~/'~'~/b'/ 7'" COMPARTMENTS
INSIDE LENGTH INSIDE WIDTH DEPTH
SEEPAGE SYSTEM:
NUMBER OF PITS
LINING MATERIAL_
NEAREST LOT LINE
SEEPAGE PIT:
OUTSIDE DIAMETER
OR WIDTH , LENGTH ., DEPTH
DISTANCE FROM WELL BUILDING FOUNDATION--
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) SQ. FT.
TILE DRAIN FIELD:
DISTANCE FROM WELl
, FOUNDATION ~-~ ·NEAREST LOT LINE
DISTANCE BETWEEN LINES ~-~//~,/.//IZ TRENCH WIDTH
SQ. FT. LENGTH OF EACH LINE "7-0 /~'-~ ~/
DEPTH OF FILTER MATERIAL BENEATH TILT'
NUMBER OF LINES
ABSORPTION AREA
DEPTH: TOP OF 11LE TO FINISH GRADE
.~'-'0 '/~ j TOTAL LENGTH /',~.c~ /
, OF LINES ,
3 ~:~ '~' IN. TOTAL EFFECTIVE
IN. ABOVE TILE /'~ /!
WELL: ~ Off'
TYPE
LOT LINE ~O
,.~ L L./.~ ~ ~ V~ T ~I~i~E~'~M ~/~' ! WATER
, DEPTH.-- BUILDING FOUNDATION ~'~ SAMPLE
NEAREST /',~ ! SEPTIC /.~....~'":'~ SEEPAGE /, Z
SEWER LINE . TANK . SYSTEM '/Od~'~' ~ C ~SSPOO[
NEAREST
OTHER
SOURCES
DISTANCES:
DIAGRAM OF SYSTEM
DATE
APPROVED / ~ HEALTH AU[HORITY
GREATEk /NCHORAGE AREA )ROUGH
HEALTH DEPARTMENT
327 Eagle St. Anchorage, Alaska 99501 279-2511
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
NAME OF APPLICANT
RESIDENCE ADDRESS
5~- Cb b~'~ MAILING ADDRESS ~_%'~9 ? ~ Zk RONE No,P77-
LOCATION OF INSTALLATION ~)'~ 6of--- ~ ~,.~ IJoot4
LEGAL DESCRIPTION
APPLICATION TO INSTALL: SEPTIC TANK f , SEEPAGE PiT ~ , DRAIN FIELD _,OTHER
TO SERVE THE FOLLOWING FACILITY ~f'~ ~ / T,~
FINANCED THROUGH '~'~ ~ TO BE INSTALLED BY
PERCOLATION TEST RESULTS ~)A , ANTICIPATED DATE OF COMPLETION ~'~".'~
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT ~'Jr'
THIS IS TO SERVE AS //~/~' ~ _(L(~/~ ~ , PERMIT TO INSTALL A
AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED
. SEPTIC TANK SIZE ~ TYPE ~'~" / SEEPAGE AREt
I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordhmnce No. 28-68 and that the
above described system is in accordance with said code.
