HomeMy WebLinkAboutT15N R1W SEC 20 Lot 20 & 22
OAAB-HD I
GP~,ATER ANCHORAGE AREA BORO]~-~H
HEALTH DEPARTMENT
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
MAILING
.-_ . ,~, PHONE-~-~.~
A D D RE S.~¢~,/~ ~ ~.~, C '
DISTANCE FROM WELL /'~'"'~2 / NUMBER OF
. MATERIAL
COMPARTMENTS
~';~--~=~---/~ ~/$~'/-~' ~/ ~) LIQUID
LIQUID CAPACITY /' ,,-') ~ ~3, GALLONS. INSIDE LENGTH INSIDE WIDTH_ DEPTH
SEEPAGE SYSTEM:
NUMBER OF PITS
LINING MATERIAL
NEAREST LOT LINE
SEEPAGE PIt: ,~--/?/~--~//g/
,/~ OUTSIDE DIAMETER OR WIDTH LENGTH ~ , DEPTH
~ ~ ~ ~ DISTANCE FROM WELL
~' TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ~' SQ. FT.
TILE DRAIN FIELD:
DISTANCE FROM ~-~ FOUN D~.~_ -~
~SA ~///~E:: T: NOE: EA C H LiNE
DEPTH: TOP OF TILE TO FINISH GRADE
. ~EAREST LOT LINE
TOTAL LENGTH
IN. TOTAL EFFECTIVE
DEPTH OF FILTER MATER AL BENEATH TILE
IN. ABOVE TILE --
WELL::
LOT LINE
DISTANCES:
TYPE.~/~..~~ DEPTH /~"//~ / DISTANCE FROM : WATER
· , BUILDING FOUNDATION6~2
NEAREST SEPTIC/~/ . / SEEPAGE
SEWER LINE ~' . TANK /' ,,~'~ , SYSTEM./.~/ 001
DIAGRAM OF SYSTEM
, NEAREST
OTHER
SOURCES
DATE
GREATEI_ .ANCHORAGE AREA :'!OROUGH
397 Eagle St. Anchorage, Alaska 99501 279-2511
SEWAGE DISPOSAL SYSTEM - APPLICATION g PERMIT
APPLICATION TO INSTALL: SEPTIC TANK
TO SERVE THE FOLLOWING FACILITY
FINANCED THROUGH ~ Z- ~
NAME OF AP~LI.CANT ~///
RESIDENCE ADDRESS /~o-~ f~
LE6AL DESCR;PT~ON ~ ~ ~ ~-~-
~ , SEEPAGE PIT , DRAIN FIELD
TO BE INSTALLED BY
PERC0~AT~O~ T~ST RESULTS ~ A~T~C~PATE~ ~AT~ 0F C0~P~T~O~
BELOW T0 BE FILLEB 0BT ~Y HEALTH BE~ART~ENT
THIS IS TO SERVE AS
MAILING ADDRESS ~-< ~ ~') ~' '~' PHONE NO.
LOCATION OF INSTALLATION
,OTHER
AS DESCRIBED BELOW. SIZE OF UNIT~:..__~O B~SEI:
.SEPT,CTANKS'ZE TYPE : ' -<A',sEEPAGE ,
DISTANCES:
Health Authority
:y that I am £amfliar w~£h ~h¢ re~u~emcn£s o~ Greater ~nchora~c ^rea ~orou~h O~d~nance No, ~8-~
described system is in ageordance with said code, ~. L ~/
above ~~A~;;~ ~~/~~~
DATE r APPLICANTS SIGNATU RE