HomeMy WebLinkAboutT15N R1W SEC 17 LT 10 E2
GAASHDI
GR~:~TER ANCHORAGE AREA BOROUGH
HEALTH DEPARTMENT
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME_ ~'~'~-~'/"~,.,~
LOCAT,ON
SEPTIC TANK:
DISTANCE FROM WEU
LIQUID CAPACITY
(~0 '
'"~ ~-O GALLONS.
MATERIAL ~.~-l.~--~.~_. NUMBER OF
COMPARTMENTS J/
~-/-~'~-~ ~' ~ ~' ~! LIQUID
INSIDE LENGTH INSIDE WIDTH DEPTH
SEEPAGE SYSTEM: SEEPAGE PIT:
/Z; /Z' , DEPTH ~"
NUMBER OF PITS_ / OUTSIDE DIAMETER OR WIDTH. , LENGTH
LINING MATERIAl ~_~r.~ DISTANCE FROM WELL_ /~C;' ~ ~)~' ~'
, BUILDING FOUNDATION ,
NEAREST LOT LINE //_///..gl TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ~ ¢L'~) ~'~' SQ. FT.
TiLE DRAIN FIELD:
TOTAL LENGTH
,FOUNDATIO , NEAREST LOT ,OF LINES ,
DISTANC H~O S TH AL EFFECTIVE
ABSORPTION ~ G
DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE iN. ABOVE TILE
b.~.~ ~.~ DISTANCE FROM WATER
WELL: TYPE 'J~ DEPTH ,BUILDING FOUNDATION. SAMPLE , NEAREST
NEAREST SEPTIC SEEPAGE OTHER
LOT LINE , SEWER LINE , TANK , SYSTEM , CESSPOOL , SOURCES__
DISTANCES:
DATE
DIAGRAM OF SYSTEM
APPROVv~~'/~z~l
Iq EALTH AUTHORITY
GAAB-HD-2
OROUGH No.
GREATEI ANCHORAGE AREA
HEALTH DEPARTMENT
327 Eagle St. Anchorage, Alaska 99501 279-2511
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
NAME OF APPL
RESIDENCE ADDRESS
LEGAL DESCRIPTION
APPLICATION TO INSTALL: SEPTIC TANK
MAILINO ADDRESS~1~'~
LOCATION OF INSTALLATION
~ ., SEEPAGE PIT ~ .,DRAIN FIELD
TO SERVE THE FOLLOWING FACILITY
FINANCED THROUGH.
PERCOLATION TEST RESULTS
TO BE INSTALLED BY
ANTICIPATED DATE OF COMPLETION
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
,OTHER
THIS IS TO SERVE AS , PERMIT TO INSTALL A
AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED
_, SEPTIC TANK SIZE. .TYPE SEEPAGE AREA
DIAGRAM OF SYSTEM
TYPE
DISTANCES:
Health Authority
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
GREATER ANCHORAGE AREA BOROUG~
HEALTH DEPARTMENT
327'EAGLE STREET
A~CHORAGE~ ALASKA 99501
CASE
Performed For Hamman Const. Co. Date Performed 7-28-70
·" .... i6
Legal Description: Lot Bloc'
...... .percolatio-~t ~-'
This Form Reports a: S~Log_~._.___~~ ----.-- ......
Depth
Feet
Soll Characteristics
2.5
3.?
9.0
~ll$1~Content Apparent fill
-~L~lllover original ground.
_~l~lRandom rock to 6" diamete2._~
ii lTiiUSCS
.I!I:IIL~. ~rn. ~±t. ~ome OrE ....
con~en~s, rts. e~c. uses
.L[[7$ily Sandy Gravel ·well
l~[~graded below 2" skip gra-
o e= 2" . n.om
_J:.[~J,~l][~o 6" diameter Sand 'c~n-
-~;~j~en~ increases wi~h dep~h~
~{~HSCS class G~d-~P
Was Ground Water Encountered? : No ~ z%~1-
t
If Yes, At What Depth ....
Reading
Date
Gross Time
Net Time
Location Sketch
Net Drop
·
COM~EN.'.,'$: One" .b'edr-oom house, pr_~recom_~m%n_d
Test Performed B):~ ENGINEERING SERVICES
Depth To H20
[)rain F~eld
ereola~lOn fat
Proposed Instal~geepage ~ ~, X
Depth Of Inlet Depth To B-----'--'~t'-tom Of Pit Or Trench
0 0
0 0
0 0 0 0
0 0 0 0 0 0
