HomeMy WebLinkAboutMCKINLEY HEIGHTS #1 BLK 4 LT 4
GP-6,TER ANCHORAGE AREA BOROI'"~H
HEALTH DEPARTMENT
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
N°. 116
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
LEGAL DESCRIPTION
DISTANCE FROM WELL -/
LIQUID CAPACITY (: ./; GALLONS.
NUMBER OF
MATERIAL /7*/-/--'.~; ../ COMPARTMENTS
LIQUID
INSIDE LENGTH ~:-- INSIDE WIDTH *- DEPTH
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS // OUTSIDE DIAMETER OR WIDTH , LENGTH ~-~'/ , DEPTH ~
, ,-z ..~ ~ . DISTANCE FROM WELL :: ':~ ~ ~"~:~'~ . BUILDING FOUNDATION - ~ 4.-
NEAREST LOT LINE. · ~ ~: TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA} :* ..:~ SQ. FT.
TILE DRAIN FIELD:
DISTANCE FROM WELt ...... ~-~OM.NDATION , NEAREST LOT LINE
NUMBER OF LINES" DISTANCE BETV~EEN LINES -TR~4CH WIDTH
A BS?~PT'I'O N, / AREA SQ. FT. --L ~,,T H OF EACH .-':LINE~./
D~PTH: TOP OF TILE TO FINISH GRADE -~E)E¢:[~ OF FILTER MATERIAL BENEATH TILE
TOTAL LENGTH
OF LINES.
IN. TOTAL EFFECTIVE
IN. ABOVE TILE__
WELL: :,, )/~-, ~ DISTANCE FROM
TYPE ~:'(:~'(//: ;:~' DEPTH , BUILDING FOUNDATION.
r~: NEAREST SEPTIC SEEPAGE
LOT LINE , SEWER LINE ~'---;., TANK / , SYSTEM
WATER
SAMPLE_
, CESSPOOL
., NEAREST
OTHER
, SOURCES
DIAGRAM OF SYSTEM
HEALTH AUTHORITY
GAAB-HD-2
GREATE
327 Eagle St.
ANCHORAGE AREA
HEALTH DEPARTMENT
Anchorage, Alaska 99501
OROUGH
279-2511
Case N o.//~/'~'
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
NAME OF APPLICANT ~/~'./~ ,~'//- 75'; ~,/:'
RESIDENCE ADDRESS ('z.m, ~/~ z~-~<
LEGAL DESCRIPTION
APPLICATION TO INSTALL: 8EPTICTANK
T0 SERVE THE FOLk0WING FACILITY
FINANCED THROUGH ~--~ ~'
PERCOLATION TEST RESULTS ~ .?
MAILING
~.. .~);'-'..; ,-PHONE NO.
LOCATION OF INSTALLATION//~}: ~r;~/~ /~ ,
SEEPAGE PIT. r~:-~ , DRAIN FIELD ......... , OTHER
ANTICIPATED DATE OF COMPLETION
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
THIS ISTO SERVEAS /';"" .~'::;?:-~:;'C;',~' ~ PERMITTO INSTALLA
AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED
SEPTIC TANK SIZE ~z'?/'z/ TYPE ;~?~:::/~2. SEEPAGE AREA -~
DIAGRAM OF SYSTEM
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
GAAB-}ID-2
GREATEI
327 Eagle St.
ANCHORAGE AREA
HEALTH DEPARTMENT
Anchorage, Alaska 99501
9ROUGH
279-~511
Case No. /J:¢:~
SEWAGE DISPOSAL SYS?EM - APPLICATION & PERMIT
NAME OF APPLICANT ~;:.~'~'~:'i ,/)!;?~Y;~;- ,~/:.. MAILING ADDRESS_~,. ,' ~;~" PHONE
RESIDENCE ADDRESS /?/// '~:;%/?)¥ __ LOCATION OF INSTALLATION/ ....
LEGAL DESCRIPTION~:~/5" '~ ~/~'~',;5~ //7 ~/~)~¢.~,: ,~ ~-' '~' '~'
APPLICATION TO INSTALL: SEPTIC TANK ...... ,SEEPAGE PIT. " ........ ,DRAIN FIELD
TOSERVETHE FOLLOWING FACILITY , / ,.'9:; :, ,~') z:/.-~
FINANCED THROUGR TO BE iNSTALLED BY ..... ~:;<~
PERCOLATION TEST RESULTS
ANTICIPATED DATE OF COMPLETION
BELOW TO BE F~LLED OUT BY HEALTH DEPARTMENT
AS DESCRIBED BELOW. SIZE OF UNITTO BESERVED-
SEPTIC TANK SIZE ~ ...... .TYPE SEEPAGE AREA ~TYPE ....... -
DIAGRAM OF SYSTEM
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.
APPLICANTS SIGNATURE ~_ ,.,~, ~, ~' ,;, ~k /,,