HomeMy WebLinkAboutRAYMOND TEDROW BLK 4 LT 24
GP"~,TER ANCHORAGE AREA BOROI'GH
HEAl. TH DEPARTMENT
327 EAGLE ST. ANCItORAGE, ALASKA 99501 279-2511
-' INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
DISTANCE FROM WELL_
LIQUID CAPACITY [ E)-Z.,?~2
GALLONS.
MATERIAL
INSIDE LENGTH
NUMBER OF
COMPARTMENTS
~c-~ ~/5 7 '~'? LIQUID
INSIDE WIDTH DEPTH
SEEPAGE SYSTEM:
NUMBER OF PITS
LINING MATERIAl
NEAREST LOT LINE
SEEPAGE PIT:
OUTSIDE! DIAMEIER
OR W,DTH /'¢'
DISTANCE FROM WELL
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREAJ
BUILDING FOUNDATION.
/"/~" Y SQ. FT.
TILE-- DRAIN FIELD:
DISTANCE FROM WELL
NUMBER OF LINES__
ABSORPTION AREA
TOTAL LENGTH
/ ,/./'"~ FOUNDATION. . NEAREST LOT LINE OF LINES
SQL F~bgh~GTH OF EACH L E'~,,LE~. ./' ,/
DEPTH: TOP OF TiLE TO FINISH GRADE
DEPTH OF FILTER MATERIAL BENEATH TILE
IN. ABOVE TILE
WELL:
LOT LINE
TYPE
DEPTH
NEAREST
SEWER LINE
SEPTIC
, TANK.
DISTANCE FROM
, BUILDING FOUNDATION.
SEEPAGE
, SYSTEM
WATER
SAMPLE
. CESSPOOL
., NEARES~
OTHER
, SOURCES
DISTANCES:
DATE
APPROVED
G A A B -H D - 2
GRE.ATE[
327 Eagle St.
ANCHORAGE AREA
ItEALTH DEPARTMENT
Anchorage, Alaska 99501
9ROUGH
279-2511
cas,
SI:iWAGE DISPOSAL SYSTEM - APPLICATION & PEI1MIT
LOCATION OF INSTALLATION AD'} ~, '{... ?Ts ,,~-./'/'~4'"~
APPLICATION TO INSTALL: SEPTIC TANK ,~/ ,SEEPAGE PIT ,,~ ,DRAIN FIFLD. ,OTHER.
TO SERVE THE FOLLOW~NG FACILITY ~ .~,--L_.,~ .: /'~---~
FINANCED THROUGH TO BE INSTALLED BY '__"~--~5'~
PERCOLATION TEST RESULTS ANTICIPATED DATE OF COMPLEIqON
BI:LOW TO BE FILLED OUT BY HEALTH DEPARTMENT
AS /.~-, ',-~., PERMTTO NSTALLA
THIS ISTOSERVE /- .y ' ./ ,
AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED
- 6%,/K~5
Health Authority
I certify that I am familiar with the requkements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the
above described system is in accordance with said code,
GAAB-IID-2
GREATEr_ ANCHORAGE AREA _.OROUGH
HEALTH DEPARTMENT :~"
327 Eagle St. Anchorag% Ala~ka~ 99501 //~ 279-2511 ~. ,~...-~
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
RESIDENCE ADDRESS :~/~ '.~' ~ LOCATION OF INSTALLATION /~f/a~
LEGAL DESCRIPTION
APPLICATION TO INSTALL: SEPTIC TANK ~ ........ , SEEPAGE PIT. Z ..... ,DRAIN FIELD
TO SERVE THE FOLLOWING FACILITY -~) '~ ~'~'~/ ~ ~-)~,-- ~
FINANCED THROUGH :~' ~ TO BE INSTALLED BY ~
PERCOLATION TEST RESULTS ANTICIPATED DATEOF COMPLETION /~ z'")
BFLOW TO BE FILLED OUT BY HEALTH DEPARTMENT
THIS IS TO SERVE AS -//~ , ~--/~f_~ _, PERMIT TO INSTALL A J~'~'~J/'~'-'~ ~"X5-¢'~'~'~"~
AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED ')~
.,~.SEPTICTANKSIZE~/6°~C~ TYPE SEEPA[ AREA ~'PE
OF SYSTEM
! certify that I am £am~]Jm' w~th tl~¢ ~¢qub'¢me~ts o£ ~¢at¢~ Anchorage ^rca Borough,Ordinance No. ~S-~S a~d that the
above described system is in accordance with said code. (.201 '7'0
DATE APPLICANTS SIGNATURE
GREATER ANCNORAGE AREA BOROUGH
HEALTH DEPARTMENT
827 EAGLE STREET
ANCHORAGE~ ALASKA 99501
,.' Date Performed ~ .
Le~a] Descz, ipti6h: Lot .~ Block o~on }~/,,~ , .... ~ To ~ .... ~
This Fc~m Reports a: s~nog , / '~~{
DepZh
i'ee~ Soil Characteristics
Was Ground Water Encountered?~_~fffa
Ii: Yes, At 9hat Depth
Date
Gross 'rime
Reading
Location Sketch
Net Time _~D~.pth To H20
Proposed Instal'i-~To-~: Seepa e
· . · g Pit ~ Drain Field
Depth Of Inlet
COMMENTS. -~/ ~ , . ~ , ttom Of P~t OP !~ench ~ ,'
Test' Perforr0ed By:.~f0~
Net Dz, op
1. Approval requested by:
Mailing Address:
2. Property Owner:
Mailing Address:
3. kegal Description:
4. Location: Echo Street
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 274-4561
Date Received .~/12/75
Time of Inspection
Date of Inspection
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
Selective Realty
Charles Keeling
Phone:
Phone:
Lot 24, Block 4, Tedrow Subdivision
5. Type of facility to be inspected
6. Well Data: C~IUNITY
A. Type
C. Construction
7. Sewage Disposal System:
A. Installed 1970
C. Septic Tank: 1.
D. Seepage Pit:
E. Disposal Field:
8. Distances:
A. Well to: Septic tank
Nearest lot line
B. Foundation to septic tank
Single
No. of bedrooms 3
B. Depth
D. Bacterial Analysis
B. Installer
Size lO00gals 2. Manufacturer
1. Absorption Area 464 sq/£t. 2.
Total length of lines
, Absorption area
, Other contamination
, Absorption area
C. Absorption area to nearest lot 'line
Steel Fab.
Material
_, Sewer Lines
1S'
EQ-034 (1/74) Page 1 of two pages
P~§e 2 of two pages - R~' ~.st for Approval of Individual ler & Water Facilities
Legal Description Lot 24~, .Block 4, llaymand Tedrow Subdivision.
Comments
Approve~ ~, ~ /~, ~' Disapproved Date 3/17/75
Approval Valid for one year from date signed
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
certify that the information contained in this request for approval to be a true and
accurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED
Date
EQ-034 (1/74)