HomeMy WebLinkAboutMCCAUGHEY BLK 2 LT 6 STELLA PLACE TOWNHOMES
GAAB-HD-I
G~TER ANCHORAGE AREA BOROUGH ~
HEALTH DEPARTMENT
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
,.-.Z 2,,.,2. --
MAILING
ADDRESS ,,~"'0,~ ~.,.~ Y~"~/"7"-..,~'~ PHONE--'.'.~,~,~
LEGAL DESCRIPTION "'/-"~""~¢' ~.~
DISTANCE FROM WELl.
LIQUID CAPACITY
NUMBER OF
~/~4~--T~AT E RI A L ~'~/-~/f~:-~"-~----~"- COMPARTMENTS
GALLONS. INSIDE LENGTH .INSIDE WIDTH
LIQUID
DEPTH__
SEEPAGE SYSTEM:
NUMBER OF PITS
LINING MATERIAL
NEAREST LOT _INE
SEEPAGE PIT:
~.,/~_. /"~ / LENGTH // / /
, , DEPTH ,~
OUTSIDE
DIAMETER.
OR
WIDTH
~/~--~'" .J~/~'...~' . DISTANCE FROM WEL~f -~,,~"~"~:~ BUILDING FOUNDATION~~'~ ~
~,~:~ J ~ TOTAL EFFECTIVE ABSORPTION AREA rWALL AREA "~"~?~ SQ. FT.
TILE DRAIN FIELD:
TOTAL LENGTH
DISTANCE FROM WELL _.~---- ~ , FOUNDATION _,....r,~4EA~REST LOT LINE ~_,.~.OF LINES ,
ABS~,~'1ON AREA '~.SO ~ LENGTH OF EACH LINE
DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE N. ABOVE TI_E
WELL: ,,x.~,~'~...,~-.,~/~'/'~,-/~,,/-" ,~'~.,~.~//----~.~) DISTANC~ FROM WATER
TYPE DEPTH ~ ., BUILDING FOUNDATION. . SAMPLE_ , NEAREST
NEAREST SEPTIC SEEPAGE OTHER
LOT LINE , SEWER LINE ~ .TANK SYSTEM . CESSPOOL SOURCES
DISTANCES:
DIAGRAM OF SYSTEM
GAA-B-HD-2
GREATEI ' NCHORAGE AREAF ROUGH
HEALTH DEPARTMENT
327 Eagle St. Anchorage, Alaska 99501 279-2511
Case No. ~ '7 '~
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
NAME OF APPLICANT~ '~? ~/~
RESIDENCE ADDRESS
LEGAL DESCRIPTION
APPLICATION TO INSTALL: SEPTIC TANK
TO SERVE THE FOLLOWING FACILITY '"~'~'
FINANCED THROUGH ~
PERCOLATION TEST RESULTS
MAILING ADDRESS~b~ gM ~-~ PHONE NO.
LOCATION OF NSTALLATION
SEEPAGE PIT ~ ,DRAIN FIELD ,OTHER
TO BE INSTALLED BY
ANTICIPATED DATE OFCOMPLETION
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
THIS IS TO SERVE AS /'~'~ , PERMIT TO INSTALL A ~-,4 ~
AS DESCRIBED BELOW. SIZE OF UNITcTO BE SERVED °'~,~',~ , '~'~-~.,,t 1~,~.~
· SEPTIC TANK SIZE /0'~ .TYPE SEEPAGE AREA,/~~ TYPE ~/'~/'~
/~[~.~.~ DIAGRAM OF SYSTEM
DISTANCES:
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. _. . !,/~ ~../ ~- .,. -/...../-.- /--
DAT,~ '['~ 7 /¢7~ APPLICANTS SIGNATUREh /~_~_~ Z- ,,/'/~-'zc"-~lL~ ::..j'.
~REATER ANCHORAGE AREA BOROU~H.~
HEALTH DEPARTMEN.T
327 EAGLE STREET
ANCHORAGE, ALASKA 99501
CASE
mr' d For 7om ~ D,! " Date Performed
Legal Descrzptlon: Lot~lock
This Form Reports a: Sozls
Soil Characteristics
Depth
Feet
Was Ground Water Encountered? /~/9 =.
If Yes, At What Depth ~.
Location Sketch
Reading Date Gross Time Net T~me DePth To H20 Net Drop
ercolalioB l"i "[ ' 'J ~,J, ~'~ ~
Proposed InstalI'atib~n~.~ Seepage Pit. , /~.~ Drain Field
Depth Of Inlet ~ ' Depth To Bottom Of Pit Or TrenchI i]/r .....
co~E~s: ~L ~ o '/ '~'~s-.i ./Z,,,,.,~, ..........
Test
Performed
B.
Date:
GREATER ANCHORAGE AREA BOROUGH c ~", ~ ~
~/~rC ~t~
INITIATED BY: J,S// DATE OF MEMO:
/~") ,r -- DATE ANSWER
TO: DEPARTMENT: ~ ~, ~.~-~...~ ..... REQUESTED
REQUESTED ACTION SCHEDULE
i,'~'~)~'i~A:rl0N 6NLY ~ PREPARE BACK-UP INFORMATION
~'FOR IMMEDIATE ACTION ~ CALL ME BEFORE YOU ANSWER
FOR YOUR CONSIDERATION f~'~ NEED YOUR RECOMMENDATION
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