HomeMy WebLinkAboutHILLCREST BLK 4 LT 1
GR"'TER ANCHORAGE AREA BOROU'~'H
HEALTH DEPARTMENT
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
N? 169
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
DISTANCE FROM WELL .//~'~- /
LIQUID CAPAC ITY_//~- ~G~-'(-'' GALLONS.
NUMBER OF /
MATERIAL c~; ¥'~/'-/¢~:'-, '-,~-'-.7~~ COMPARTMENTS
~'~/' ~ /~/~ ~'/~6~/~ LIQUID
INSIDE LENGTH ~SIDE WIDTH // DEPTH ____
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS / OUTSIDE DIAMETER
LINING MATERIAL C~-&~(,/~'-~'~-(-'~'~
NEAREST LOT LINE /J~'~ /
OR WIDTH .~..2..~.C- , LENGTH_~-'L~'~,-~''- , DEPTH ../
DISTANCE FROM WELL ./x/~,~ / BUILDING FOUNDATION ~-~/---? /'/~',
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ~"~"~"~ ~'~ SQ. FT.
TILE DRAIN FIELD:
DISTANCE FROM WELL / ,FOUNDATION '"'"~. NEAREST LOT LINE ~?FTIT Li~L ~N GTH
NUMBER OF LINE~____DISTANCE BETWEEN LINES I __TRENCH WIDTH .~'// ~
L
DE~,T~: TOP OF TILE TO FINISH GRADE DEPTH OF FILTE~BENEATE
IN. TOTAL EFFECTIVE
IN. ABOVE TILE
WELL: TYPE ,~'.~'~/g~r:-/_.%'..//' DEPTH /-~-~.,~', / DISTANCE FROM //"A'4~/'~/;('~' WATER
.... BUILDING FOUNDATION, ~/~..~" __SAMPLE_ -,/~"~ ., NEAREST
LOT LINE _J~,:~',~ / NEAREST ,.,,,.,~ SEPTIC / SEEPAGE " ~:/ OTHER .~__.._.~
, SEWER LINE, . TANK /'~':~--~ , SYSTEM__/'/-/~ , CESSPOOL , SOURCES
DISTANCES:
DIAGRAM OF SYSTEM
GAAB-H D-2
GRE.ATEI
327 Eagle St.
ANCHORAGE AREA
ItEALTH DEPARTMENT
Anchorage, Alaska 99501
)ROUGH
279-2511
SEWAGE DISPOSAL SYSTEM - APPLICATION & PEItMI1
NAME OF APPLICANT ~, /~6...~,._.
RESIDENCE ADDRESS
LEGAL DESCRIPTION, -/'~? /
APPLICATION TO INSTALL: SEPTIC TANK ,SEEPAGE PIT /~ ,DRAIN FIFLD ,OTHER
TO SERVE THE FOLLOWING FACILITY ~'/"~;~ .l'~'~/'('"'"r¥ A.';~'"¢.c.~
~ -
FINANCED THROUGH .~'i'/-/, ~Td ~ .AN~FiCiPAT~O.DAf,TO'BEINS~ALLED BY_ ~"'¢("''--
PERCOLATION ~EST RESULT~'~';~M/ OF COMPLETION d~'~
BELOW TO BE FILLED OUT BY HEALTH.DEPARTMENT
THIS IS T0 SERVE AS /~_'A %~.,~¢
AS DESCRIB"~D BELOW,
· SEPTIC TANK SIZE ._//~ ~'
,pERMIT TO INSTALL A -'<'~' '::'":; "~'?~'~":' -~' ~*,~ ,
~z'"';"'~"Y~" SEEPAGE AREA ~
TYPE -
~')~ ~'c ~ DIAGRAM OF SYSTEM
DISTANCES:
/ /.
/ /
I O¢~ti£y that I am £amiliar with the requh'ements of Greater Anchorage Area Borough Ordhmn? N~2~68 and that the
abov. d.scrib.d syst.m is in aocordanc, with said cod..
DATE __' /
: ::;2 ,REATER ANCHORACE AREA p.
BO.,O
- [. ,r, , ;[q HEALTH DEPAP. TMEU? CASE
.~:~' ZL 327 EAGLE STREET
Legal Description: Lot / BlocK~ Smmlv~s:.on ~f/~f,~,a ~-? --
Th~s Form Reports a: So~ls Log ......... /~ ........... 2~,2,~ercolat~on Tesz
Depth V~ l~l; 6~ {
Feet Soil Characteristics Location Sketch
/
I
~ Iff
Readi~'~ ~
....... · ' -~ I ~oss ,'~me Net Time Depth To H20
Z::ii'.:.:.:i:::: :f::2'.'.:'.T:::::.i:'.'~ ........... : ................................ ~ ......................................
FY'C;.'>:: Cd '::~: ~ 6 ~.~['U~.':':{~]"[''' S,~¢,}>~t?e Pit'
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