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HomeMy WebLinkAboutLAKE RIDGE TERRACE BLK 2 LT 24 C~-'~,L~TER ANCHORAGE AREA BOR( ~H " HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 N? 338 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME LOCATION MAILING ('/~'20 l'~' ADDRESS U~ PHONE LEGAL DESCRIPTION SEPTIC TANK: D,STANCE FROM WELL LIQUID CAPACITY ///~ MATERIAL ~¢~ ..~ ..~.~ NUMBER OF COMPARTMENTS / //~/~'~t,~-~ [~'7O LIQUID GALLONS. INSIDE LENGTH. INSIDE WIDTH DEPTH___ SEEPAGE SYSTEM: SEEPAGE PIT: NEAREST LOT LINE TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) SQ. FT, TILE DRAIN FIELD: DISTANCE FROM WELL NUMBER OF LINES ABSORPTION AREA DEPTH: TOP OF TILE TO FINISH GRADE , FOUNDATION ~ , NEAREST LOT LINE DISTANCE BETWEEN LINES ~7. ~' ' '/~ TRENCH WIDTH SQ. FT. LENGTH OF EACH LINE ~'V t ./~. /~/~ ! A DEPTH OF FILTER MATERIAL BENEATH TILE TOTAL LENGTH /~Z' , OF LINES IN. TOTAL EFFECTIVE IN. ABOVE TILE ff~.~ DISTANCE FROM WATER WELL: TYPE DEPTH , BUILDING FOUNDATION. SAMPLE NEAREST SEPTIC ~ ~ i SEEPAGE ~)C.~! LOT LINE , SEWER LINE , TANK , SYSTEM , CESSPOOL , NEAREST/~-- OTHER , SOURCES DISTANCES: DIAGRAM OF SYSTEM APPROVE ......... C ......... GAAB-I~,~D-2 GREATE~ -'XNCHORAGE AREA .. ')ROUGH Case HEALTH DEPARTMENT ' 327 Eagle St. Anchorage, Alaska 99501 279-2511 ~ '~ ( ) SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT NA~E OF APPLICANT )~/~ MAILING ADDRESS~~ ~/r~'~PHO~E NO. RESIDENCE ADDRESS ~ ~~ LOCATION OF INSTALLATION~/~ ~7~ ~~ LEGAL DESCRIPTION ~ ~¢' ? ~/0 6~;~, . Z~'~ ~ APPLICATION TO INSTALL: SEPTIC TANK ~ , SEEPAGE PIT ,DRAIN FIELD ~' ,OTHER TO SERVE THE FOLLOWING FACILITY ~ ~¢~L ~~ FINANCED THROUGH ~ ,j TO BE INSTALLED BY ~/~/~ ~~XEST ~SULTS /~D~¢AASTIC~ATEn DATE 0F C0~LET~0S ,~/~/~ BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED · SEPTIC TANK SIZE /.I ~:~¢'O TYPFCZ~,,t/'c£z-- ~,¢'~-'SE-EPAGE-AREA L/~/~'~-" DIAGRAM OF SYSTEM HEALTH AUTHORITY OR LICENSED DESIGNER I certify that I am familiar with the requirements of Great~,~-Anchorage Area Borough Ordinance No. 28-68 and that the above described system is in accordance with said code. //}1~7'~' ///~/.If) /~b2t,//~'~,(7- ¢;/L_ '--'~-'/E-~'"F\) ,aTF ~-~?',12~- /'7~ APPLICANTS GN TURE _ - ~'~ .:~_~/-~:-,;'~--- GREATER ANCMORAGE AREA BORO[ .. HEALTH DEPARTMENT 32? EAGLE STREET ANCHORAGE, ALASKA 99501 CASE 0o0 1o0 5,0 7.0 10 .O ~Performed For 5~r. Rodger Sullivan Date Performed June 17, 1,970 Legal Deseripti0n: Lo~' Z;+ ~l'o~'~"~Subdivision Lower Fire-'La~e ..... This Form Reports a: S~nog ~~... '-P~r%ol%tio~ Tes~ Depth Feet Soil CharacterisTics organic Small organic content. CLASS "OL" silty gravel. well graded 3/8~. USCS CLASS "GMd" )arent lens of fine to sandy gravel - in color/USCS "GP" Silty gravel with random fractional rock 2" aver- age maximum diameter. USCS CLASS "GMu" Location Sketch LAKE / I Was Ground Water Encountered? NO If Yes, At What Depth Reading Date Gross Time Net Time }tlnute ' ' Depth To H20 Net D~op P~oposed Instal~SeepaEe Pit Drain Field Depth Of Inlet Depth To Bottom 0~ 'fit Or Trenc~ MM ' 'T~ · · · ' · CO ,EN.o. Entlre area str~ r-~-q~d° Reccgmme_~k% Dlacinz drain field ~~van plans ..... -EH~.3 ue~room Ior OO~ feet s~uareH ~otal ' Date: