HomeMy WebLinkAboutSOUTHWOOD PARK #1 BLK 5 LT 433
GAAB-HD I
GREATER ANCHORAGE AREA BOROUGH
~.~ HEALTH DEPARTMENT ~
327 EAGLE ST. ANCHORAGE, ALASKA 99501 '~'~)-2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCATION
SEPTIC TANK:
DISTANCE FROM WELL
MAILING
GALLONS. INSIDE LENGTH
NUMBER OF /
COMPARTMENTS
LIQUID
INSIDE WIDTH DEPTH
SEEPAGE SYSTEM:
NUMBER OF PITS_
LINING MATERIAL
NEAREST LOT LINF
SEEPAGE PIT:
OUTSIDE DIAMETER OR WIDEH
dem£ 7- FROM WELL --'--
3 / TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)
/'Z/,LENGT. /Z/
, DEPTH
TILE DRAIN FIELD:
DISTANCE FROM WELL
NUMBER OF LINES.
ABSORPTION AREA
FOUNDATION NEAREST LOT LINE
DISTANCE BETWEEN LINES .TRENCH WIDTH
SQ. FT. LENGTH OF EACH LINE
DEPTH: TOP OF TILE TO FINISH GRADE
TOTAL LENGTH
, OF LINES
IN. TOTAL EFFECTIVE
DEPTH OF FILTER MATERIAL BENEATH TILE
IN. ABOVE TILE__
~,/~ ~ DISTANCE FROM WATER
WELL: TYPE DEPTH , BU LDING FOUNDATION. . SAMPLE NEAREST
NEAREST SEPTIC SEEPAGE OTHER
TANK SYSTEM , CESSPOOL SOURCES
LOT LINE · , or_vvE~ L.'-- ,, .....
DIAGRAM OF SYSTEM
APPROVED "~~/' ~' HEALTH ALItHORHY
GAAB-HD-2
GREATEK ANCHORAGE AREA )ROUGH
HEALTH DEPARTMENT
327 Eagle St. Anchorage, Alaska 99501 279-2511
Case No. ~ :~ ~,
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
RESIDENCE ADDRESS LEGAL DESCRIPTION ~~ ~-'-'
APPLICATION TO INSTALL: SEPTIC TANK ~'¢~, SEEPAGE PIT J , DRAIN FIELD. , OTHER
TO SERVE THE FOLLOWING FACILITY_ ~'~
FINANCED THROUGH TO BE INSTALLED BY
PERCOLATION TEST RESULTS c~H ANTICIPATED DATE OF COMPLETION
/
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
THIS IS T0 SERVE AS ~/c: ~~ PERMIT T0 INSTALL A
DISTANCES:
AS DESCRIBED BELOW, SIZE OF UNIT TO BE SERVED
SEPTIC TANK SIZE "~ _TYPE ~--~)_SEEPAGE AREA
" DIAGRAM OF SYSTEM
//7
Ith 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.