HomeMy WebLinkAboutSPENARD HEIGHTS TR 24AYf
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GAAB-HD. I
Gpr:-&TER ANCHORAGE AREA BOROU"~H
HEALTH DEPARTMENT
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCATION
SEPTIC TANK:
NUMBER OF
DISTANCE FROM WELL_~-~.,'.-'.~,/,4~, ,/-~? ~,.'~ MATERIAL O~';.,"V'~,,,~-C~:~.~?'- COMPARTMENTS
LIQUID CAPACITY /xO ~-) a) GALLONS. INSIDE LENGTH. INSIDE WIDTH
LIQUID
DEPTH ____
SEEPAGE SYSTEM:
NUMBER OF PITS
LINING MATERIAL__
NEAREST LOT LINE
SEEPAGE PIT:
OUTSIDE DIAMETER
'~ '- OR WIDTH , LENGTH , DEPTH
, DISTANCE FROM WELL OOj~:~j:,)?, /~:_? ~'0. BUILDING FOUNDATION
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)
TILE DRAIN FIELD:
DISTANCE FROM WELL FOUNDATION , NEAREST LOT LINE
NUMBER OF LINES /'"~"/'"~DIST~q C E BETWEEN/ / /,LIN E~.,.~*'-~ TRE CH~WIDT
ABSORPTION ARE>/ ~(~.~ 'LENGTH OF EACH LINE
DEPTH: TOp OF TILE TO FINISH GRADE
DEPTH OF FILTER MATERIAL BENEATH TILE
TOTAL LENGTH
OF LINES
IN. TOTAL EFFECTIVE
_IN. ABOVE TILE
WELL: c'~. ,.*;? ,~f-- DISTANCE FROM WATER
TYPE r'/-.$~'~/)?/'/D~' ,/~-/~, ,~'" DEPTH. ~ BUILDING FOUNDATION. ~" -- SAMPLE ../'~/C~ , NEAREST
.~...-,-~- NEAREST ~ SEPTIC ~,, SEEPAGE OTHER
LOT LINE ~ SEWER LINE .TANK , SYSTEM " ~ CESSPOOl -- ~ , SOURCES__
DIAGRAM OF SYSTEM
DISTANCES:
HEALTH AUTHORITY
GREATE~ ANCHORAGE AREA OROUGH Case
HEALTH DEPARTMENT
327 Eagle St. Anchorage, Alaska 99501 279-2511
SEWAGE/',~DISPOSAL SYS.~EM - APPLICATION & PERMIT
NAME OF APPLICANT ,//~.-~/v,:z~ ~_~-~2_z,._~:-t~ MAILING ADDRESS ,,,~fz/,~.
RESIDENCE ADDRESS O~.~'/~- C'~',~.~.~.,.~ ~ LOCATION 0F INSTALLATION ~
LEGAL DESCRIPTION '~A(:'Y ~ ~
APPLICATION TO INSTALL: SEPTIC TANK
TO SERVE THE FOLLOWING FACILITY
FINANCED THROUGH
SEEPAGE PIT '~-~
, DRAIN FIELD
TO BE INSTALLED BY
//~
, OTHER
PERCOLATION TEST RESULTS
ANTICIPATED DATE OF COMPLETION (~ ~- "~: ~r'~'k~ J-~)'/.(,. '~?_
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
THIS IS TO SERVE AS ____~_~V~.~ ~ . ~.~. Z'/~]--)j~_ ,~E R M IT TO I NSTA L L A .~.t~,"~'~ ~~~,.
AS DESCRIBED BELOW, SIZE OF UNIT TO BE SERVED "~ 1~~~
_. SEPTIC TANK SIZE ~ TYPE ~~ SEEPAGE AREA_ ~TYPE ~v~.~.~-
DIAGRA~ OF ~Y~TE~
DISTANCES:
. ,~'30 CoL.~o%
that I am familiar with the requil'cmel~ts of Greater Anchorage Area B?}jough O~/dinaiic¢ No.22x%6- ._8 ~lnd,that t, he
~bo~e de.or,be. ~s~e.~ ~s ~n aooord=~ w~t,~ ~aid oo.e..~' *~:d ;~/~4~
~REATER ANCHORAGE AREA BOROUGH
ItEALTH DEPARTMENT
327 EAGLE STREET
ANCHORAGE, AI, ASKA 99501
CASE #
Performed For 79~r ~/~'/~-~r Date Performed
Legal Descr~ptxon: Lot Block . ~ubd~w. sxon/~z/,R~/ ,¢.,~L
This Form Reports a: So~ls Log~.~ · -.. ercoia~lon'Tes~
Depth
Feet
3---
Soll Characteristics
Was Ground Wa~er Encountered?_..2~
If Yes, A~ What Depth ...................
Reading
Date
Proposed nstallat~on: Seepage Pit
Gross Time
Net Time
Location Sketch
Depth To H20
Drain Field
Net Drop
Depth 0£ Inlet '-._~,~.~.~Dep~~Om O~f'~pi
Test: Performed B
Data Certified By:~~~~
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