HomeMy WebLinkAboutSPERSTAD #2 BLK 4 LT 207Z
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GAAB-HD-2
GREATEI
327 Eagle St.
'.NCHORAGE AREA
HEALTIt DEPARTMENT
Anchorage, Alaska 99501
SEWAGE DISPOSAL
279-2511
SY$¥F_M - APPLICA¥1ON & PERMIT
RESIDENCE ADDRESS
APPLICATION TO INSTALL: SEPTIC TANK ~ ., SEEPAGE PIT ~ ,DRAIN FIELD
TO SERVE THE FOLLOWING FACILITY
MAILING ADDRESS ~,/"-/'2~-' ,.,~t~ . PHON~NO
LDCAT'ON OF 'NSTALLAT'DN~/~ ~'~"~'
,OTHER.
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
THIS IS TO SERVE AS //5 ~.~'4///~'d~A ~ ~~
, PERMIT TO INSTALL A -~¢,¢g'"~' ¢ ~ ~ ,.
AS DESCRIBED BELOW. SIZE OF UNITTO RESERVED.. '~ ~~e~._
., SEPTIC TANK SIZE "7~> TYPE ~ SEEPAGE AREA ~L/~ ' '
~-~ DIAGRAM OF SYSTEM
DISTANCES:
I certify that I am familiar with the l'equh'ements of Greater Anchorage Area Borotmh Ord/~naime NO; _'~a~d that the
above described system is in accordance with said code. ~//~?~] ]//Ft4~,}~;~(~/'2>~///~·
//
G~'"ATER ANCHORAGE AREA BORO' '~H
HEALTH DEPARTMENT
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
N°. 124
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME ,~-'~::~,,~.'~'~:'-'
LOCATION ,~,/.,~-~
SEPTIC TANK:
MAILING
ADDRESS
LEGAL DESCRIPTION .,,~-g~'~-~o ~/'~. ,~, -J'~--~" ,-7'~~.''~~
~UID CAPACITY ,/~ (-~ GALLONS.
NUMBER OF ~
MATERIAL ,, f~'-'~ COMPARTMENTS
~LIQUID
INSIDE LENGTH '~"~INSIDE WIDTH - DEPTH
SEEPAGE SYSTEM:
SEEPAGE PIT:
OUTSIDE DIAMETER
/ w ./,
~-/ OR WIDTH /-z.~
NUMBER OF PITS , LENGTH /¢'"~ /, DEPTH
LINING MATERIAL DIS[ANCE F~OM WELL /dW ~W~/~ . BUILDING FOUNDATION~
NEAREST LOT LINE ~ ~ ~ ~
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) sq. FT.
TILE DRAIN FIELD:
~ ~ IOTAL LENGTH
WELL: TYPE ~~ DEPTH ~ DISTANCE FROM ~ ~WATER L~ ~-~, NEAREST
, BUILDING FOUNDATION. SAMPLE
NEAREST ~EPTIC ~ ~ .... SEEPAGE ~ ~ OTHER
LOT LINE / , SEWER LINE ~ .,TANK ~ , SYSTEM. , CESSPOOL , SOURCES
DISTANCES:
DIAGRAM OF SYSTEM
App ROVED. '.~.~ ~'~~
HEAL[H AUTHORITY