HomeMy WebLinkAboutT15N R1W SEC 9 LT 70
GAAB-HD- I
G; ~TER ANCHORAGE AREA BORO!
DEPARTMENT OF ENVIRONMENTAL QUALrlY
3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCATION
SEPTIC TANK:
MAILING ~¢.
ADDRESS PHONE.
,LEGAL DESCRIPTION Z'/
DISTANCE FROM WELl ¢7
LIQUID CAPACITY____-/-C7'' ~",)C~
.MATERIAL
GALLONS. INSIDE LENGTH.
NUMBER OF /
COMPARTMENTS
INSIDE WIDTH, DEPTH
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS. // __OUTSIDE DIAMETER
LINING MATERIAL~'(~' ¢~/. ,~¢~'(~./~)' *' '~
NEAREST LOT LINE -~,~-~! ¢ '~* /(~
.... OR WIDTH /~" , LENGTH /~ , DEPTH
__ DISTANCE FROM WELL ///~ ' , BUILDING FOUNDATION
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ~'~: ~-'~C~ SQ. FT.
TILE DRAIN FIELD:
DISTANCE FROM WELL_
NUMBER OF LINES__ __x/
ABSORPTION A~/_
~ .NEAREST LOT LINE
DISTANCE BETWEEN LINES_~"'-~ TRENCH WIDTH
SQ. FT. LENGTH OF EACH LINE~'"'"'"'~
DEPTH: fOP OF TILE TO FINISH GRADE
TOTAL LENGTH
OF LINES
DEPIH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE
WELL: TYP E'~'¢', J J',~ b DEPTH c'~' '~~'
,__ NEAREST SEPTIC
LOT UNE ., SEWER LINE TANK
DISTANCE FROM - ' WATER
,BUILDING FOUNDATION. ~'~'~ _SAMPLE ~OO~,~6 , NEAREST
C~ '~! SEEPAGE //~,~ / ,. OTHER
, SYSTEM , CESSPOOL , SOURCES__
DISTANCES:
DIAGRAM OF SYSTEM
APPROVED
DA, E /fy -//7/
GAAB-HD-2
GREATEI~ ANCHORAGE AREA'
HEALTH DEPARTMENT
327 Ea~le St. Anchorage, Alaska 99501
~ROUGH
279-2511
Case No.
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
R ES,OENCE A D DH ESS _~ ~,~ LO CAT,ON OF,NSTAL'AT'ON ~
LEOALDESCRIPTION ~ 7~' ~ /
APPLICATION TO INSTALL: SEPTIC TANK ~, ,SEEPAG~PIT~,DRAIN FIELD ,OTHER
FINANCED THROUGH TO BE INSTALLED BY
PERCOLATION TEST RESULTS /~¢'~'~' .ANTIOIPATEB BAT 60M"LETION
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
.
THIS IS TO SERVE AS z~,.,~¢ "~"-"' PERMIT TO INSTALL A ~-ir- ~ ~- - :
¢-'~/.¢.~¢.~"~ AS DESCRIBED BELOW, SIZE OF UNIT TO BE SERVED ~.~
': . SEPTIC TANK SIZE /¢'~¢ ~;'~' TYPE/¢?~'~/ SEEPAGE AREA TYPE
DIAGRAM OF SYSTEM
DISTANCES:
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.
APPLICANTS SIGNATURE