HomeMy WebLinkAboutT15N R1W SEC 9 LT 111
GR~:ATER ANCHORAGE AREA BOROI'E~H
HEALTH DEPARTMENT
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
DISTANCE EROM WELL
LIQUID CAPACITY 6
ADDRESS
LEGAL DESCRIPTION~Z" .... .._¥. k,....... ....,.b'"~-~-''~/'
.////.-.= NUMBER OF
MATERIAL ... COMPARTMENTS /
GALLONS. INSIDE LENGTH. iNSIDE WIDTH. ~ DEPTH
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS J/ OUTSIDE DIAMETER_
NEARES1 LOT LINE ~-'~
OR WIDTH
. DISTANCE FROM WELL ~'"~'~
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)
f /
,LENGTH /1~ ,DEPTH
BUILDING FOUNDATION
SQ.
TILE DRAIN FIELD:
NUMBER C~ LINES.// DISTANCE BETWEEN LINES TRENCH WIDTH IN. TOTAL EFFECTIVE
ABSORPTION AREA SQ. FT. LENGTH OF EACH LINE
DEPTH: TOP OF TILE TO FINISH GRADE
DEPTH OF FILTER MATERIAL BENEATH TILE
IN. ABOVE TILE
(~'~.j~ DISTANCE FROM ~ t WATER ~.., NEAREST
WELL: TYPE /'(..~.~?'-~) , DEPTH , BUILDING FOUNDATION. SAMPLE ,
f NEAREST SEPTIC ~'""(j~ /' SEEPAGE ~ ! OTHER
LOT LINE ~ '~ , SEWER LINE /.'/ , TANK . SYSTEM , CESSPOOl -- , SOURCES
DISTANCES:
DIAGRAM OF SYSTEM
OROUGH No.
GREATET ANCHORAGE AREA
HEALTH DEPARTMENT
327 Eagle St. Anchorage, Alaska 99501 279-2511
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
RESIDENCE ADDRESS
LEGAL DESCRIPTION
APPLICATION TO INSTALL: SEPTIC TANK ~' ,SEEPAGE PIT ~ ,DRAIN FIELD.
TO SERVE THE FOLLOWING FACILITY
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
MAILING ADDRESS ~"~¢~
LOCATION OF INSTALLATION (/Z~/.~
,OTHER
THIS IS TO SERVE AS //'~ ~/2~4154'¢' , PERMIT TO INSTALL A
AS DESCRIBED BELOW. SIZE OF UNIT TO RE SERVED
· SEPTIC TANK SIZE [~ ·TYPE ~"¢?~c~( SEEPAGE AREA TYPE
DIAGRAM OF SYSTEM
DISTANCES:
ify 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.