HomeMy WebLinkAboutT15N R1W SEC 9 LT 32B
GF-'~TER ANCHORAGE AREA BOROUGH
HEALTH DEPARTMENT
327 EAGLE ST. ANCHORAGE., ALASKA 99501 279-2511
N? 791
iNSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
LEGAL DESCRIPTION
DISTANCE FROM WELL
LIQUID CAPACITY
GALLONS.
NUMBER OF
MATERIAL .~"~/1=~ COMPARTMENTS
INSIDE LENGTH INSIDE WIDTH
LIQUID
DEPTH____
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS / OUTSIDE DIAMETER'~ OR WIDTH
NEAREST LOT LINE TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)
, LENGTH. /~H
~.UJL~)J~ G FOUNDATION--
SQ. FT.
TILE DRAIN FIELD:
DISTANCE FROM WELl
NUMBER OF LINES~'/~
ABSORPTION AREA
DEPTH: TOP OF TILE TO FINISH GRADE
POUNDATION 77'
, , NEAREST LOT LINE ~' ,~' , OF LINES /~7
//'
SQ. FT. LENGTH OF EACH LINE ~)_, ~/ ~
DEPTH OF FILTER MATERIAL BENEATH TILE
IN. ABOVE TILE
WELL: Typ E ,~Z~//,~:~) DEPTH.
LOT LINE 7~ //~' ~:~ NEAREST ~
, SEWER LINE
· . D~STANCE FROM
, BUILDING FOUNDATION.
SEPTIC ' SEEPAGE ~
TANK -~--~:) , SYSTEM
WATER
SAMPLE //]~.,t~?~i~: , NEAREST
OTHER
, CESSPOOL , SOURCES
DISTANCES:
DIAGRAM OF SYSTEM
DATE
De?th
~as Ground Water
Xf Yes, A't
ReadlI~g
GREATER ANCHORAGE AREA BOI~oUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3500 TUDOR ROAD POUCH §*6§0
ANCHORAge, ALASKA 99502
TELEPHONE 279.8686
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
PERMIT
NAME
NSTALLATION LOCATION
LEGAL DESC~PT[~
SEEPAGE PIT
NOTEt THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
INSTALLATION OF: SEPT]C TANK
TYPE AND SIZE OF FACILITY TO BE SERVED
FINANCED THROUGH 5~L/~
COMPLETION DATE ANTICIPATED
FINAL INSPECTION= 24 HOUR NOTICE R~QUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE ~DC)~> ~lLl,,. TYPE
MINIMUM DISTANCES, REQUIREMENTS
SEPTIC TANK TO SEEPAGE PIT WALL
SEPTIC TANK SEEPAGE PIT
TO NEAREST LOT LINE.
DRAIN FIELD ./~
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING ]NSTALLAT]ON.
[ CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS Of GREATER ANCHORAGE AREA BOROUGh ORDINANCE NO, 28-6B AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE.