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HomeMy WebLinkAboutLot 14, 15 GAAB HD I Go~'~,.TER ANCHORAGE AREA BOROU~',H H EAL'rH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYS'[EM NAME. LOCATION SEPTIC TANK: DISTANCE FROM WELL LIQUID CAPACITY SEEPAGE SYSTEM: (~'~} / __MATERIAL__ GALLONS. INSIDE LENGTH '"~' NUMBER OF PITS LINING MATERIAL NEAREST LOT LINE__ OUTSIDE DIAMETER ~)/~/¢~ ~ ,~. ' 7-~F NUMBER OF / .COMPARTMENTS LIQUID INSIDE WIDTH _ .DEPTH OR WIDTH_ , LENGTH__ __, DEPTH DISTANCE FROM WELL__~Ik_~!-- ., BUILDING FOUNDATION TO[AL EFFECTIVE ABSORPTION AREA (WALL AREA) SQ. FT. TILE DRAIN FIELD: DISTANCE FROM WELL NUMBER OF LINES_ ABSORPTION AREA DEPTH: TOP OF TILE TO FINISH GRADE , FOUNDATION_ __, NEAREST LOT LINE .DJSTANCE BEIWEEN LINES_ TRENCH WIDTH SQ. FT. LENGTH OF EACH LINE DEPTH OF FILTER MATERIAL BENEATH TILE TOTAL LENGTH , OF LINES IN. TOTAL EFFECTIVE IN. ABOVE TILE WELL: r'~ k~ ~ TYPE__~(~IVvL~'~-d' , DEPTH. NEAREST LOT LINE , SEWER LINE kT' °,STANCE FROM 93' -, BUILDING FOUNDATION WA[ER SAMPLE ____ CESSPOOl DIAGRAM OF SYSTEM , NEAREST OTHER , SOURCES DISTANCES: ft-.G: .;\-n ': 0 ,..u I DATE APPROVED GAAB-HD-2 GREATEk ANCHORAGE AREA ~ 91t~OUGH ItEALTH DEPARTMENT 327 Eagle St. Anchorage, Alaska 99501 279-2511 SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT NAME OF RESIDENCE ADDRESS LEGAL. ,DESCRIPTION APPLICATION T0 INSTALL: SEPTIC TANK_ ~'~__, SEEPAGE PIT.__ TO SERVETHE FOLLOWING FACILITY ,~ 8~ ~V'O0 Iv~ _ MAILING ADDRESS '-~'; LOCATION 01: INSTALLATION PHONE ND.__ FINANCED THROUGH PERCOLATION TEST RESULTS , DRAIN FIELD. , OTHER TO BE INSTALLED BY_ ANTICIPATED DAI'E OF COMPLETION THIS IS TO SERVE AS DISTANCES: AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED___ . SEPTm TANK S~ZE. '7,Si:~ .TYPE d~,'~'C'ZZ_/~EEPAGE AREA DIAGRAIVl OF SYSTEM /~' ?'1/': ,PERMITTO ,NSTALLA ,S¢/~.p+((~, '"'j"E'4 [)~-~ Health Authority I certify that I am familiar with the requb'ements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the above described system is in accordance with said code, DATE__ / ~ APPLICANTS 8IG NATU RE '~-~?'~:~/