HomeMy WebLinkAboutWESTGATE PARK BLK 3 LT 8 (2)
Municipality of Anchorage ~_~t
DEPARTME.N.T OF ~EALTH & ENVIRONMENTAL PROTECTION POUCH 6-650
ANCHORAGE. ALASKA 99501
INSPECTION REPORT ON ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL
NAME ~-,,~3C~E:(~ ~-~.~T'~'~CA-~tE~:,. LOCATION
,..~IL::~- ~C~C- ~ ~ ~'~ PERMIT NUMBER
ADgRESS %~ ~OX~ LEGAL DESCRIPTION ~
PHONE(S) ~--~0~ ~ ~ ~~ ~ ~OFBEDROOMS
MANUFACTURER
SEPTIC TANK
DISTANCES
FR0~,~M T.~0 SEPTIC SEEPAGE SEWER CESSP00L
TANK SYSTEM LINE WELL
WELL ~
LOT
LINE
CAPACITY IN GALS.
MATERIAL
INSIDE DIMENSIONI
I LENGTH iWlOTH
#OF '~
COMPARTMENTS
DEPTH
SEEPAGE SYSTEM
[] TILE DRAINFIELO
NUMBER OF LINES
DISTANCE BETWEEN LINES
DEPTHS: [
TILE TO GRADE FILL BELOW TILE
LENGTH EACH TOTAL LENGTH
TRENCHWlOTH
FILL ABOVE TILE
[]SEEPAGETRENCH OR []PIT
NIDTN LENGTH DEPTH
[] LOG CRIB
[] RINGS- DIA.
FILL MATERIAL DEPTH
TOTal. EFFECTIVE ABSORPTION AREA; SO~ FT.
WELL
CLASSIFICATION . DEPTH PiPE MATERIAL
INSTALLER
REMARKS .,_, ,,
DATE I~. ~ '~L~J~J APPROVED BY
SYSTEM DIAGRAM
· * DEPEff~:TI'"IENT ]:)~-- HEEII_TH AND EN'v'IF:ONMEI?TRL F'P"TTECTION
F'Ef~'.i"I I T NO. ,:: 779..¢u ', -
HFELZ_.HNI ?.ub:R. NEff"IFICNEK %R.H E,:',..',
LOCR~ Z ON I'"i ~ I<E
LEGRL LE: Es:: I.,.IE:].'GFErE PI.cZ LOT SIZE 6588 S];!L.IFIE:E FEET
T'¢PE OF SOIL. FIB'S_;ORBTION S'¢STEM IS: TRENCH
h'iR;:-::IMUM Iq]Ji-,'lBEI;'. OF EflEDROOMS; = 5
SOIL RFITING ,::SI2 FT,-'"BR)= E~
TFIE REQIJiF~ED SIZE: OF ]'EIE SOIL RBSOF?.f:'TION S'¢STEM IS:
THE L. ENGTH DIMENSION I:E; THE LENGTFI ,::IN FEET) OF THE TRE:NC:FI OR DREIINF:IELD.
THE DEPTN OF FI TRENCH OR F:'ZT :IS; THE DZ':.,TFINCE E:E'TI.4EEN THE SURFEIC:E OF THE
GR.O]JND RND THE BOTTOM OF TEIE E:.~CF¢,,,'FITION ,::]:N FEET).
THERE IS; NO SE-I- t.,JZE:,TH FOR TRENCHES'5.
THE: GRFI'v'EL ])IEF'TH Z:E, 'FEll-:.' MINIMUM DEPTH OF GRFI'v'EL BETHEEI",I THE: OL.FFF'FIL. L P]:F'E
FIND ]~HE BOTTOM OF THE EXCFI'v'FITION (IN FEET).
· [:-4: L:Z ~]:~ IU JL I~ ... ~::. if.'.- 'T I~-~ ~'-.~ I1<: ]E ::i::: ~2} ~S (-:'E~ L:~ I~-.Ii L. L. L, ~ -a
......................... F' i~-'~ C: frs:.' ~':"~ ~ F.~' IF:" L... tF:~ [~-..~ '3F (.} F" 'T' ~.: ~-%~ ~'-4~
la F'FICKFIGE: PLFINT i'"l]:lY BE II'-,ISTEILL. EI.":, 8T "['HE PERi"IITTEE'"S OPTION SUB.TECT TO TF.IE
FOLL. ONING CONDITIONS;:
t. EITNER FI CL..FISS I OR II NSF RPPROVED P]_FINI" P1FI'T' 8E IN:E;TFILLED.
2. R COi'.,ITINUOIJS MFIINTENFINCE FIGREEP1ENT IS REI]:!UtRED. IF R hlRIN]'ENFINCE
FIGREEMENT 15 NOT KEPT CURRENT "r'OU I"IFI'¢ BE REQUIRED TO ENLflRGE THE SOIL
]:~E:~;ORPI"ION S"r'STEM RND,"OR "r'OU iVlEl'¢ BE SUBJECT TO PRO-C, ECLITtON.
E:FICKFII_LING 01:' F:IN'¢ SYSTEM klITHOU].' FINFIL INS;PECTION FIND FtPPRO'v'RL BV TEltS
DEPFIF}:Ti'"IENT k!IL.L. BE :~:;I.JBJECT TO PROSECUTION.
.'.tE~E~ FEET FOR R PRI'v'FITE I.,~ELL. OR 2EdE~ FEET FOR F~ PUBLIC F!ELL.
OTHER REE.!UIREMEI'.,n"~., iVlFi¥ F-IPPI_'~.'. .S:PECIFICRTIONS FIND CON:i~,Tf;?.UE:TION I}~RGRFIMS RRE
FiVEIILREd_E TO IN'::q]JRE PROPER II'.,ISTF:ILLFITION.
I CERTIF'~' TNI:~-f'
±: i I:~1"1 F:Ri"]ILIFIR WI'T'H THE] REQUIREMENTS FOR ON-SITE 9EHERS] FIND I.'-IEI-LS; ElS SE']"
FORTH 'E':'¢ THE MUNICIPRLIT"t OF EINCHORRGE.
2: i I.'.tILL ].lq.:,T L.L :''PIE .:,rs, fEe'1 IN FIcCOF;:[:'FINCIE WI'TI:t TEIE CO[:'E:S.
~:: I UNDERSTRN[:' THRT TEIE ON-SITE SEI.4EF'. S;"r'STEM MFI'¢ REQUIRE ENL.RRGEI"]EN].' IF THE
RESIDENCE IS RE:MODIEL. E[:' 'f'O INCLUDE MORE THFIN 5 E:E[:,RO(]I'fl'.'5.
IVlUNICI '.ITY OF ANCHORAGE
POUCH 6-650 · ANCHORAGE, AK 99502 · PHONE 279-8686
FINANCE DEPARTMENT
CASH RECEIPT
26381
Collecting Orgn. No.
40-007 (Rev. 1/77)
o n
IVIUNIC,,,,~..'-ITY O F ANCHORAGE
POUCH 6-650 · ANCHORAGE, AK 99502 · PHONE 279-8686
FINANCE DEPARTMENT
CASH RECEIPT
No. 26381
RECEIVED
FROM 2,-¢ -. ~'~
.ADDRESS
REMARKS
- "~:; DATE
I~FI~ !~:111il II IIIII I IIIII I II
Org/CC Adct~Obj .Cost Center, WA/WO 6
Amount
40 od7 Rev 1/77 D STRIBUT/oN: ~hite ~ Treasury; Yeli~'.~ Cu${~m~r; Pink; Book; G01denr r