HomeMy WebLinkAboutDALE BRIGGS BLK 2 LT 1A1bale Briggs
Block 2
Lot 1A
#050-182-86
GA AS Fp �, _ GfFATER ANCHORAGE AREA BOROJIGH
HEALTH DEPARTMENT
' 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
MAILING
NAME ��y/O Xo. ADDRESS j✓1T. LZ9, PHONEa!7j-
to7/i /4-e -::/
SEPTIC TANK:
/ NUMBER OF /
DISTANCE FROM WELL -�� MATERIAL CSW C COMPARTMENTS
LIQUID CAPACITYgam! GALLONS. INSIDE LENGTH -INSIDE WIDTH DEOPTH
SEEPAGE SYSTEM: SEEPAGE PIT: Gi�/�c r
NUMBER OF PITS OUTSIDE DIAMETER �'� OR WIDTH ! / , LENGTH �, DEPTH /
LINING MATERIAL 0el<1 DISTANCE FROM WELL `f« / BUILDING FOUNDATION`a
NEAREST LOT LINt/i %%ACX• e�e TOTAL EFFECTIVE ABSORPTION AREA (VJAII AREA) J / 50. FT.
TILE DRAIN FIELD:
DISTANCE FROM
NUMBER OF LINES / DISTANCE BETV/EEN LINES
ABSORPTION AREA SO. FT. Ltt*6117 OF EACH LINE
OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH
TOTAL LENGTH
OF LINES
EFFECTIVE
ABOVE TILE-
ISTANCE FROM
WELL. WATE
TYPE iL/��� DEPTH �na / ,BUILDNG FOUNDATION. / SAMPLENEAREST
/ NEAREST SEPTIC / SEEPAGE////````/ OTHER
LOT LINE n , SEWER LINE-, TANK -�� , SYSTEM, CESSPOOL . SOURCES_
DIAGRAM OF SYSTEM
DISTANCES:
f >o 4
f
1 A'. '' t
DATE
GAA$IID3• GREATEIXNCHORAGE AREA '91ROUGH
IIEALTII DEPARTMENT
327 Eagle St. Anchorage, Alaska 99501 279.2511
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
NAME OF APPLICANT Ucnt i d RO\n e_JS MAILING ADDRESS
RESIDENCE ADDRESS
LOCATION OF INSTALLATIO
LEGAL DESCRIPTION L , T i r5 me ti
APPLICATION TO INSTALL: SEPTIC TANK SEEPAGE PIT.
TO SERVE THE FOLLOWING FACILITY
FINANCED THROUGH
Case No. �2
PHONE NO.6 /-�2 7-2
" , DRAIN FIELD , OTHER
TO BE INSTALLED BY
PERCOLATION TEST RESULTS ANTICIPATED DATE OF COMPLETION
THIS IS TO SERVE AS
DISTANCES:
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
PERMIT TO INSTALL A
AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED
SEPTIC TANK SIZE TYPE SEEPAGE AREA TYPE
DIAGRAM OF SYSTEM
Health Authority
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.
DATE APPLICANTS SIGNATURE
r , _ ^' ,RrATER ANCHORAGE AREA. BOROU ' �
HEALTH DEPARTMENT CASE #
327 EAGLE STREET
ANCHORAGE, ALASKA 99501
0'
2'
M
10'
Performed For Hnmmnn Const. Ca. Date Performed "g^}r 22, 1)70
Legal Description: Lot 1 block 'T Subdivision T1r1 n
This Form Reports a: Soi�Lop, v -Percolation 'Vest
Depth
rPrt Soil Characteri-tics Location Sketch
s�
Was Ground Water Encountered? NO o
P
If Yes, At What Depth
1
N
Reading Date
IIIIHro.'r,
Depth
inorpnnic silt. o,itf
nll root'.rts rennin.-
through it. USCS CLA.",S
-11ML"
Net Drop
9nndy rilty grnvel 1/2.
to ?/l, of averapr --ix-
int:^ si.se. USCS CLASS
9-*
Sandy Fr^vol with e . _�11.
—V
(:;A
Skin ",r.nded 1" to 2" nve
�'sC..
era^e maxim tm di nmeter.
erco acion ainu
e
Random boulders to 1.0"
•-,0
USCS CLASS "GP" Contin -
Iles to 't lenst 12'
�.
depth.
s�
Was Ground Water Encountered? NO o
P
If Yes, At What Depth
1
N
Reading Date
Gross Time Net Time
Depth
To H2O
Net Drop
erco acion ainu
e
Proposed Instal ation: Seepage Pit
Depth Of Inlet Depth
COMMENTS: A" in nnntrinrya to't n;t mom+
is relativn.v oo^e nnn normnn n
Test Performed Bl; / >jtv
Data Certified By: / �I
Date: 1,1a:v . , . t,
Drain rield
ttom Of Pit Or Trench
I .-i l+ n"n Thl.Mrinn
r.romnnt, 1',O to 1'/5 no- Vt..