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HomeMy WebLinkAboutCAMPBELL HEIGHTS #1 BLK 7 LT 25 GRr. ATER ANCHORAGE AREA BORO~,LGH HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 9950! 279.251! INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME SEPTIC TANK: . DISTANCEFROMWEL~Jf'~'.F/i,/'3~,~ MAI'ERIAL LIQUID CAPACITY ~,f~. tl~ .~-,' o ADDRESS PHONE NUMBER OF ,~-~' 7 ~.) L,OU,D GALLONS. INSIDE LENGTH. .INSIDE WIDTH DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITT' i OUTSIDE DIAMET~"'-~ OR WIDTH LINING MATERIAL~'~''~''~~'~ ,DISTANCE FR~ · BUILDING FOUNDATION NEAREST LOT LINE. TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) SQ. FT. TILE DRAIN FIELD: DISTANCE FROM WEL~'J~" ~'~) .FOUNDATION NUMBER OF LINES ~ ' DISTANCE BETWEEN LINES ABSORP;,ON AREA /~ ~'7~ DEPTH: TOP OF TILE TO FINISH GRADE , /~ ,/ NEAREST LOT LINE /~ / TOTAL LENGTH // , OF LINES / SQ. FT. LENGTH OF EACH L,NE / ~ )~ r · ~ DEPTH OF FILTER ~TERIAL BENEATH IILE IN. ABOVE TILE WATER SAMPLE WELl.: DISTANCE FROM TYPE '%~"~ '~. DEPTH ~ oBUILDING FOUNDATION. /1/,j, . NEAREST NEARESI SEPTIC SEEPAGE ~ OTHER LOT LINE ~ . SEWER LINE ~ ,JANK ~ , SYSTEM ~ , CESSPOOL , SOURCES DIAGRAM OF SYSi~ DISTANCES: · .:... :::::;'l~*~./...~,.,l: .... :.:.j..~.=j .... ..... Il I',¥ -~. ~,,: .~ ~ . : . : . .............. :.-:- ...... : ...... ~ . :~ ...~,-. ~ f~ :~::;.-~ .... ' ' ' i : ..... "' ' ' : ' ; ' ; ~;' ~ :-. u.,,, :~:':'::J::..~.::~[: .... -.-,,- .~, : '.'..-~ . .' ..... -y ... ~: .':. :: :~ .': .: ............... T ....................... ~ ......... [ ....... ~ ~-:.::':~ ~ .... DATE GREA'~EI~ANCHORAGE AREA ,f'=~)R H 327 Eagl~e St. Anchorage, Alask~ 09501 NAME OF APPLICANT/Z~f~''~ RESIDENCE ADDRES~ LEGAL ~ ~,~'f MA~UNG ^DDRESSq2~ 2) ¢,r ,~', .~// PHONE DESCRIPTION~ ~/F ~" ~ 2~ APPLICATION TO INSTALL: SE~IC TANK , SEEPAGE PIT , DRAIN FIELD ~ , OTHER / PERCO~TION TEST RESULTS ANTICIPATED DATE OF COMPLETION ~BELOWTO BE FILLED OUT BY HEALTH DEPARTMENT THIS IS TO SERVE AS · SEPTIC TANK SIZE DISTANCES: AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED ~ "L~'/'Z44'~' TYPE SEEPAGE AREA TYPE DIAGRAM OF SYSTEM 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 a~cordance with said code.