HomeMy WebLinkAboutCAMPBELL HEIGHTS #1 BLK 8 LT 11
GI~£*?~R ANCHORAGE AREA BOROL~._~A
*' HEALTH DEPARTMENT
327 EAGLE'ST. ANCHORAGE, ALASKA 99S01 279-2~1
,/
%,.
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCATION ~)~"/~
MAIL"NG
ADDRESS.
LEGAL DESCRIPTION
__PHONE
SEPTIC TANK:
DISTANCE FROM WELL ,/~0~ ~ / C)~:)/U(',
MATERIAl
LIQUID CAPACITY /~) O GALLONS. INSIDE LENGTH
NUMBER OF
COMPARTMENTS
INSIDE WIDTH :~
/
DEPTH
SEEPAGE SYSTEM:
NUMBER OF PITS
LINING MATERIAl
NEAREST LOT LINE
SEEPAGE PIT:
~- ~?~ ~" DISTANCE FROM WELL ~4~
~ TOTAL EFFECTIVE ABSORP~ION AREA ~ALL AREA)
, LENGTH ,Z~ , DEPTH
. BUILDING FOUNDATION
so.
TILE DRAIN FIELD:
DISTANCE FROM WELL
NUMBER OF LINES
ABSORPTION AREA
., FOUNDATION,
DISTANCE BETWEEN LINES
SQ. FT. LENGTH OF EACH LINE
DEPTH: TOP OF TILE TO FINISH GRADE
, NEAREST LOT LINE
TRENCH WIDTH
TOTAL LENGTH
,, OF LINES
.IN. TOTAL EFFECTIVE
DEPIH OF FILTER MATERIAL BENEATH TILE
IN. ABOVE TILE
~ ~ J~j~.~.~_/.~_ '~ DISTANCE FROM WATER
WELL: TYPE ' !~" DEPTH ,BUILDING FOUNDATION SAMPLE ., NEAREST
NEAREST SEPTIC SEEPAGE OTHER
LOT LINE .. SEWER LINE , TANK , SYSTEM , CESSPOOL , SOURCES
DIAGRAM OF SYSTEM
DISTANCES:
. . [
DATE
APPROVED
327 !;k,;',S :TRKKT ~
~NCHDR/::r, !?.~:'Ki ~9501
Excavator . ~chackle
· Pcr~cr'~ed rot ~er - Gordon Anderson
T~is [cm, ~or~s , -<;~,c &::a~..'~v:sio= Cambell Heig :s
'~ ' - .... .o~ xx -i'~ '
Depth
~'eet
4--
5---
6'--
7~
8---
brown silty sand (SM)
loose gray gravelly sand
(SW) and sandy gravel (GW)
intermixed
Was Ground Water Encountered? no
If Yes, At Wkat "-
· ,%.th ~
I.ocat f =n S~etch
Reading ['ate C~oss 7i~e "' 7i~e
D~pth To H20 Net-Drop
Prcpo~ea Insral~seekage ri: xx Drain Yield
Deo~L Of /r,~et ., - -.
· .. .e,-ln ~o Bottom Of Pit Cr Trench 10
COM'-TI~T$:
Test' Performed B'y:__RI E. Carlisle
~ These recomnendations are computed
from visual observations and based
Data Certified aY:~_~{oral Test{n~ ServiD~_ In~ the unified classification system.
Date:
G'~ATER ANCHORAGE AREA BORO"'~IH
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-25! !
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCATION
/~ I.._ _ ,~A,L,NO ~'/"t/~ I J~'~ ~ ~/-~'PHONE
LEGAL DESCR,P,ON
SEPTIC TANK:
~'/.~
DISTANCE FROM WELL~'~ lt/'l'~:/I~Z~7~,mATEelA~ ~' COMPARIMENTS
GALLONS. INSIDE LENGTH.
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS
',N,NG MATER,A,
NEAREST LOT LINE
O.TS,OE D,AMETER OR W,OT. / ~-' .. LENGT. / Z... DEP,. 7
0,STANCEFROMW L, "",,: ,"/' , ILDINGFOUNDATION
TOTAL EFFECTIVE ABSORPTION AREA ~ALL AREA)
/
TILE DRAIN FIELD:
, DISTANCEFR~I , ,FOUNDATIOhJ~TUNE
N~INES ~ glST~~NES TRENCH WIE'H~'~/
ABSORPTION AREA SO. FT. LENGTH OF EACH LINE
TOTAL LENGTH
,.,--'"O~LlhJES~'~
IN. TOTAL EFFECTIVE
DEPTH: TOP OF TILE TO FINISH GRADE
DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE
WELL: TYP ~:~1~-~ TH ' ATION. .SAMPLE
~ N~RF~T- $E~'i,C SEEPAGE: -- ~ OTHER
LOT LINE . SEWER LINE , TANK , SYSTEM , CESSPOOl
DISTANCES:
DIAGRAM OF SYSTEM
OAAB-H Do2
GREATE.V~. 'ANCHORAGE AREA ~...OROUGH
HEALTH DEPARTMENT
327 Eagle St. Anchorage, Alaska 99501 279-2511
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
NAME OF APPLICANT A~'~/~, g"~(,~'~&~
RESIDENCE ADDRESS y,7~C ~ ~ ,~ ~ ~LOCATION OF INSTAL~TION
APPLICATION TO INSTALL: SE~IC TANK ~ ~SEEPAGE PIT ,DRAIN FIELD
uw
PERCO~TION TEST RESULTS ~ ~ ANTICIPATED DATE OF COMPLETION
'~?$- qT/q
MAILING ADDRESS g'/'/~'! -~ 4/2 ~:,~/r"' PHONE NO. --
OTHER
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
THIS IS TO SERVE AS '/~ ~/',P'~'~'~ . PERMIT TO INSTALL A
AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED
. SEPTIC TANK SIZE /~f~ TYPE ~ SEEPAGE
~-'~.~ Lt~ DIAGRAM OF SYSTEM
DISTANCES:
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.
