HomeMy WebLinkAboutCAMPBELL HEIGHTS #1 BLK 8 LT 23
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GRr~TER ANCHORAGE AREA BOROU~H
HEALTH DEPARTMENT
327 EAGLE ST. ANCHORAGE, ALASKA 9950! 279-25t!
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCATION~:~
SEPTIC TANK:
ADDRESS ! '" ~' ,~l~'g~/~'~ PHONE
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF(PITS ~O R W ID~..~...~ ~4~.~I~:1~ ,DEPTH
LINING MAI~.~_..~ US~l~l~.r- r.uM ~ ~.LL ., BUILDING FOUNDATION
· NEARESI LOT LINE TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ,SQ. FT.
TILE DRAIN FIELD:
DISTANCE FROM WC~. FOUNDATION A
NUMBER OF LINES f DISTANCE BETWEEN LINES
ABSORPlION AREA /~ I~ SQ. FT. LENGTH OF EACH LINE
DEPTH: TOP OF TILE T~ FINISH GRADE ~'~'
WELL: TYP~/'*) DEPIH
NEAREST SEPTIC
LOT LINE ~'~' , SEWER LINE ~ ..TANK
NEAREST LOT LINE
TRENCH WIDTH
DEPTH OF FILTER MATER~AL BENEATH TILE
DISTANCE FROM ~./_ WATER
, BUILDING FOUNDATION. ~,-'~-- SAMPLE
SEEPAGE
~f~-~- , SYSTEM ~,~- , CESSPOOL
TOTAL LENGTH ~ /
OF LINES .
~" IN. TOTAL EFFECTIVE
ABOVE T,LE
/~ , NEAREST
OTHER
, SOURCES
DIAGRAM OF SYSTEM
DISTANCES:
GREATE . NCHORAGE AREA T )ROUGH C,seNo.
IIEALTI! DEPARTMENT
327 Eagle St. Anchorage, Alaska 99501 279-2511
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
RESIDENCE ADDRESS ~'~ ,"'~ .,~ ~ ~'~--"-
LEGAL DESCRIPTION
APPLICATION TO INSTALL: SEPTIC TANK
TO SERVETHE FOLLOWING FACILITY "~/'~"~- '~'~'~,/'/'~"~.-~
FINANCED THROUGH ~'t';'~7',~'= TO BE INSTALLED BY ~-'~
~TEST RESULTS ,,//~ ./"'J',~C,,O/"~, ANTICIPATED DATE OF COMPLETION
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
~)~/~"~A~'~--~ P H 0 N E NO.
LOC~TION OF INSTAL~TION ~ ~ ~ ~
SEEPAGE PIT ,DRAIN FIELD ¢/ , OTHER
AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED ''~' ~::~
· SEPTIC TANK SIZE ,.~c~? TYPE'~",I"'/~'-'r·'Z--'' SEEPAGE AREA
DIAGRAM OF SYSTEM
DISTANCES:
I certify that I am familiar with thc requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the
above described system is in accordance with said code.