HomeMy WebLinkAboutCAMPBELL HEIGHTS #1 BLK 8 LT 24
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GR?A~TER ANCHORAGE AREA BOROU?~
HEALTH DEPARTMENT ~
327 EAGLE ST. ANCHORAGE, AlaSKA 99501 27,,~z511
INSPECTION REPORT. ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK: /7J~/~' ~).
LIQUID CAPACITY ~'~. GALLONS. INSIDE LENGTH ~gTo S / INSIDE WIDTH. ~ ' DEPTHLIQUID
SEEPAGE SYSTEM: SEEPAGE PIT:
NEAREST LOT UNE. TOTAL EFFECTIVE ABSORPTION AREA JWAtL AREA) .SQ. FT.
TILE DRAIN FIELD:
DISTANCE FROM WELL~--~t~J~,
NUMBER OF LINES
TOTAL LENGTH / ~",~1 /
OF LINES / -~J /.
IN. TOTAL EFFECTIVE
ABSORPT,ONAREA "/'9'/ SO. FT. LENGT. OFEAC. L,NE/~;2~':
DEPTH: TOP OF TILE TO FINISH GRADE
DEPlH OF FILTER MATERIAL BENEATH TILE/r~' a/ IN. ABOVE TILE/z~)__
k.~[! ,~,
WELL:
TYP _~/]f/~, ~. DEPTH ,BUILDING FOUNDATION.~SAMPLE , NEAREST
NEAREST SEPTIC SEEPAGE OTHER
~'/~- , SEWER LINE ~/( ., TANK · ~ ., SYSTEM ~A~'-- , CESSPOOl r , SOURCES
LOT LINE
DISTANCES:
DIAGRAM OF SYSTEM
o**...o-2 GREATER ~NCHORAGE AREA I tROUGH
IIEALTH DEPARTMENT
SEWAGE DISPOSAL SYSTEM - APPLiCATiON & PERMIT
NAMEOF APPLICANT ~ ~J~ft~ MAILING ADDRESS ~,)'~ .~ PHONE NO..
RESIDENCE ADDRESS ~ I ~ ~R--r'~4 ~ //j. LOCATION OF INSTAL~TION ~ ~
LEGAL BESCRIPT~
PERCOLATION TEST RESULTS ANTICIPATED DATE OF COMPLETION.
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
THIS IS TO SERVE AS
,PERMITTO INSTALL A ~2~'~ ~'~'"'~
AS DESCRIBED BELOW/. SIZE OF UNIT TO SE SERVED. -~., ~', ~ ~/~-'~
. SEPTIC TANK SIZE, /~)~ TYPEC/7-~/¥'L,~,/,/7--SEEPAGE AREA TYPE
DISTANCES:
~....~,.'_.~,~J~..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 accordance with ~aid code. .
Zi ,'.'be / -
DATE ~ '~ APPLICANTS SIG NATU R ~'~
t- HEALTH DEPARTHENT ~ CASE
327 EAGLE ST~SET
ANCHORAGE~ ALASKA 9950~
This Fc~ Re~o~ts a: So~ls-~' Lo~ ,,~ .... Percola:ion Tes: '
Depth
Feet
Soll Characteristics
Was Ground gate~' Encountered?
L
If Yes, At What Depth_7~'~.
Reading
Date
G~oss Time
Net Time
Frcposed Instal~Seepa[e Pit mw/
Location Sketch
Depth To H20
Drain Field
Net Drop