HomeMy WebLinkAboutCAMPBELL HEIGHTS #1 BLK 8 LT 36
Gp~ATER ANCHORAGE AREA BORG,*, ~'~H
HEAl.IH DEPARTMENI
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279.2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
MAILING
ADDRESS .~'-~"~ ~~ ,~--~- PHONE~'~'~'~'~'
LEGAL DESCRIPTION ~-~'2"'"',~'~-~-'~-,,~.. ~~ ~
SEPTIC TANK:
DISTANCE FROM WELL/~/~',/~,. /~/.~' MATERIAL ~.~./.)~/~__.~/~7~,.c~.~ NUMBER OF
COMPARTMENTS /
LIQUID CAPACITY ./ ~ ~ ~ GALLONS. INSIDE LENGTH INSIDE WIDTH~DEPTH
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS ~ETER ~ LENGTH ~J~FPZJ4-.----
NEAR'EST LOT UNE TO/AL EFFECTIVE ABSORPIION AREA JWALL AREA) SQ. FT.
TILE DRAIN FIELD:
DISTANCE FROM WELL~'?.,~- '/~'~7''"~/~ ~ · FOUNDATION.
NUMBER OF LINES ~ ~'~ DISTANCE BETWEEN LINES
ABSORPTION AREA //'/-~' SQ. FT.
, NEAREST LOT LINE
TRENCH WIDTH
LENGTH OF EACH LINE // ~ ~:~ /
DEPTH: TOP OF TILE TO FINISH GRADE
TOTAL LENGTH.,~ .~j
· OF LINES
IN. TOTAL EFFECTIVE
DEPTH OF FILTER MATERIAL BENEATH TILE
IN. ABOVE TILE
WELL:
TYPE .~ ~ DEPTH
tOT LINE ~/~ NEAREST SEPTIC
DISTANCE FROM · /') ~ · WATER
BUILDING FOUNDATION. ~"/~- SAMPLE . · NEAREST
., SYSTEM ~"'/"~" , CESSPOOL ~ , SOURCES
DISTANCES:
DIAGRAM OF SYSTEM
: ': ':' · ~ .... ; t ....
APPROVED
GAAB-IIDo2
~ GREATE~ANCHORAGE AREA~OROUGH
llEALTI! DEPARTMENT
327 Eagle St, Anchorage, Ala~,a 99501 279-2511
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
.AME oF APPLICANT'-~'C J~ ~
RESIDENCE ADDRESS ~")~ ~ ¢
LEGAL DESCRIPTION
APPLICATION TO INSTALL: SE~IC TANK
PERCOLATION TEST RESULTS
LOCAT,ON OF,NSTAL~TION O~mr~// #'h
,SEEPASE PIT ~ ,BBAIN FIELB , OTHER
ANTICIPATED DATE OF COMPLETION ~ ~ ~C
BELOWTO BE FILLED OUT BY HEALTH DEPARTMENT
THIS IS TO SERVE AS
~ F' ~v~/J(~, ,PERMIT TO INSTALL
AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED
SEPTIC TANK SIZE "7~-~-"'O TYPE ~,C~L~"~'SEEPAGE AREA
DISTANCES:
TYPE
DIAGRAM OF SYSTEM
%
I certify that I am familiar with the requirements of Greater Anchorage Are___rough Ordinance No. 28-68 and that the
above described system is in accordance with said code.