HomeMy WebLinkAboutCAMPBELL HEIGHTS #1 BLK 8 LT 3807 ' o?
.,GREATER ANCHORAGE AREA BOROLIGH
! ~ HEALTH DEPARTMENT ( t
327 EAGLE ST. ANCHORAGE, ALASKA 99501 2,/9-2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME
LOCATION ~/~,/~fJ~ ~'~'
SEPTIC TANK:
ADDRE SS [ ~,-. ~,... v .,/..,/~'./'~,/'~e.~q~ PHONE__
DISTANCE FROM WELL MATERIAL . . COMRARTMENTS ( ~
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS
LINING MATE~
OUTSIDE DIAMET~ OR WIDTH ,~'~H. . DEPTH
NEAREST LOT LINE TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) .SQ. FT.
TILE DRAIN FIELD~,
DISTANCE FROMWE ; I ' - /,FOUNDATION
NUMBER OF LINES ~" DISTANCE BETWEEN LINES
ABSORPTION AREA '~'"~) ~
DEPTH: TOP OF TIL~/~T~ FINISH GRADE
NEAREST LOT UNF /~ /.~ TOTAL LENGTH.-~.~/ !
· . OF LINES ,c:::~ ~'''~' ,
-~.3-/ '~/
TRENCH WIDTH IN. TOTAL EFFECTIVE
SO. FT. ,ENGT. OFEAC.,,NE Y',r"
DEPTH OF FILTER MATERIAL BENEATH TILE ~ IN. ABOVE TILE
DISTANCE FROM
DEPTH '*'-- , BUILDING FOUNDATION. ~'- SAMPLE
SEEPAGE
~/~- , SYSTEM
NEAREST SEPTIC
LOT LINE ,L~ ~ , SEWER LINE ~:~ , TANK
/
WATER
· J~-/~* , NEAREST
OTHER
, CESSPOOL ~ , SOURCES
DIAGRAM OF SYSTEM
DISTANCES:
DATE
~' GREATE.~.ANCHORAGE AREA f'"OROUGH
IIEALTil DEPARTMENT
327 Eagle St. Anchorage, Alaska 99501 279-2511
Case NO. ,
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
NAME OF APm CANT/--/~4X~/M~.,
RESIDENCE ADDRESS ~--~,~'
.--,. _. _~ 'g'-3 ~ -75"~,4
MAILING ADDRESST~'dO ,/J-/--,~'/'~,~c'~,~PHONE NO.
/. /
SEEPAGE PIT ~ . DRAIN FIELD
/~'~-'p e. "T~ ~-R ·
TO ,E INSTALLED RY ~- .'/>'~'
APPLICATION TO INSTALL: SEPTIC TANK
TO SERVE THE FOLLOWING FACILITY
FINANCED THROUGH ~"'L~"Z- ~
PEta~.J:}LATION-TEST RESULTS
,OTHER
ANTICIPATED DATE OF COMPLETION
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
/ /
THIS IS TO SERVE AS//~' //-1/~/'l,/,~'"/4/"~ , PERMIT TO INSTALL A
AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED '~"~Z:~,,~'-~)~. 'T-~
· SEPTIC TANK SIZE
DISTANCES:
~ ~_- 5'
TYPE ~-~z_ SEEPAGE AREA
:~,,'Z'TT~ 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 s~id code. /~7-
DATE /4 ///'/~¢' ' ' :'/
Fee ~;
Was Ground Water r. ncoum:a~? ' ~,~
If Yes, Al: ~ha~ Depth ~/.
Locaq::t on Sketch
!
Net T{me ~epth To 1420
Net Drop
Proposed Znsta: Seepage Pit
Depth Of Inlet · e Drain Field ,
.. . . .*-'1. . '_- -...- ,.
Test Performed By:~erct.o