HomeMy WebLinkAboutCAMPBELL HEIGHTS #1 BLK 8 LT 400/¥
07 ' 0
GR~"'k~TER ANCHORAGE AREA BOROU~'~I
D'~..,~RTMENT OF ENVIRONMENTAL nUALI'. /
3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 27g-8686
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
MAILING
LEGAL DESCRIPTION
?x~/~z///~ NUMBER OF
DISTANCE FROM WELL ~ MATERIAL ~/~//~/~//~/~'~-~/~--~ ~1 ~ , COMPA~IMENTS.
-u~u~D CAPAC.~ ~ / /~
OALLO~S. INSIDE LENGTH INSIDE WIDTH
LIQUID
,DEPTH
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS / OUTSIDE DIAMETER
OR WIDTH
LINING MATERIAL ~-
NEAREST LOT LINE.
, DISTANCE FROM WELl
TO/AL EFFECTIVE ABSORPTION AREA ~VALL AREA)
, LENGT. ~/ , DEPTH
~IN FIELD:
DISTANCE F R0 ~ ~ EJL~~~- FOUNDATION.
NUMBER OF LINES DISTAN~
ABSORPTION AREA SQ. FT.
., NEAREST LOT LINE.
IRENCH WIDTH
LENGTH OF ~
EACH LINE
DEPIH: TOP OF TILE TO FINISH GRADE
.DEPTH OF FILLER MATERIAL BENEATH TILE
TOTAL LENGTH
., OF LINES.
IN. TOTAL EFFECTIVE
WELL:
LOT LINE
TYPE~//~Z'~''~'/,ZZ~ DEPTH
NEAR~ST '
· SEWER LINE
DISTANCE FROM WATER
, BUILDING FOUNDATION. SAMPLE , NEAREST
SEPIIC SEEPAGE OTHER
· TANK o SYSTEM , CESSPOOL , SOURCES__
DIAGRAM OF SYSTEM
.DISTANCES:
DATE
GREAfER ANCHORAGE AREA BOROUGH
PERMIT NO.
SEWAGE DISPOSAL SYSTEM
INSTALLATION LOCATION U ~C~
LEGAL DESCR,PT,O. ~ ~o ~ ~
.o,L T.T RESULTS
APPLICATION AND PERMIT
DRAIN FIELD OTHER
TO SE ,.$TA'.LSO S¥ ,~'t ecoo,.v'tc ~'X.
NOT~ THIS PERMIT IS HOT VALID WITHOUT ~OIL TEST
FINAL INSPECTION~ 24 HOUR NOTICE REQUIRED. BACKFILLING OF' ANY SY~"rEM WITHOUT FINAL INSPECTION BY THE
HEALTH DEPARTMENT AUTHORITY WILL BE 8UBJECT TO PROSECUTION.
SEPTIC: TANK SIZE ~'/ ~''(~
TVPE ,~P~/~
FOUNDATION TO SEEPAGE PiT
SEPTIC TANK TO SEEPAGE PiT WALL
SEEPAGE PIT ~0 ~ DRAIN FIELD
WATER MAIN TO SEPTIC TANK SEEPAGE PIT
DRAIN FIELD
"~ I
sE.,¢ TA.K 5 0 SEE,'AGE ".T
TO RIVER, LAKE, STREAM.
CONFORM TO BOROU EGULATIONS REGARDING INSTALLATION.
/// LICENSED DESIGNER
GREATER AtlCNF)RAGE AREA BOROUGH
DE~RTNErIT OF ENVIROHriENTAL Q~"LITY
3500 TUDOR ROAD .'
ANCtlORAGE, ALASKA 995D2
'CASE
P~rformed For~'~)AIp~VL~ ~AL~u~ .Date Performed~~
Lepal Description: L'ot~Block (~, Subdivision ~.
This Korm Reoorts Soils Log X Percolation Tes~_ ~
~e~th
Feet
Soil Characteristics
Was Ground Water Encountered?..
If Yes, At what Depth?
' t i
~eading Date Gross Time Net Time Depth to H20 Net Drop
~ ·
./
'I
n Rate tiinute
Proposed Inst--: See~a~ Pit ~ Drain Field
De~h of Inlet ~ Depth To Bottom Of Pit Ok Trench
-ct~p~--.~-e.F_.]o_c._~_._.~l_~' ~ co ~ ' 'a.4L.~ '
Test Performed ByG.~.A.~. 6~S IA~. Data Certified ~y:~
Date~~~
