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HomeMy WebLinkAboutEAGLE RIVER VALLEY RANCHETTES LT 9DL ©6'o 2..21 lC GE.EATER ANCHORAGE AREA BOROUGH ! ~ HEALTH DEPARTMENT ~' "~ ,~-,~/'"'~ 327 EAGLE ST. ANCHORAGE, ALASKA 99S01 279-251! INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: DISTANCE FROM WELL '~ ~'~ MATERIAL -S ~-~'~/ NUMBER OF COMPARTMENTS LIQUID CAPACITY /~O~) GALLONS. INSIDE LENGTH INSIDE WIDTH DEPIH__ SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS / OUTSIDE DIAMEIER OR WIDTH ~2 /., LENGTH LINING MATERIAl ~/ DISTANCE FROM WELL ~)~ * ' ,. BUILDING FOUNDAT'O"~ NEAREST LOT LINE ~ ~ j TOTAL EFFECTIVE ABSORPTION AREA ~ALL AREA) TILE DRAIN FIELD: DISTANCE FROM WELL NUMBER OF LINES ABSORPlION AREA , FOUNDATION. DISTANCE BETWEEN LINES .SQ. FT. LENGTH OF EACH LINE DEPTH: TOP OF TILE TO FINISH GRADE · NEAREST LOT LINE ' TRENCH WIDTH TOTAL LENGTH · OF LINES IN. TOTAL EFFECTIVE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE WELL: LOT LINE TYPE WATER ~SAMPLE ~ --~-~'// ~/~'/~'",,~ DISTANCE FROM DEPIH , BUILDING FOUNDATION.. NEAREST NEAREST SEPRC SEEPAGE OTHER ., SEWER LINE ., TANK , SYSTEM CESSPOOl , SOURCES DIAGRAM OF SYST~ .... .. ,~' ~..~'....~:'~ ~ ::'~:~' .~.~ ..~ : .~ . ~ ; .... ......... , DISTANCES: DATE o~^~..~ GREATEI..ANCHORAGE AREA ~ROUGH Ca. No. //~' HEALTH DEPARTMENT 327 Eagle St. Anchorage, Alaska 99501 279-2511 APPLICATION TO INSTALL: SEPTIC TANK TO SERVE THE FOLLOWING FACILITY FINANCED THROUGH ~ PERCOLATION TEST RESULTS. SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT NAME OF APPLICANT ~,~4-~ ~C~),~g~MAILING TO BE INSTALLED BY ~ ~ ANTICIPATED DATE OF COMPLETION BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT ~O~&E , OTHER THIS IS TO SERVE AS ,,""~J~, ..~'7Z-."F~.~'~",PERMIT TO INSTALL A AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED · SEPTIC TANK SIZE DISTANCES: '~/"~' ~('.) TYPE 54oo~ SEEPAGE AREA .~g ]3' TYPE DIAGRAM OF SYSTEM h Authority 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 said code. / / /