HomeMy WebLinkAboutAL CROSS BLK 2 LT 1/1/ Cr�ss 5/ea
06d'/72 -Z7
dant
3/
bar
G(I~,~ATER ANCHORAGE AREA BOR("~GH
HEALTH DEPARTMENT ' 'N.°3J.?
327 EAGLE ST. ANCHORAGE, ALASKA 99S01 279-2511
.... INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
NUMBER OF
DISTANCE FROM WELL ,~" ~ ~/"~.,"~,'~'~' MATERIA~~'~'~,'/~''' C~'~/~e~~2'~ COMPARTMENTS /
LIQUID
LIQUID CAPACITY //'~-'-~ GALLONS. INSIDE LENGTH / INSIDE WIDTH. ~ .DEPIH
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMSER OF PIIS / OUTSIDE DIAMETER
LINING MATERIAl f-
NEAREST LOT LINE
/ OR WIDTH.
· DISTANCE FROM WELl/.
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)
.. LENGTH .~e'"D / , DEPTH ~"
BUILDING FOUNDATION
SQ. FT.
TILE DRAIN FIELD:
DISTANCE FROM WELL ~NDATION ~ ~~E., EAREST LOT LINE
NUMBE~ OF~~'/ DISTANCE BETWEEN LINES ~TRENCH WIDTH
A~'PTION AREA SQ. FT. LENGTH OF EACH LINE ~,~ /
DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MAT
TOTAL LENGTH
, OF LINES
IN. TOTAL EFFECTIVE
IN. ABOVE TILE
WELL: J'~'"'~"~'~ "~:~//~'~"'~'('"' . ~ DISTANCE FROM ~ WATER ~
1YPF-~,'"*~~'~' -- . DEPTH *"'-. BUILDING FOUNDATION SAMPLE , NEAREST
,~EAREST SEPTIC
LOT LINE -- SEWER LINE '~'~ANK ~ SEEPAGE ~ OTHER ~
, SYSTEM CESSPOOL ~ SOURCES --
,,,'~'-c~ ~,.'/,~.~
DISTANCES:
DIAGRAM OF SYSTEM
o^A,.,,.., GREATEr~"ANCHORAGE AREA'~OROUGH c,~
~ ~''" llEALTII DEPARTMENT "
~,; 327 Eagle St. Anchorage, Alad~a 99501 279-2511
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
A.',CAT,O. TO .NSTA..: SE.,C TA.K, t'/ .SE?7~,T ~'''.D~A,. F,ELD .OTHER
~,.ANCEDTHROD~. ~.,. . q~BEiNSTA~LE~BY
~£RCG~AT,O, TEST .Es,~,TS o/~ .<Z]'./~'tf/~,NT, C,~ATEO D^T~ OF CO,~'ET,~,. 2 ~.4 ,.-/:~-~.~.
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
THIS IS TO SERVE AS
· SEPTIC TANK SIZE
TYPE~"~/~tffT-'SEEPAGE AREA ~TYPE
DIAGRAM OF SYSTEM
DISTANCES:
UJ~ cc.
above described/stem i/~n accordance with said code.
C
I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the
M.UNICIPALITY Or~-~,NCHORAGE
POUCH 6-650 ANCHORAGE, ALASKA 99502
1
I~Pt¥ DATE
FORM 91-008{3/76)
July 20, 1978
A1 Court.ney
823 Gambe11 Street
Anchorage, Alaska
Subject= Lots 1, 2, 3, 4, $ Block 2 Al Cross Subdivision
V
This department requests ~he septic tank and seepage pit
be filled in when the business building on the property is
connected to the public sewer.
Additiona11~, the sewer service line must be cast iron
and outside a forty '(40) foot radius of the w~11.
Further expansion of the building Itiliztng the well is
prohibited without pr~or departmental approval.
If there are any questions, please contact this office
at 264-4720.
Sincerely,
. ~ucnnolzv R.S. ~
Senior ~nvironmental Spe~la-Iist-
mm/lib