HomeMy WebLinkAboutEAGLE RIVER VALLEY RANCHETTES LT 7BVo.I I
ANCHORAGE AREA BOROU-~-,H
HEALTH DEPARTMENT
327 EAGLE ST. ANCHORAGE, AI.ASKA 99501 279-2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
_ ADDRESS
SEPTIC TANK:
PHONE
DISTANCE FROM WEL~'-'~"'"'~ /'
LlOUl0 CAPACITY GALLONS.
MATERIAL .COMPARTMENTS
LIQUID
__DEPTH
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS / OUTSIDE DIAMETER OR WIDTH /~'-
LINING MATERIAL_~-J~-J/./7~ ~//V~'~ .DISTANCE FROM WELL ~"<~ ~'
NEAREST LOT LINE ~:~' / TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)
LENGTH ~/? , DEPTH
,BUILDING FOUNDATION~___~.
TILE DRAIN FIELD:
DISTANCE FROM WELL
NUMBER OF LINES
ABSORPTION 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
'. WATER
SAMPLE.
WELL: TypE'~_.Z~. UTil.-.I TII~-~ DISTANCE FROM
, DEPTFI~ . ,BUILDING FOUNDATION.
NEAREST SEPTIC SEEPAGE
LOT LINE , SEWER LINE. , TANK , SYSTEM , CESSPOOL
DIAGRAM OF SYSTEM
DISTANCES: ............................. ' ,': .... t :-'. ~ : ...... '" ":': J .......
j '':' :" ' i"~ : :" ';! , i ........
............ :-i: ................... 7-~"~J~?/~,~:~'::''. ................. ~ ........ ~ .... . :~
~ : .... : ~ ~ 1 ......
, NEAREST
OTHER
· SOURCES
GREATEI,.. ANCHORAGE AREA
327 Eagle St. Anchorage, Alaska 99501 279~.~5 '11
SEP 23 1969 ;
SEWAGE
NAME OF APPLICANT
RESIDENCE ADDRESS
LEGAL DESCRIPTION
DISPOSAL SYSTEM - APPLICATION & PERMIT ~
~,~ :,; !,~2.EOIIAGE A ?uTJ~, ~
MAILING ADDRESS.~V~ e03 C~. PHONE NO .... ~
SEEPAGE PIT L.---, DRA~N FIELD
TO BE INSTALLEB Ry
APPLICATION TO INSTALL: SEPTIC TANK
TO SERVE THE FOLLOWING FACILITY
FINANCED THROUGH ../~/
PERCOLATION TEST RESULTS
, OTHER
ANTICIPATEO BATE OF COMPLE.TION, ~ ~'f/~ ~ ~" ~'
T.,S ,S TO SERVE AS ,PERM,TTO,NSTALLA
.AS D~R,,ED ,EL0W. SiZ~ 0, ,,~ ~0 ,~ S~,V,~ ~ ~, ~/
. SE~IC TANK SIZE /~ ~ 0 TYPE ~ ~
DIAGRAM OF SYSTEM ~"
DISTANCES: ~
~. ~,~
Health 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.