HomeMy WebLinkAboutCHRISTOPHER PARK Block 1 Lot 91s c.Ct'
G~"A?I~R ANCHORAGE AREA BOROm~q
HEAL?H DEPARTMI~NT
327 ~:AGLE ST. ANCHORAGE, ALASKA 9950! 279-2511
N? 373
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME 5 MA,.NO. ,
ADDRESS~O~ 1~; ~)O~. PHONE
~ ~ v - LEGAL DESCRIPIION
SEPTIC TANK:
DISTANCE FROM WELL
u~uo CAPAaTY Z:~TO
MATERIAL ~"~b~'~' ' ~'~' NUMBER OF
COMPARTMENIS
GALLONS. INSIDE LENGTH /~' (~' /~70 LIQUID
INSIDE WID~H DEPTH
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER GE P~TS/~OUTS~DE D~AMETER_
NEAREST LOT LINE ~ ~'~'~:~'?'"~'~ TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)
LENGTH lq , DEPTH
~'-~ ' i¥'
OR WIDTH
.D,BTANCE FROM WEU /f~'
BUILDING FOUNDATION
.SQ. FT.
TILE DRAIN FIELD:
DISTANCE FROM WELL FOUNDATION ., NEAREST LOT LINE
NUMBER OF LINES /,~/TRENCH WID
ABSORPTION AREA SQ, FT. LENGTH OF EACH LINE
TOTAL LENGTH
. OF LINES
.~--~-~'TI~ I-"~'A L EFFECIIVE
DEPTH: TOP OF TILE TO FINISH GRADE
DEPTH OF FILTER MATERIAL BENEATH TILE
DEPTH__,,?j~//~//~(~ytu DISTANCE FROM WATER
BUILDING FOUNDATION SAMPLE
NEAREST SEPTIC ~-~' S[EPAGE //~ '
LOT LINE ., SEWER LINE , TANK , SYSTEM , CESSPOOL
IN, ABOVE TILE
., NEAREST
OTHER
, SOURCES___
DISTANCES:
DIAGRAM OF SYSTEM
DATE
GREATEF
327 Eagle St.
NCHORAGE AREA ""ROUGH
HEALTH DEPARTMENT
Anchorage, Alaska 99501 279-2511
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
PHONE NO.__
NAME OF APPLtCANT/~~/~/~fl//4//~'/=~z~//'~&<y' - MAILING ADDRESS
LEGAL DESCRIPTION ~?~ ~ ': 7~, _2y~3
APPLICATION TO INSTALL: SE~TICTANK ~,SEEPA~E~IT_ ~ ,gRAIN FIELD .... OTNER
TO SERVE THE :OLLOWlNG FACHJTY. -: ~~2
F~UAUCE~ TH~OUGU 3:~ TO ~E mSTALLS~ ~.~z~:~:~/~:
PEROOLATION TEST ~ESULTS :~ ANTICIPATED DATE OF COMPLETION ~
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED --~ -~~Y
~/~/~ DIAGRAM OF SYSTEM
DISTANCES:
:'/: ~/// ~z~:~
1 certify that I am familiar with the requirements of Greater Anchorage Arca Borough Ordhmnce No. 28-68 and that the
above described system is in accordance with said code. fl:Y- ;/~: Y~
Depth
Feet
_
iEATER ANCHORAGE AREA BOROUGH
HEALTH DEPARTMENT CASE
327 EAGLE STREET
ANCHORAGE, ALASKA 99501
Legal Descrip~on: Lot ~<. Block . Subd/~6n
This Form RepoPts a. Solls Log .... ~__~es~
$oil Chavacterlstics Location Sketch
if Yes, A!' :U'at ' ~
Depth To HpO
Net Drop