HomeMy WebLinkAboutNORTON PARK LT 32Dld-/
GI~=~,TER ANCHORAGE AREA BOROI'~H
HEALTH DEPARTMENT
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279.2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCATION
SEPTIC TANK:
DISTANCE FROM WELLI/J'9< ~."~f.,~l~'~'~'~'il MATERIAL ~~ NUMBER OF
COMPARTMENTS
LIQUID CAPACITY _l ~ ~-(''~ GALLONS. INSIDE LENGTH INSIDE WIDTH
LIQUID
DEPTH
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS / OuTsOE DIAMETER OR WIDTH / / _, LENGTH I '~ , DEPTH_
LINING MATER~AI L_ '~'lL rZ.~ '~,¢Z.~ . DISTANCE FROM WELl ~,1~'~' ~¢,' ....
, BUILDING FOUNDATION
NEAREST LOT LiNE t.~ C
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ~' ~'~ ~SQ. FT.
TILE DRAIN FIELD:
DISTANCE FROM V~ELL FOUNDATION TOTAL LENGTH
, . b,IE~,REST LOT L NE ~ , OF LI~/~7
ABSORPTION ARE~ . ' SQ. FT. ~LENGTH oF EACH LINE / // ( ,//
DEPTH: TOP OF TILE TO FINISH GRADE
'f,
NEAREST
LOT LINE SEWER LINE_
DEPTH OF FILTER MATERIAL BENEATH TILE
IN. ABOVE TILE.
DISTANCE FROM WATER
, BUILDING FOUNDATION SAMPLE NEAREST
SEPTIC SEEPAGE OTHER
., TANK , SYSTEM. , CESSPOOL SOURCES
DISTANCES:
DIAGRAM OF SYSTEM
I'
'4 '11"--'~ I
DATE
....?"
APPROVED -',iL,
/ /
GAA B -H D-2
GREATE -
327 Eagle St.
kNCHOI{AGE AREA
ItEALTH DEPARTMENT
Anchorage, Alaska 99501
')ROUGH
SEWAGE DISPOSAL SYSYEM - APPLICA¥1ON & PERMIT
RESIDENCE ADDRESS /~L~
LEGAL DESCRIPTION
APPLICATION TO INSTALL: SEPTIC TANK. ~/'
TO SERVE THE FOLLOWING FACILITY
FINANCED THROUGH
PERCOLATION TEST RESULTS
MAILING ADDRESS~__.~/~ ~/d'~
LOCATION OF INSTALLATION
PHONE
, SEEPAGE PIT. ~ , DRAIN FIELD
,OTHER
TO BE INSTALLED BY_~"'~-/~
ANTICIPATED DATE OF COMPLETION
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
,
AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED ~7~ /"/~%~-~.~
SEPTIC TANK SIZE f'~.z~-/_) _TYPE_ ~;~7_ SEEPAGE AREA TYPE ~/~..~
DIAGRAM OF SYSTEM
DISTANCES:
I/~C ~! HEALTH AUTHORITy
OR
LICENSED DESIGNER ~ ~ t,i,~ ~
'tify that I am familiar with the requfl'ements of Greater Anchorage Area Borough Ordflmnce No. 28-68 and that the
above described system is in accordance with said code.
DATE :~'~ ~ /~ APPLICAN'rSSIGNATURE~,~(~.~-,
'REATER ANCHORAGE AREA BOROUGH
HEALTH DEPA~:THENT
327 EAGLE STREET
ANCHORAGE, A[,ASKA 99501
CASE #
' formed For /z
Le~a' Descriot~on: Lot ~ 3 Block
Th~s ~'c~m ~,'e~or~s a; Soils Log~ ~rcolatlon
Feet Soil Characteristics
Was Ground Water Encountered? .... ~/~,~,
Ii: Yes~ At What Depth
Reading
Date
Gross Time
Location Sketch
Net D~'op
......
P.."oposed notallat~on: Seepage Pit /..~ Drain F~eld
Depth Of Inlet ~'~,
Data Certified Sy:~~d~
1977
D~zzler- Szauey P. Self
Guy Vanderhook
.x,L~ i,OG
0 22 ft.
~2 39 ft.
39 ....... 57 ft.
57 ....... 79 ft.
79- 97 ft.
97 ...... 102 ft.
Sand Gravel
Gravel
Clay
Clay Gravel
Silt Sand
Gravel, Water
MUNICIPAliTy OF ANC~0
DEPl'. OF
· A~ '~OTECTIoN
RECEIVED
Bailed
x-z ft water in well