HomeMy WebLinkAboutROBERT BROWN LT 3B
GR,~TER ANCHORAGE AREA BORO!'~%H
HEALTH DEPARTMENT
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
ADDREssMAILING ~4~'7 6)'~(~i,/~-./'~~) PHONE
GALLONS.
MATERIAL
INSIDE LENGTH
r'd,49~Z./Y- NUMBE. OF
gOMPARTMENTS
LIQUID
INSIDE WIDTH : /
~ DEPTH.~
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS / OUTSIDE DIAMETER
LINING MATERIAL-'~),/~ u j~c/~' q ~'?~J/]~J('")J
I
NEAREST LOT LINE /~:'~ /
OR WIDTH
D,STANCE FROM WEL' /725¥
.LENGT. / 5--.DEPT" &/,
, BUILDING FOUNDATION 8'-~-/.
TILE DRAIN FIELD:
DISTANCE FROM WELL
NUMBER OF LINES
FOUNDATION
DISTANCE BETWEEN LINES
, NEAREST LOT LINE
TRENCH WIDTH
TOTAL LENGTH
OF LINES
IN. TOTAL EFFECTIVE
ABSORPTION AREA
DEPTH: TOP OF TILE TO FINISH GRADE
SQ. FT.
LENGTH OF EACH LINE
DEPTH OF FILTER MATERIAL BENEATH TILE
IN. ABOVE TILE.--
WELL:TypE'~/CC~J~DEPTH. 6 /' OISTANCEFROM ~5-'/ WATER ~0
, , BUILDING FOUNDATION. SAMPLE. , NEAREST
('"~/t~~ '/ NEAREST ¢~ / SEPTIC SEEPAGE /~ .~ / '
LOT LINE , SEWER LINE TANK ~ / OTHER
· , SYSTEM / ~) , CESSPOOL ~ , SOURCES
DISTANCES:
¥_~ ~. -
DIAGRAM OF SYSTEM
"" 0ROUGU
GREATEL ANCHORAGE AREA
ItEALTH DEPARTMENT
397 Eagle St. Anchorage, Alaska 99501 g79-2511
Case No. /7~
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
NAMEOF APPLICANT /~0 Jz,~'-
LEGAL DESCRIPTION
APPUCATION TO INSTALL'. SEPTIC TANK
TO SERVE THE FOLLOW~N~ FAC~UTY
FINANCED THROUGH
PERCOLATION TEST RESULTS
MAILING ADDRESS .__~ZO'? ,._~/:~___-Az, C~NE
!
LOCATION OF INSTALLATION /~'5~
TO BE INSTALLED BY ~
ANTICIPATED BATE 0F COMPLETION
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT ~
THIS IS TO SERVE AS /'~"~, ~~/---~ PERMIT TO INSTALL A ,,.~-O_~L/L~./L~.~.~
AS DESCRIBED BELOW. SIZE OF UNIT TO B/E~SERVED ~gt/
· SEPTIC TANK SIZE 7~'=)'-7--~ TYPE C'~~t~EEPAGE AREA ,.~z/~' TYPE
DIAGRAM OF SYSTEM ._.
/ ~/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.