HomeMy WebLinkAboutBRUCE Lots 3 & 4GAAB-HD-I
Ge:ATER ANCHORAGE AREA BOROI'~H
HEALTH DEPARTMENT
.... 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCATION
SEPTIC TANK:
PHONE
DISTANCE FROM WELL
LIQUID CAPACITY
GALLONS.
MATERIAL ~A~' ~ ~-~. 2)"~.
INSIDE LENGTH. '~ !
~(~/j~ ~,. NUMBER OF
COMPARTMENTS
INSIDE WIDTH ~i
!
LIQUId"'"'/ r~ .~
DEPTH f~-L----..~--~r
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS
LINING MATERIAl
NEAREST LOT LINE
OUTSIDE DIAMETER OR WIDTH
DISTANCE FROM WELL
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)
LENGTH , DEPTH
BUILDING FOUNDATION__
SQ. FT.
TILE DRAIN FIELD:
DISTANCE FROM WELL /~ 7
NUMBER OF LINES /
ABSORPTION AREA ~C~O /'~
DEPTH: TOP OF TILE TO FINISH GRADE
, FOUNDATION.
DISTANCE BETWEEN LINES
SQ. FT. LENGTH OF EACH LINE
NEAREST LOT LINE
TRENCH WIDTH
DEPTH OF FILTER MATERIAL BENEATH 'fILE.
TOTAL LENGTH, .
, OF LINES lOG
IN. TOTAL EFFECTIVE
IN. ABOVE TILE
WELL: TYPE ~.,t'j/~'~ , DEPTH ,~"~'
LOT LINE ~ ! NEAREST ~._.~ i SEPTIC
SEWER LINE , TANK
DISTANCE FROM ,~,',.,.J WATER
, BUILDING FOUNDATION. JmJ'/Z,)w SAMPLE
,1~ ~_j SEEPAGE j ,~,.."~ ~
SYSTEM ,CESSPOOL
, NEAREST
OTHER
, SOURCES__
DISTANCES:
DIAGRAM OF SYSTEM
DATE
APPROVED
GAAB-HD-2
GREATEr.
327 Eagle St.
/ANCHORAGE AREA . ~)ROUGH
HEALTH DEPARTMENT
Anchorage, Alaska 99501 279-2511
Case No. ~
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
RESIDENCE A.I]43 R~$S.~'~ &~r// ~2,,~ ~.~
,.~D,~ri ~ ;~.e. .~Tw~ ~, LEGAL DESCRIPTION
APPLICATION TO INSTALL: SEPTIC TANK ~ ,SEEPAGE PIT,
TO SERVE THE FOLLOWING FACILITY
FINANCED THROUGH ,~'d'~//V~'
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
MAILING ABBRES~<:~O~ ~/~.~/~' PHONE
, DRAIN FIELD , OTHER
TO BE INSTALLER BY ~.~/f
ANTICIPATED DATE OF COMPLETION
THIS IS TO SERVE AS ~~~~~-~ PERMIT TO INSTALL A
AS DESCRIBED BELOW, SIZE OF UNIT TO 'BE SERVED
.SEPTIC TANK SIZE ,,)'7~"~) TYPE ~EEPAGE
DISTANCES:
/ /Health AuthOrity--
certify that ! am familiar with the requh'eme~ts of C-reate~ A~cho~a~e
~bove described system is ~ accordance with sa~d code.