HomeMy WebLinkAboutEAGLE RIVER VALLEY RANCHETTES LT 8CVo.7
GAAB-HD- I
^.CHOEAGE ^.E^ BO.O . H
HEALTH DEPARTMENT
327 EAGLE ST. ANCHORAGE· ALASKA 99501 279-2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME
SEPTIC TANK:
DISTANCE FROM WELL ~,'~'~) ~'/'
LIQUID CAPACITY /0~ GALLONS.
~'~'~/ ADDRESS
~GAL DESCRIPTION
MATERIAL COMPARTMENTS
INSIDE LENGTH
PHONE __
LIQUID
DEPTH __
SEEPAGE SYSTEM:
NUMBER OF PITS
LINING MATERIAl
NEAREST LOT LINE
SEEPAGE PIT:
OUTSIDE DIAMETER
OR WIDTH '//c:~-J', LENGTH. ~"~ /, DEPTH
DISTANCE FROM WELl ~ ~/ ,BUILDING FOUNDATION
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ~/ ~ ,SQ. FT.
TILE DRAIN FIELD:
DISTANCE FROM WELL
NUMBER OF LINES
ABSORPTION AREA
DEPTH: TOP OF TILE TO FINISH GRADE
~ FOUNDATION
DISTANCE BETWEEN LINES
SQ. FT. LENGTH OF EACH LINE
DEPTH OF FILTER MATERIAL BENEATH TILE
, NEAREST LOT LINE
TRENCH WIDTH
TOTAL LENGTH
· OF LINES
IN. TOTAL EFFECTIVE
IN. ABOVE TILE
WELL: TY~EE~// ~/7~./~"/,~ ~.~ DISTANCE FROM WATER
, DEPTH , BUILDING FOUNDATION SAMPLE . NEAREST
NEAREST SEPTIC SEEPAGE OTHER
LOT LINE , SEWER LINE .. TANK . SYSTEM , CESSPOOL . SOURCES
DIAGRAM OF SYSTEM
GREATEL~?ANCHORAGE AREA ~.~.~ROUGH
ll£ALTH DEPARTMENT
$27 Eagle St. Anchorage, Alaska 99501 279-2511
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
Case No./'~ ?
NAME OF APPLICANT,
RESIDENCE ADDRESS
Box 922 E.E.
Laurence Williams MAILING ADDRESS, PHONE NO.,
LOCATION OF INSTALLATION E.R. Valley Ranchettes
LEGAL DESCRIPTION Lot 8-C N~ of S¥t~ of Sec ? T14 N Range 1 ¥1SM
,SEEPAGE PIT X ,DRAIN FIELD , OTHER
~[ob[le Home
TO BE INSTALLED BY, Dan C. Bell
ANTICIPATED DATE OF COMPLETION 15
APPLICATION TO INSTALL: SEPTIC TANK X
TO SERVE THE FOLLOWING FACILITY
FINANCED THROUGH
PERCOLATION TEST RESULTS ~1~
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
June 69
AS DESCmBEO BELOW. S~ZE O, UNiT TO.,E SERVED ~ /~,~~
/ TYPE
· SEPTIC TANK SIZE/g'P4'Pt"P TYPE ~ SEEPAGE AREA ~
DISTANCES:
DIAGRAM OF SYSTEM
/~)v-H e-alt-h-A-u;h'0 ,ity
' ' ho g, rea Boroueh~rdmanceNo 28-68 and that the
I certify that I am familiar with the requirements of Greater ^nc rage r g ' .
above described system is in accordance with said code.