HomeMy WebLinkAboutILIAMNA ACRES TR 11
_..~ ~...~--~ 1 G R ~: ~.T E R
'~~ ANCHOEAGE A"EA BOROI.'~H
HEALTH DEPARTMENT
327 EAGLE ST. ANCHORAGE, ALASKA 99501 27%2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCAI'ION ~F~z' ~"J) ~ Pr-~/v/~)/b/ ~j~
MAILING
ADDRESS
LEGAL DESCRIPTION
PHONE
SEPTIC TANK:
/
LIQUID CAPACITY /~t"~.,~ GALLONS.
MATERIAL ~' ;~,,,,,~c..~,,//./ 5,,~ NUMBER OF /
COMPARTMENTS
,&/, 0f~.-5.¢"0'7-,/'~r.~ >"'-~4-".,~ L,C~U,D
INSIDE LENGTH INSIDE WIDTH DEPTH
SEEPAGE SYSTEM: SEEPAGE
NUMBER OF PITS / OUTSIDE DIAMETER
~EAREST LOT L,NE /7 z
DISIANCE FROM WELL /~-:~¢¢"2 / BUILDING FOUNDATION.
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
, NEAREST LOT LINE
TOTAL LENGTH
OF LINES
TRENCH WIDTH
IN. TOTAL EFFECTIVE
DEPTH OF FILTER MAIERIAL BENEATH TILE:
IN. ABOVE TILE
D E p T H ~..2~,/_/,~ DISTANCE FROM . ~"~ /
, . , BUILDING FOUNDATION. 7x~ WATER
· SAMPLE "~J], NEAREST
LOr LINE ? NEAREST ..~¢*/SEPIIC ~L~ / SEEPAGE ~ / ~ OTHER
, SEWER LINE ~ , TANK SYSTEM CESSPOO ' SOURCES
DISTANCES:
Z">~ B': ,?2/
J
DIA~G RA~MM O:
DATE
APPROVED
GREATEh . ,NCHORAGE AREA;
GAAB-HD-2 Case No.
HEALTH DEPARTMENT :' ~ ~
327 Eagle St. Anchorage, Alaska 99501 ~79-2511 d~N 16 1969
SEWAGE DISPOSAL SYSTEM ~ APPLICATION & PE<~'~~'~w~':''~'ri~ ~;::::~,~mqr .,.
-(~' (,~, lb ~.~C,k .,x,t~. , C~o__.C. MAILING ADDRESS'~ o~ ~ ~ '(L~/~. PHONE NO.~&/ff ~2~
NAME OF APPLICANT ~:- e .
RESlOENCEADDRESS/~¢~~ /5~/J~ /~af LOCATION OF INSTALLATION ~0~c7 ~o,~. f~s (
LEGAL DESCRIPTION ~-~/t~' /~ ./-~ ~./,~,z~z¢ ~,~/~
aPPUCATmN TO INSTALL: SEPTIC TA,~ loc O. SaEPAGE P~T . OaAm F~aLa . OT,ER
TO SERVE THE FOLLOWING FACILITY /q
FINANCED THROUGH fJ I?~ ,~ ~7- ~.
PERCOLATION TEST RESULTS(
(,~ ~ d_go,, ,~ tq o ,~-- ¢
TO BE INSTALLED BY~-, ~-~ _k___~__ cvs. ~-~
")ANTICIPATED DATE OF COMPLETION '~-i;,-~,~ ~_
./
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
THIS IS TO SERVE AS
AS DESCRIBED BELOW.
· SEPTIC TANK SIZE
DISTANCES:
, PERMIT TO INSTALL A
SIZE OF UNIT TO BE SERVED
TYPE SEEPAGE AREA_
DIAGRAM OF SYSTEM
~TYPE
Health Authority
I certify that I am familiar with the requh'ements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the
above described system is in accordance with said code.
DATE ~' '- fr_) - t "~ APPLICANTS SIGNATU · ..~
GAAB-HD-2
GREATEK
327 E.agle s~.
.. ,NCHORAGE AREA 't )ROUGH
HEALTH DEPARTMENT ' ~
Anchorage, Alaska 99501 279-2511
Case No.
SEWAGE DISPOSAL SYS'TEM - APPLICATION & PERMIT
NAME OF APPLICANT '
RESIDENCE ADDRESS /
LEGAL DESCRIPTION
APPLICATION TO INSTALL: SEPTIC TANK
TO SERVE THE FOLLOWING FACILITY
FINANCED THROUGH '~,
PERCOLATION TEST RESULTSi
,.i: ~,', ~-, ,'. ........ : :~, ,z.(2. MA ILI N G A O D R ESS J-'; ,~ ;', '.i:; ' ~ 'f .... -', .... ' ' ~ ,PHONE N 0
,. . [t ~u~ ~(, .
.';'/?.'// LOCATION OF INSTALLATION 'i;'. x ~¥'/.~ ~ ., ·
~I <:~ ,:; ~, SEEPAGE PIT ., DRAIN FIELD , OTHER
TO BE INSTALLED BY .~.. ' ~ , i , '
)ANTICIPATED DATE OF COMPLETION .'"'" ~
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
THIS iS TO SERVE AS , PERMIT TO INSTALL A
AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED
, SEPTIC TANK SIZE
DISTANCES:
Health Authority
TYPE SEEPAGE AREA ____~ TYPE
DIAGRAM OF SYSTEM
I certify that I am familiar with the requkements of Greater Anchorage Area Borough Ordhmnce No. 28-68 and that the
above described system is in accordance with said code.
f' ~':'" .";:;": I-'"" ,¢ ' ,"}'/"' )
DATE /' /'() L. ~ APPLICANTS SIGNATURE .i~ ~ ~'~:"( d ,...- ~.[,.~...-~.r..~..~.c~.~:.~.!,. ....
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