HomeMy WebLinkAboutROCKY LEDGES TR A2GAA~-HD- I " ~
GI~'~*"~ER ANCHORAGE AREA BOROI~
Dr.r~RTMENT OF ENVIRONMENTAL OUALI'I~
3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686
REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
MAILING
LOCATION
LEGAL DESCRIPTION
SEPTIC TANK:
DISTANCE FROM WELL /."~,<~-- /
LIQUID CAPACITY ./$ ~-) GALLONS.
NUMBER OF
MATERiAL~Z~7~/2,bjz ~Z~L-~j __ ! (-~7/,'~- ~,,~ COMPARTMENTS
INSIDE LENGTH INSIDE WIDTH
LIQUID
DEPTH
SEEPAGE SYSTEM:
NUMBER OF PITS
LINING MATERIAL
NEAREST LOT LINE.
SEEPAGE PIT:
OUTSIDE DIAMETER
OR WIDTH ///_.,,~ !
DISTANCE FROM WELl ./_~'¢s~--~ /
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)
LENGTH r~ 7
, , DEPTH
, BUILDING FOUNDATION
~-~/'(~ SQ. FT.
TILE DRAIN FIELD:
FOUNDATION
DISTANCE FROM WELL
NUMBER OF.~./LINES ~B~TWEEN LINES~~LiNE ~....EACH
ABSORPTION ~A~.,~,,~ SQ, FT. LENGTH OF
DEPTH: TOP OF TILE TO FINISH GRADE
, NEAREST LOT LINE
TRENCH WIDTH
TOTAL LENGTH/
OF LINES~ /
IN. TOTAL EFFECTIVE
DEPTH OF FILTER MATERIAL BENEATH TILE
IN. ABOVE TILE~
WELL. ' I ~
TYPE ' ~t2x~~, DEPIH
NEAREST SEPTIC
LOT LINE '-- ., SEWER LINE ~ , TANK
DISTANCE FROM
BUILDING FOUNDATION.. ~'~ ~ WATER _
, SAMPLE_ , NEAREST
SEEPAGE OTHER
/ ,'._~ ~'~' , SYSTEM ///_~,) 4' , CESSPOOL -- SOURCES
DISTANCES:
7'0 ~.~ ~- t.,~..- ~
DIAGRAM OF SYSTEM
' ' GR?'TeR ANCHORAGe ARea
3500 TUDOR ROAD POUCH 6-550
ANCHORAGE+ ALASKA 9950;:
T£LEPHON£ 2?9,8656
SEWAGE DISPOSAL SYSTEM ~ APPLICATION AND PERMIT
pERMIT NO.: .....
NAME OP APPLICANT MAILING ADDRESS
I NST~LLATION LOCATION ....
,N.,~AL,~T,ON DP, SEP.,D T-- ' ~ "AGE P;T/¢~-
COMPLETION DATE ANTICIPATED
PHONE
OTHER
NOTB~ THIS PERMIT IS NOT VALID WITHOUT ~OIL, 'TEST
FINAL, INSPECTION~ ;14 HOUR NOTICE REQUIRED. RACKF'IL,LING OF ANY ISYSTEM WITHOUT FINAL, INSPECTION BY THE
HI:AL,TM DEPARTMENT AUTHORITY WILL, BE SUBJECT TO PROSI[GUTION.
MINIMUM DIll'ANGER, REQUIREMENT8
FOUNDATION TO SEPTIC TANK ~
FOUNDATION TO SEEPAGE PIT ;~ ~ . DRAIN FIELD
SEPTIC TANK TO SEEPAGE PIT ~A~L /~
~E~IC TANK ~'~ ,, ~EEPA~E PIT
~ELL TO 8E~IC ~ANK ~& ~ /
DRAIN FIELD ,,, ~~
WATER MAIN TO SEPTIC TANK ~ DRAIN FIELD
TO RIV[~. LAKE, STRE~.
CAST IRON INTO AND OUT OF B~PTIC TANK AND INTO CRIB CROSSING GAP OF
~CAVATION ~ FEET INTO UNDISTURBED ~O1~,
/
'"~ ¢ DRAIN FIELD
SEEPAGE PiT
ALSO CONSIDER AREA WELLS.
SEEPAGE PiT
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PiT
FI'I'rED WITH AIRTIGHT REM, OVABLE CAPE.
GRAVEL, BACKFILL,
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION,
/ \' ~EALTN AUT"OR'TV
OR
LICENSED DEBIGN.R
DIAGRAM OF SYSTEM
I CERTIFY THAT i AM FAMILIAR WITH THE REQUIREMENTB OF GREATER ANCHORAGE A~REA BOROUGH ORDINANCE NO. ES-BE AND THAT THE ABOVE
DESCRIBED ~YBTEM IS IN ACCORDANCE WITH SAID CODE.
... ....,...,..,o.._.
/
~EATER ANCHQRAGE AREA BORO',
DEPARTMENT OF ENV-IRONMENTAL QUA[.ITY
3500 TUDOR ROAD
ANCHORAGE, ALASKA 99502
CASE
Performed For
Leqal Descrintion: Lot Block__
This Form Re~orts Soils Log x
Date Performed
S u b d i v i s i o n ~2 rock~ Lecl~_es .Sub.
Percolation Test
7
8
9
Depth
Feet
Soil Characteristics
1
2
3
5,
6
sand~ gravel
(125)
poorly graded sands
mixed with gravel
(l~O)
Was Ground Water Encountered?
If Yes, At what Depth?
Reading
Date
Gross Time
Net Time
Depth to H20
Net Dropi
Percolation Rate Minute
Proposed Installation: Seepage Pit ~ Drain Field
De~th of Inlet Depth To Bottom Of Pit Or Trench
C~M!~ENTS:__~.~)_~s~r~y~per bedro~.~ Small amount of silt~.material
present, Hole l4'~_
Test Performed BV_/~9-~-~ ~', ~~-_' [~ata Certified By: