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GREP"7ER ANCHORAGE AREA BOP*IUGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME SI,XMIMS MAILING ADDRESS N220 U -da r , // PffUEL5x"]
LOCATION ;Pe -T 0e S CRee_4 LEGAL DESCRIPTION 17 /o5 S/o
SEPTIC TANK:
DISTANCE//'' % NUMBER OF
FROM WELLf.//'+�— MANUFACTURER 1rKee/Y MATERIAL $Ze-1 COMPARTMENTS
INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH _ I IQUID CAPACITY X000 GALLONS.
42Il2-Trl2611111i'
NUMBER OF PITS �. DIAMETER OR WIDTH J-&-, LENGTHJI, DEPTH
, 1
LINING MATERIAL ni Q CRIB SIZE: DIAMETER -8LDEPTH r DISTANCE FROM: WELLCo,vwA
TOTAL EFFECTIVE d
BUILDING FOUNDATIONAQL NEAREST LOT LINE . ABSORPTION AREA (WALL AREA) n % b SQ. FT.
ADDITIONAL ABSORPTION
WELL:
1
TYPE mMuNiT CONSTRUCTION
BUILDING NEAREST NEAREST
FOUNDATION LOT LINE SEWER LINE
CESSPOOL , OTHER SOURCES
APPROVED DISAPPROVED REMA
DISTANCES:
INSTALLED BY:
PIPE MATERIAL: 600-S
LOT SLOPE:
REMARKS:k��� /✓e%ice'
aT %,nrE ocrrZiw
Form No. EQ -031
10
DEPTH
DISTANCE FROM:
SEPTIC SEEPAGE
TANK SYSTEM_
DIAGRAM OF SYSTEM
DATE - 26Z2 -7 APPROVED
G.A.A.B.
R
n
• ,_.. GREATER ANCHORAGE AREA BOROUGH
r �'•
� 3 DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO.
Iplp`�� 5]50"C'•STREET ANCHORAGE. ALASKA 99501
�•� �Il fi TELEPHONE 274-4561
SEWAGE DISPOSAL SYSTEM — APPLICATION AND PERMIT
NAME OF APPLICANT MAILING ADDRESS � PHONE
INSTALLATION LOCATION
LEGAL DESCRIPTION
INSTALLATION OF: SEPTIC TANK �•' SEEPAGE PIT DR-AKINN FIELD OTHER
TYPE AND SIZE OF FACILITY TO BE SERVED
FINANCED THROUGH / TO BE INSTALLED BY
SOIL TEST RESULTS /4.�s��' NOTE* THIS PERMIT IS NOT, VALID WITHOUT SOIL TEST
COMPLETION DATE ANTICIPATED
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL SE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE 'i ���� / TYPE %tsTlr_` SEEPAGE AREA SIZE
MINIMUM DISTANCES. REQUIREMENTS - DIAGRAM OF SYSTEM -
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT '?� / DRAIN FIELD
SEPTIC TANK TO SEEPAGE PIT WALL .c..�
SEPTIC TANK SEEPAGE PIT �?� DRAIN FIELD
TO NEAREST LOT LINE. _
WELL TO SEPTIC TANK EEPAGE PIT -
DRAIN FIELD ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK /n SEEPAGE PIT �y
DRAIN FIELD �-
/7 �
SEPTIC TANK. .�ii SEEPAGE PIT ///` /,T DRAIN FIELD
TO RIVER. LAKE. STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION B FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
G.A.A.B.
OR
LICENSED DESIGNER
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.
DATE Al APPLICANT'S SIGNATURE
FORM NO. EO -014
- - CRF.A.TER AIlU'M!�^,' AEEA BOR,_,;){
HChLTii I*`PA�TMENT
32" EA.HE STREET
AL:C40RA^F, ALMA XA 95501
Perfcrited For j1 0 L
VnQuYXP
Legal Dcscriptien: Lot 9=
This Fera, Reports a: Soils Loi
Depth
LeetEcil C!.a:.__teristics
6u
Soli-t.�l6a.v�dt� o�fAue_�
Gm codes 1r1}o gnj5v1er'
—z sand -t g cauel mix fit a,e.
r�rn w1{(� uec.t 11 -Me .54
present-.
Was Ground Water Encountered? '___._ "off
e
If Yes, At What Depth
Date
CASE N
ormed_L� �
Location Sketrh
Frcposcl Installat� lie Seepa e Pit ✓ Drain rield
Dept}, 0.' Inlet !,Cntn ;o bcttoa Of Fit Or Trenc
COM '3EtiT8:. 4; r,..t77 a r_ vin i i c c [v/ 1.1 Al _
PII^L
1 J
Test Performed St•: Z'j r
Data Certified Ey: Date ,
GREATER ANCHORAGE AREA BORDUGH
Department of Environmental Quality
3330 'Ce Street. Anchorage. Alaska 99503 274-4561
Date Received September 20, 1973
Time of Inspection
Date of Inspection September 20, 1973
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER b WATER FACILITIES
FOR
Conventional
1. Aoproval Requested By: Kr. Tom Ott]"
Address, P.O. Box 8869 Anchorage AK 99508 Phone:
2. Pronerty Owner: Glen Reed Phone*
3. Legal Description: Lot 109 Dawn Subdivision
4. Locations Peters Creek
5. Type of Facility to he Inspected: Single.Family Dwelling
Numher of Bedrooms: Two !21
6. Well Datas
A. Type community B. Depth
C. Construction
7. Sewage Disposal System:
D. Bacterial Analysis
A. Installed 1973 __ 9. Installer
C. Septic Tank: 1. Size 1000 Galt. Manufacturer Greer
D. Seepage Pit$ I. Size 14'x13'x62. Material Steel
E. Disposal Field: Total Length of Lines
B. Distances:
A. Wsll Toe Septic Tank__ , Absorption Area Sewer Lines
Nearest Ldp Line Other Contamination
B. Foundation to Septic Tank '> Absorption Ares
C. Ansorption Area to Nearest Lot Line
r
Rngnast for Approval of andividusl Sewer 6 Mater Facilities j
Page Two
9. Comments$
Dissoproved
Approval valid for One Year From Date Signed
Anchorage Area 9orough, Department of Environmental Quality
DIAGRAM OF SYSTEM
I certify that the information Contained in this request for approval to be a true
and accurate representation of the subleet sewer and water facilities located Ott
Signed Date