HomeMy WebLinkAboutDEBORA #2 BLK E LT 330
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GRE/` "" ANCHORAGE AREA BOF"M
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME 6lo"It°'1 KCai MAILING ADDRESS � ?99 A(erty Vrrine PHONE 61V -,2211q
LOCATION 7M LEGAL DESCRIPTION 33 Q/nzk F �cGF,a�, dpi
SEPTIC TANK/:: uco� /Mo
DISTANCE NUMBER OF
FROM WELL 1" MANUFACTURER �54e1" Fav -MATERIAL �COMPARTMENTS—/
INSIDE
OMARMENTS—
INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH I IQUID CAPACITYIft GALLONS.
SEEPAGE PIT:
NUMBER OF PITS DIAMETER !(-PL OR WIDTH!lZ, LENGTH, DEPTH
I �
LINING MATERIAL Lca CRIB SIZE: DIAMETER DEPTH DISTANCE FROM: WELL.
�,,''''1 1 TOTAL EFFECTIVE
BUILDING FOUNDATION, NEAREST LOT LINE 7 ABSORPTION AREA (WALL AREA) SQ. FT.
ADDITIONAL ABSORPTION
WELL:
TYPE I'f �� CONSTRUCTION-'"""�aFN DEPTH
DISTANCE FROM:
BUILDING NEAREST NEAREST SEPTIC SEEPAGE
FOUNDATION LOT LINE , SEWER LINE , TANK -,SYSTEM.
CESSPOOL , OTHER SOURCES
APPROVED DISAPPROVED REMARKS
DISTANCES:
INSTALLED BY:
I
PIPE MATERIAL:
64) /•
LOT SLOPE: IQ
REMARKS:
DATE
Form No. EQ -031
DIAGRAM OF SYSTEM
i�
T •�
E-- $ `'
ROVED
GREATER ANCHORAGE AREA BOROUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C" STREET ANCHORAGE. ALASKA 99303
TELEPHONE 274-4561
SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT
NAME OF APPLICANT
INSTALLATION LOCATION
LEGAL DESCRIPTION —
INSTALLATION OF: SEPTIC TANK
TYPE AND SIZE OF FACILITY TO BE
Lo -t
MAILING
DRAIN FIELD
PERMIT NO.
PHON_ -`;?
OTHER
FINANCED THROUGH TO BE INSTALLED B
SOIL TEST RESULTS l''�"' 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 BE SUBJECT TO PROSECUTION.
SEPTIC TANK S1ZE
SEEPAGE AREA SIZE
MINIMUM DISTANCES. REQUIREMENTS
FOUNDATION TO SEPTIC TANK 2-'
`
FOUNDATION TO SEEPAGE PIT DRAIN FIELD
SEPTIC TANK TO SEEPAGE PIT WALL 94P %n
SEPTIC TANK - SEEPAGE PITS DRAIN FIELD
TO NEAREST LOT LINE.
leo ��
WELL TO SEPTIC TANK ---� SEEPAGE PIT
DRAIN FIELD ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK SEEPAGE PIT
DRAIN FIELD
SEPTIC TANK. " /J j)
- SEEPAGE PIT oO .DRAIN FIELD
TO RIVER. LAKE. STREAM.
`CAST IRON INTO AND OVT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION B FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRnN SIPHON PIPES ON SEPTIC TANK AN
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO BO UGH EGULATIONS REGARDING INSTALLATION.
G.A.A.B.
OR
LICENSED DESIGNER
DIAGRAM OF SYSTEM
I CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.58 AND THAT THE ABOVE
DESCRIBED YSTEM IS IN ACCORDANCE WITH SAID CODE.
DATE APPLICANT'S SIGNATURE
FORM NO. E o"
GREATER ANCHORAGE AREA BOROUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY Case #
3330 "C" Street
ANCHORAGE, ALASKA 99503
Performed For Dated Performed WIZ73
Legal Description: L t 3i—Block E' Subdivision_�t)ebnr,,_-+-.a,
This Form Reports Soils Log X Percolation Test
- Soil Test Must Be Logged To 4' Below Proposed Seepage System -
Depth
Feet
Soil Characteristics
1—
2—�
3—
S rn'�So
4-f
5-}
3w 'a
6—
7—
B—
5rn 25�
9—
10—
11—
12—
w - ss
13—
14—
Was Ground Water Encountered? no
If Yes, At What Depth?
mmmmm��
Reading Date Gross Time Net Time Depth to H2O Net Drop
rercoiation Kate minute
Proposed Installation: Seepage Pit Drain Field
Depth of Inlet Depth to ottom of Pit or TrencE
COMMENTS:
Test Performed BY /%Lw.c f�,t,«� 0 Date Certified BY:
Date: