HomeMy WebLinkAboutDEBORA #2 BLK F LT 17GREA .ER ANCHORAGE AREA BOR. AH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME M KS t o P4 V J/&"/A/ MAILING ADDRESS
I Or ATI nN
SEPTIC TANK: 11 _
DISTANCE �fSrf" sep1r�` T$N�� NUMBER OF
FROM WELL MANUFACTURERMATERIAL �I L��' ,_COMPARTMENTS
INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY GALLONS.
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TILE DRAIN FIELD:
77 P i r TOTAL LENGTHp�
DISTANCE FROM WELL L7 Z FOUNDATION—_0 NEAREST LOT LINEOF LINES �llll
t2 I/
NUMBER OF LINES R / DISTANCE BETWEEN LINES—TRENCH
eWIDTH — IN. TOTAL EFFECTIVE
ABSORPTION AREA v�`' SQ. FT. LENGTH OF EACH LINE ` /! T (/ ,
gZ Fr DEPTH OF FILTER
DEPTH: TOP OF TILE TO FINISH GRADE MATERIAL BENEATH TILE 6/PIN. ABOVE TILE IN.
Rl �t6
WELL:frr�Tf � PwI3
TYPE CONSTRUCTION DEPTH DISTANCE FROM:
BUILDING
NEAREST
NEAREST
SEPTIC
SEEPAGE .` Z
FOUNDATION_,
LOT LINE ,
SEWER LINE
, TANK ,
SYSTEM ,
CESSPOOL
, OTHER SOURCES
APPROVED
DISAPPROVED
REMARKS
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WEER •QQ 2G�F
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DISTANCES:
INSTALLED BY:
SEWER LINE DEPTH:
PIPE MATERIAL:
LOT SLOPE:
REMARKS:
Form EQ -032
DIAGRAM OF SYSTEM
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DATE �K APPROVED
G.A.A.B. —
VN
`V
NAME OF APPLICANT
INSTALLATION LOCATION
LEGAL DESCRIPTION
INSTALLATION OF:
GRED R ANCHORAGE AREA BOf — IGH
DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO.
5550"C"STREET ANCHORAGE, ALASKA 99507
TELEPHONE 274-4581
SEWAGE DISPOSAL SYSTEM — APPLICATION AND PERMIT .;z -n.
TYPE AND SIZE OF FACILITY TO BE SERVED
FINANCED THROUGH
SOIL TEST
COMPLETION DATE ANTICIPATED
MAILING ADDRESS /9E6 pNOryE
NOTE, THIS PERMIT 15 NOT VALID WITHOUT SOIL TEST
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 S12E TYPE SEEPAGE AREA SIZE TYPE
,uct i laa oM )ICL r ,-
MINIMUM DISTANCES. REQUIREMENTS DIAGRAM OF SYSTEM ltitcGS
FOUNDATION TO SEPTIC TANK
�y �c.c. Sern� v6ctc
FOUNDATION TO SEEPAGE PIT D'R,A IIN FIELD �.
SEPTIC TANK TO SEEPAGE PIT WALL 1'✓ LL S
SEPTIC TANK SEEPAGE PIT
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK
DRAIN FIELD
WATER MAIN TO SEPTIC TANK
DRAIN FIELD
SEPTIC TANK, SEEPAGE PIT
TO RIVER. LAKE. STREAM.
DRAIN FIELD
SEEPAGE PIT
ALSO CONSIDER AREA WELLS.
SEEPAGE PIT
DRAIN FIELD
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION S FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.Of ��p .e�►
GRAVEL BACKFILL P2 z7Z
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
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4,21
.A.A.S.
OR
LICENSED DESIGNER
1 CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.88 AND THAT THE ABOVE
ESCRIBED SYSTEM IS IN ACCORQANCE WITH SAID CODE.
E APPUCANT'S SIGNATURE
1 NO. EQ -6I4
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■
■ENNEN
0 MEN
1 CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.88 AND THAT THE ABOVE
ESCRIBED SYSTEM IS IN ACCORQANCE WITH SAID CODE.
E APPUCANT'S SIGNATURE
1 NO. EQ -6I4
}p TO
i SUBJECT
0
DUPLICATE
X
AT
DATE SIGNED - -
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P SEND ►ARi7 I AND 7 WITH CARBON INTACT
4S 469
►AR 7 WILL BE RETURNED WITH REPLY
DETACH AND FILE FOR FOLLOW-UP
DETACH AND FILE FOR FOLLOW-UP
TAP
a
1
DATE
SIGNED
DETACH AND FILE FOR FOLLOW-UP
TAP
a
DATE
SIGNED
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4S 4169
SEND PARTS 1 AND S WITH GE60N INTACT -
NA" • Wui •E anuamm WITH EErtT 11
DETACH AND FILE FOR FOLLOW-UP