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GRE~-~R.. ANCHORAGE AREA BORC ~GH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
DISTANCE /~]'O/9(3~;./) .~, NUMBER OF
FROM WELL / MANUFACTURER ~-CZ~ MATERIAL~(~A~ COMPARTMENTS ~
INSIDE LENGTH ~ INSIDE WIDTH ~ LIQUID DEPTH '~ .LIQUID CAPACITY /~ GALLONS.
SEEPAGE PIT: f '
NUMBER OF PITS / DIAMETER '"~ OR WIDTH /~ , LENGTH '~, DEPTH //
LINING MATERIAL ~/~/~ CRIB SIZE: DIAMETER ~ DEPTH DISTANCE FROM: WELL~ /~"
BUILDING FOUNDATION ~ , NEAREST LOT LINE~O /~ TOTAL EFFECTIVE
ABSORPTION AREA (WALL AREA) ~ ~ SQ. FT.
ADDITIONAL ABSORPTION
WELL: ,
TYPE
BUILDING
FOUNDATION __
CESSPOOL
APPROVED
CONSTRUCTION
NEAREST
LOT LINE
OTHER SOURCES
DISAPPROVED
DEPTH DISTANCE FROM:
NEAREST SEPTIC SEEPAGE
SEWER LINE TANK_ SYSTEM
REMARKS
DISTANCES:
INSTALLED BY: ~tCt-tfi~b YE~--C~
PIPE MATERIAL:
LOT SLOPE:
REMARKS:
Form No. EQ-031
DIAGRAM OF SYSTEM
GrEATeR ANCHORAGE AREA BorouGh
DEPARTMENT OF ENVIRONMENTAL QUALITY
33:30 "C" STREET ANCHORAGE, ALASKA 99503
TELEPHONE 274-456 !
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
PERMIT NO..
PHONE
INSTALLATION LOCATION
INSTALLATION OF: SEPTIC TANK ' (~ SEEPAGE PIT
TYPE AND SIZE Of FACILITY TO BE SERVED
DRAIN FIELD ., OTHER
FINANCED THROUGH
SOIL TEST RESULTS
NOTE: THIS PERMIT IS NOT~ALID 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.
TYPE ~/'~'~"~'~;~' ~'~- SEEPAGE AREA SIZE
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT ~ , DRAIN FIELD
SEPTIC TANK TO SEEPAGE Pit WALL
SEPTIC TANK , SEEPAGE PiT¢~~ DRAIN FIELD
TO NEAREST LOT LINE.
WE~TD SEPTICTANK --?-- SEEPAGE PIT
DRAIN FIELD ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK , SEEPAGE PIT
DRAIN FIELD
,
SEPTIC TANK,//~//'----?--~'~ SEEPAGE PIT , DRAIN FIELD
TO RIVER, LAKE, STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP 0F
EXCAVATION 5 FEET [NTO~N~ISTLrR~ED SO~L.
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.
DIAGRAM OF SYSTEM
I CERTIFY THAT [ AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
DSSCRISSD SYSTEM iS IN ACCORDANCE WITH SAID CODS.~/~~ .~~, ,/ ~
DATE APPLICANT'S SIGNATURE ~
Russell Oyster
694-2774
Civil Engineering
Soils ~t Foundations
0 E~ E EIV~-~NEERING 6' DEVELOPed,tENT CO.
Performed for: Name:
Legal Description:
Depth (feet)
0
Box 90, Davis St., Eagle River, Alaska 99577
694-2774 or 333-5240
SOIL LOG
Earl Ellis
333-5240
Surveying
Land Development
Mailing Address: '~.~(~5 ~. ~'?J~ ~C~.~'~'~'c~,
Soil Characteristics
7
10
ll
12
Ground ~ater £ncountered: Yes
Proposed Installation:
Comments: ~q~
Performed by:
Seepage Pit__
__ No "--~ If yes, what depth__
~ Drain Field