HomeMy WebLinkAboutPREUSS #3 BLK 10 LT 8050
GRE/~ eR ANCHORAGE AREA BOP
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
DISTANCE ,...~, NUMBER OF
FROM WELL ,~ ~/- . MANUFACTURER ~"~/~'~/~/~/~ ~ MATERIAL ~/~/¢-¢'¢'/r~/- //~/~[//~?COMPARTMENTS
INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY -/,/)('~"~
GALLONS.
NUMBER OF PITS DIAMETER
LINING MATERIAL
BD,LD,NG FOUNDAT,ON
ADDITIONAL ABSORPTION
OR WIDTH
CRIB SIZE: DIAMETER
NEAREST LOT LINE
LENGTH DEPTH
DEPTH DISTANCE FROM: WELL
TOTAL EFFECTIVE
ABSORPTION AREA (WALL AREA) SQ. FT.
WELL:
BUILDING
FOUNDATION /~
CESSPOOL
APPROVED
CONSTRUCTION
NEAREST
LOT LINE
OTHER SOURCES
DISAPPROVED
NEAREST //~ SEPTIC
SEWER LINE /'0 ' , TANK
REMARKS
DISTANCE FROM:
SEEPAGE
SYSTEM
DISTANCES:
LOT SLOPE:
REMARKS:
Form No. LQ-031
DIAGRAM OF SYSTEM
SEWAGE
GREA ;R ANCHORAGE AREA BCE jGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C" STREET ANCHORAGE, ALASKA 99503
TELEPHONE 274-4561
DISPOSAL SYSTEM -- APPLICATION AND PERMIT
NAME OF AFPL,CANT Z-¢
INSTALLATION LOCATION
INSTALLATION OF: SEPTIC TANK ~'~/~/ ''~ "/~)~/'~'~ SEEPAGE Pit
TYPE AND SIZE Of FACILITY TO BE SERVED ~~
FINANCed THROUGH TO BE INSTALLED BY
SOIL TEST RESULTS //~"~ /~ / ~'~)~'~'~ ~: ! -- ~ /
., DRAIN FIELD
COMPLETION DATE ANTICIPATED
NOTE= THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
· ~¢2,,,~ t.' Ix/--( 2'n cc. L/it ~"x'>'-.,';~--,' ~'.-,/
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 SIZE
TYPE
MINIMUM DISTANCES, REQUIREMENT~
FOUNDATION TO SEPTIC TANK
FOUNDATION TO S~A~ , DRAIN FIELD
SEEPAGE AREA SIZE
SEPTIC TANK TO SEEPAGE PIT WALL
SEPtiC TaNK ~'!
TO NEAREST LOT LINE.
/
WELL TO SEPTIC TANK
/
DRAIN FIELD
/(~ /
., DRAIN FIELD
SEEPAGE PIT
ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK
DRAIN FIELD
SEPT]C TANK, ///~'-~ /.. SEEPAGE PIT
TO RIVER, LAKE. STREAM.
SEEPAGE PIT
, DRAIN FIELD
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP Of
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAge PIT
PITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL ~// ~' / > ~/~ ~-62 LC ~
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION,
TYPE
DIAGRAM OF SYSTEM
OR
LICENSED DESIGNER
CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GrEATEr~¢RAge AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
(~~HO~-~GE: AREA BOROUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C" STREET ANCHORAGE, ALASKA 9950:3
TELEPHONE 274-456!
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
PERMIT NO.
INSTALLATION OF: SEPTIC TANK ~ SEEPAGE Pit
, DRAIN FIELD ' . OTHER
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.
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.
WELL TO SEPTIC TANK ./~J , SEEPAGE PIt
DRAIN FIELD / C~ / ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TA~K , SEEPAGE PIT
DRAIN FIELD ~ ~/ .
SEPTIC TANK, . ~/~ . SEEPAGE PIt .ff~ / ~ DRAIN FIELD
SEEPAGE AREA SIZE
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INST,~LLATION.
OR
DIAGRAM OF SYSTEM
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.
~.~/O ~ E GEoTEcHNICAL ~' DEVELOPMENT CO.
Box 90, Davis St., Eagle River, Alaska 99577
694-2774 or 688-2280
Russell Oyster
694-2774
Soils Et Foundations
Earl Ellis
Land Development
SOIL LOG
Performed for:
Legal Description:
Depth (feet)
0
1
2
3
4
,5
Sotl Characteristic;
8
g
lO
ll
12
Ground Water Encountered:
/
Yes No
Proposed Installation:
Co~ents:
Seepage Pit______
If yes, what depth
Drain Fie~d
Performed by: Date: