HomeMy WebLinkAboutJOHN WELLS 1952 ADDITION BLK 2 LT 10ID
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GAAB HD-I
Gg''~'TER ANCHORAGE AREA BOROI"-H
B~..AFITMENT OF ENVIFIONMElYTAL QUAL~
3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME ~z~?_?J'._Z_'_'/'~_~'/f/~:L~/j=':: ADDRESS ~ - - PHONE
- .5~1'-tC- TANK:
DISTANCE FROM WELL .....
LIQUID CAPACI1Y_ _/~,:~ d:~/_ ........... GALLONS.
· , NUMBER OF /..,/
MATERIAL >:/ .:~' :,:: - COMPARTMENTS
/ - LIQUID
INSIDE LENGI'H ~'-~ INSIDE WIDTH ~DEPTH.__
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS ......... .~:~SIDE DIAMETER OR WI , LENGTH , DEPTH
LINING MA1ERI:~L.--z_ ~. DISTANCE FROM WELt ~< ._ ~, BUILD-jNG FOUNDATION_ ' __
NEAREST LOT LINE ............... TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) .SQ. FT,
TILE DRAIN FIELD:
DISTANCE FROM WELl . ,~'O~UNDATION_
NUMBER OF LINES .... __.~.._~_ __DISTANCE BETWEEN LINES__
ABSORPTIONS-REA SQ. FT. LENGTH OF EACH LINE
DEPTH: TOP OF TILE TO FINISH GRADE
, N EA R EST -l:®~x.~N E
TOTAL LENGTH
OF LINES
.IN. TOTAL EFFECTIVE
DEPTH OF FILLER MATERIAL BENEATH TILE
IN. ABOVE TILE
WELL:
LOT LINE
~ ~ DISTANCE FROM WATER
...... D E PTH /'~¥~ ~ ' ____
BUILDING FOUNDATION. _~ SAMPLE /'[/'~:~ NEAREST
NEAREST 'SEP~ (~.~ , -
~ SEEPAGE ~// OTHER
SEWER LINE ~/) ~' , TANK .~:: .5
...... SYSTEM____--
DISTANCES:
DIAGRAM OF SYSTEM
APPROVED__
GRE>~'ER ANCHORAGE AREA BON.,.JUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3500 TUDOR ROAD POUCH 6-650
ANCHORAGE, ALASKA 99502
TELEPHONE 279-8686
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
PERMIT NO,
r.> d./~ £;/~/d_/_~.,:'// ./~L/d. /,.-> ~/-:: ~/~.
SOIL TEST ~ESULT$ ,~:~///~: NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
co o. AT* *.
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION.
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT , DRAIN FIELD
SEPTIC TANK TO SEEPAGE PIt WALL /', ~
WE LLTO SEPT]CTANK e~ , SEEPAGE PIT
SEPTIC TANK, ~2~ ~ /
~ SEEPAGE PIT ~/~ DRAIN FIELD
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.
DR
DIAGRAM OP SYSTEM
I CERTIFY THAT ] AM FAMILIAR WITH THE REQUIREMENTS OF GREATER A~j~HORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
:/:,:,// :::,.
DATE ..... APPLICANT'S SIGNATUR~ ?~:~::~: '
GRE',~'ER ANCHORAGE AREA BO¼OUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3500 TUDOR ROAD POUCH 6-SS0
ANCHORAGE. ALASKA 99502
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
' /,¢ 2 ,-' .- . .,. ~.t.; , . . ,,
INSTALLATION OF: SEPTIC TANK /' - /-';
SEEPAGE PIT DRAIN FIELD ., OTHER
SOIL TEST RESULTS
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING Of ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE ¢ / r' TYPE . ] /i;,,..:..~ '~ : :
NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
SEPTIC TANK, _, SEEPAGE PIT '
TO RIVER, LAKE, STREAM.
SEEPAGE PIT
ALSO CONSIDER AREA WELLS.
, DRAIN FIELD
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 W]TH THE REQUIREMENTS OF GREATER AiXLCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE.
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