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HomeMy WebLinkAboutDRAKE BLK 2 LT 8C7 GAAB-HD-I GE' TER ANCHORAGE AREA BOROI' H DI:rARTMENT OF ENVIRONMENTAL 9UALIb, 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING NAME ~'-'/~2f,~-~/~'z((--- '~/[/~ ~-~', . ADDRESS LOCATION ~-/~/I/'~'~r/~ 7: /~),4~/-/-~/"c.~) ,~7~, LEGAL DESCRIPTION. SEPTIC TANK: DISTANCE FROM WELL~O<~/ LIQUID CAPACITY /~O GALLONS. M AT E R i Ab.~,~.._,~/.~ NUMBER OF COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH SEEPAGE SYSTEM: NUMBER OF PITS LINING MATERIAL NEAREST LOT LINE SEEPAGE PIT: OUTSIDE DIAMETER OR WIDTH ~'/ j' ~/~'~"~' f~/) DISTANCE FROM WELL /,,~i~ / 7'~ TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) LENGTH '~-'Z)-cg(2' , DEPTH BUILDING FOUNDATION. ~ ~"~'~ SQ. FT. ~"EN~LR~ N~....F I E L D: DISTANCE FROM WELl NUMBER OF LINES ABSORPTION AREA DEPTH: TOP OF TILE TO FINISH GRADE TOTAL LENGTH , NEAREST LOT LINE OF LINES , ~. IN. TOTAL EFFECTIVE FO~ DISTANCE BETWEEN LINES SQ. FT. LENGTH OF EACH LINE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE WELL: TYPEn.-~,~./c_/L~- .~c~-~ DEPTH NEAREST LOT LINE SEWER LINE DISTANCE FROM WATER BUILDING FOUNDATION SAMPLE , NEAREST SEPTIC SEEPAGE -~ OTHER , TANK <~/~- SYSTEM /~ ':~ , CESSPOOL , SOURCES DISTANCES: ]/r~T,,~ zb,/.,.,.,.,.,.,.,.,~,o DIAGRAM OF SYSTEM DATE G.A.A.B. Grea/er ANCHORAge AREA BO~Ugh DEPARTMENT OF ENVIRONMENTAL QUALITY 3~00 TUDOR ROAD POUCH 6-6~O ANCHORAGE. ALASKA 99502 TELEPHONE 279-8686 SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT PERM,T no. NAME OF APPLICANT INSTALLAT,ON LOCATIOn LEGAL DESCRIPTION /~ INSTALLATION OF: SEPTIC TANK SEEPAGE PIT TYPE AND SIZE O~ FACILITY TO BE ~ERVED FINANCED THROUGH SOIL TEST RESULTS COMPLETION DATE ANTICIPATED ~,- DRAIN FIELD OTHER NOTE: THIS PERMIT IS NOT VALIO WITHOUT SOIL TEST FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCES, REQUIREMENTS FOUNDAT,ON TO SEPT,C TANK ..5" ~ FO,NDAT,On TO SEEPAGE P,T .20' _ --: DRAIN FIELD SEPTIC TANK 3 I , SEEPAGE PIT.J/~l- , DRAIN FIELD /_/~_ TO NEAREST LOT L,NE. .,,r,,~l~ FRO' >*~/~-/'~'~* ' WELL TO SEPTIC Tank , SEEPAGE Pit ~_/~D DRAIN FIELD /~0 ALSO CONSIDER area WELLS. WATER MAIN TO SEPTIC TANK /~ ~ SEEPAGE PIT DRAIN Field [ 01 I SEPTIC TANK, ~ ~ , SEEPAGE PIT~/00 ' ., DRAIN FIELD TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UN.DISTURBED SOIL. 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 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. DATE ' "'~ ~ APPLICANT'S SIGNATURE