HomeMy WebLinkAboutDRAKE BLK 2 LT 8C7
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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