HomeMy WebLinkAboutELMRICH VILLAS #3 Block 3 Lot 1 Public Information
OAAB-H~/ · GR~'"~ER ANCHORAGE AREA BOROU:'-~
DE¥,~RTMENT OF ENVIRONMENTAL QUALIT~ r
3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
tt,(, ~ '/.. ' z/ ":' ' "'
NAME
LOCA¥10N ,Z7-~>'?/:?;/7/
SEPTIC TANK:
MAILING /7, ~.,~/
Z~"(-~/~r PHONE
ADDRESS
LEGAL DESCRIPTION
DISTANCE FROM WELL
......... ~7~COMPARTMENTS
LIQUID
.INSIDE WIDTH DEPTH
SEEPAGE SYSTEM:
NUMBER OF PITS
LINING MATERIAL~
NEAREST LOT LINE
SEEPAGE PIT:
_OUTSIDE DIAMETER OR WIDTH
/
/2'
(.)~/~C~-/~'?~-~ ' ~~'~//J~'~ '~.'DISTANCE FROM WELl
IOIAL EEFECIIVE ABSORPlION AREA (WALL AREA)
/ ; /
, LENGTH DEPTH
BUILDING FOUNDATION
~AIN FIELD:
DISTANCE FROM WELL FOUNDAIION
NUMBER OF LINES DISIANCE BEIWEE [~['~'~'~~'~'~
ABSORPTION AREA SQ. FT.
, NEAREST LOT LINE
TRENCH WIDTH
LENGTH OF EACH LINE -
DEPTH: TOP OF TILE TO FINISH GRADE
TOTAL LENGTH
OF LINES
IN, TOTAL EFFECTIVE
DEPTH OF FILTER MATERIAL BENEATH TILE
WELL:
LOT LINE
T Y P E/'~,~/~?/,7'~ w/.(///~/ DEPTH.
NEARES('
, SEWER LINE
DISTANCE FROM WATER
, BUILDING FOUNDATION. SAMPLE_
SEPTIC SEEPAGE
, TANK , SYSTEM , CESSPOOL
, NEAREST
OTHER
, SOURCES
DISTANCES:
DIAGRAM OF SYSTEM
DATE APPROVED.
G.A.A.B.
':; GRF_,..;'Er ANCHORAGE AREA BOROUGH
',~' . DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO.
~ 3500 TUDOR ROAD POUCH 6-650
ANCHORAGE, ALASKA 99502
SEWAGE DISPOSAL SYSTEM m APPLICATION AND PERMIT
NAME OF APPLICANT .//~,,¢J/.~ ~'., ' ~~' ~,~,~ .~ .//~/ ~/~ ..o.~
INSTALLATION LOCATION ~/~
LEGAL DESCRIPTION ~ /~ ~/~ ~/~ ~/-/ ~A ~
~OIL TEST RESULT5 ,_ ~~ NOTE= THIS PER~IT !~ NOT VALID WITHOUT ~IL
FINAL INE4~EGTION; ~4 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
HEALTH DEPARTMENT AUTHORITY WILL BE SUSJECT TO PROSECUTION.
SEPTIC TANK SIZE
MINIMUM DISTANCES, REQUIREMENT~
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT
. DRAIN F~ELD
SEPTIC TANK TO SEEPAGE PIT WALL f~
SEPTIC TANK ~/ . SEEPAGE PIT TO NEAREST LOT LINE. '
WELL TO SEPTIC TANK ,
DRAIN FIELD
WATER MAIN TO SEPTIC TANK
DRAIN FIELD
SEPTIC TANK,
TO RIVER, LAKE, STREAM,
. DRAIN FIELD
SEEPAGE PIT
ALSO CONSIDER AREA WELLS.
. SEEPAGE PIT /,~ /
· DRAIN FIELD
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
SEEPAGE AREA SIZE /~/,'f//-'
EXCAVATION S FEET INTO UNDISTURBED SOIL,
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PiT
F(TTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
HEALTH AUTHORITY
OR
LICENSED DESIGNER
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28~68 AND THAT THE ABOVE
DESCRIBED BYSTEM IS IN ACCORDANCE WITH SAID CODE,
DATE APPLICANT'S SIGNATURE ~ ,
DEP~TMENT OF ENVIRONHENTAL QUALITY
3500 TUDOR ROAD
ANCHORAGE, ALASKA 99502
CASE #
Performed For Date Performed
Leoal Oescrintion: Lot.i .Block 3 Subdivision F..LI~tC~ ?II-LA
'This Korm Reoorts Soils Log X Percolation Test_
De~th
Feet
Soil Characteristics
LT. Bt~)l~ I~i~-TY
Wa.s Ground Water Encountered?~ d'?oj
If v~, At what Depth?~~ 3' e
Reading Date Gross Time Net Time Depth ~~'q~~ Drop
'' ~
I ~
Percolation Rate --- Minute
Proposed Installa'tion: Seepage Pit ~ Drain Field ""-
Deoth of Inlet ~ Denth To Bottom Of Pit Or Trench__~.
Date:~
the Munkipai Co~e oF OFdbanees ~Sewage DfSlMSal I~aetlee.,
~Septle lfmk-seepa~ ~jr~ sewefe dlopos~l ftoflitieo shoal not be
eR the oubJ~t p~SUlf~ ~o publte oewe~ by the ~ ~m I~?? ~to~ season.
You must apply f~ee, e eo~meatlma permit f~om the permit offleeF f~ ~e ~i~t~
RECEIPT FOR CERTIFIED MAIL--30(. (plus postage)
STREET AND NO.
P.O., STATE AND ZIP CODE
OPTIONhL SERVICES FOR ADDITIONAL FEES
1, Shews to whom and date doliverod ........... -1~'
RETURN Ik With delivery to addressee onlY_, ............
RECEIPT · 2. Shows to whom date and where delivered .. 35¢
SERVICES With del very to addressee only ...~ ........ 856
DELIVER TO ADDRESSEE ONLY ............................................... :~...., 50d
SPECIAL DELIVERY (extra fee required) ...................................
POSTMARK
OR DATE
PS Form ' NO INSURANCE COVERAGE PROVIDED-- (See other side)
Apr. 197] 3800 NOT FOR INTERNATIONAL MAIL * GPo: ~072 o-4e0-?4e
~. Dy~ ~
Tax' Code: ."~ ~'~.~ate: ~-~-, ~. ~ '
I~;Owner: -. ,.~
Mailin~ Address:
User / Tenant:
Property Address:
Subdivision. ~' ~ ~ ~ ~loc~ ]Lot
~/~~.~ ~ /~11'
DYE TEST;
~ POS/five
. ~ {"
ADDI OGNA~ INFORMATION:
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