HomeMy WebLinkAboutCREEKSIDE PARK #1 LT 64ksicl
j:)O r k C ,D'
I
L
Gl' TER ANCHORAGE AREA BOROI '{
I~-I~'ARTMENT OF ENVIRONMENTAL I1UALIYr
3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
ADDRESS HONE
LEGAL DESCRIPTION ~-~,~"~..
DISTANCE FROM WELL ~/.~'~,~' /'/'-'~
LIQUID CAPACITY ,,'/~::~'~-) GALLONS.
NUMBER OF
MATERIAL --~-,~-'~/-~ COMPARTMENTS
LIQUID
INSIDE LENGTH ~ INSIDE WIDTH ~ DEPTH__
SEEPAGE SYSTEM:
NUMBER OF PiTS
LINING MATERIAl
NEAREST LOT LINE.~~f)j~'
S E EPA G E P IT: '~)"~'~1~>"'~ ~::~~-" "~/-~//--~ ~//'/~/~"~/'~--
/ OUTSIDE DIAMETER / OR WIDTH /'~-'~ LENGTH /~--~ /
, DEPTH
~-~,-'J",~""'",J'"',~" DISTANCE FROM WELL ~/~'/4~"/-/'---~/~ BUILDING FOUNDATION
~ / TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ~' '~'~ SQ. FT.
TILE DRAIN FIELD:
DISTANCE FROM WELL FOU,..~ . NEAREST LOT LINE
ABSORPTION A~C-'A/~ SQ. FT. LENGTH OF EACH LINE _ ~,
DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL
TOTAL LENGTH
· OF LINES
IN. TOTAL EFFECTIVE
~A'-BO V E TILE
WELL: ~/~ ) DISTANCE FROM WATER
TYPE -~¥~'~--'~--- : DEPTH // , BUILDING FOUNDATION. ~ SAMPLE
NEAREST SEPTIC SEEPAGE
LOT LINE / , SEWER LINE / .,TANK / , SYSTEM ~ , CESSPOOL
, NEAREST
OTHER
'-'~-, SOURCES__
DISTANCES:
DIAGRAM OF SYSTEM
DATE
APPROVED ' ' "G.J~.A.B. -
GREA--,cEr ANCHORAGE AREA BOF~:flJGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3500 TUDOR ROAD POUCH 6-650
ANCHORAGE, ALASKA 99502.
TELEPHONE 279.8686
PERMIT NO.
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
LEGAL DESCRIPTION
INSTALLATION OF: SEPTIC TANK
TYPE AND SIZE OF FACILITY TO BE SERVED
FINANCED THROUGH
COMPLETION DATE ANTICIPATED
SEEPAGE PIT DRAIN FIELD OTHER
TO BE INSTALLED BY ~:::~ff~/~-~
· ,~,,::~'"~ NOTE: THIS PERMIT IS NOT VALID WITHOUT ~lL
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
FOUNDATION TO SEPTIC TANK
fOUndatiON TO SeePAge PIT ~ ~] ( DRain field
SEPTIC TANK TO SEEPAGE PIT WALL
SEPTIC TANK
TO NEAREST LOT LINE.
Well TO SEPTIC Tank
DRAIN FIELD
DIAGRAM OF SYSTEM
, SEEPAGE PIT
ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK f~-~ SEEPAGE Pit /~
DRAIN FIELD
SEPTIC TANK, JJ~/ SEEPAGE Pit /K'_~_//~
~ DRAIN FIELD
TO RIVER, LAKE. STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST lEON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE Pit
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
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