HomeMy WebLinkAboutCREST VIEW BLK A LT 13LI
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GR TER ANCHORAGE AREA BOROL
D~I~RTMENT OF ENVIRONMENTAL OUALI~Y~
3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
N A M E
LOCATION
MAILING 3//~0/ .,~-~..,,,~r'~ PHONE "--'"'
(..7-~::~:~J~/~V/ ADDRESS .
~---~' '~'~'-~'/~ LEG A L DESCRIPTION
SEPTIC TANK:
DISTANCE FROM WELl
LIQUID CAPACITY ,~
NUMBER OF .~
MATERIAL j .~--~.r-~-~_ COMPARTMENTS
GALLONS. INSIDE LENGTH z-~""~INSIDE WIDTH z..----- DEPTH
SEEPAGE SYSTEM:
SEEPAGE PIT:
NUMBER OF PiTS / OUTSIDE DIAMETER / OR WIDTH /'-~"-
LINING MATERIAL~/~ ~J~./~' .... DISTANCE FROM WELL ~ /~
NEAREST LOT LINE /~/ /' TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)
,,' /
· LENGTH //'~'~ , DEPTH
BUILDING FOUNDATION
~ ~ SQ. FT.
TILE DRAIN FIELD:
DISTANCE FROM WELL
NUMBER OF LINES
ABSORPTION/
FOUNDATION ~ ,~_.~REST LOT LINE
~BETWEEN LINES H WIDTH
SQ. FT. LENGTH OF EACH LINE
TOTAL LENGTH
, OF LINES
IN. TOTAL EFFECTIVE
,~...~
DEPTH: TOP OF TILE TO FINISH GRADE
DEPTH OF FILTER MATERIAL BENEATH TILE
IN. ABOVE TILE
WELL:
LOT LINE
DISTANCE FROM
TYPE ~./]?e,' DEPTH ~/ BUILDING FOUNDATION, ~ WATER
. , SAMPLE_ ~ NEAREST
SEPTIC SEEPAGE ~ OTHER
~ NEAREST I.~ ~
SEWER LINE ,TANK SYSTEM , CESSPOOL ~ , SOURCES__
DISTANCES:
DIAGRAM OF SYSTEM
DATE
APPROVED
GREATER ANCHORAGE AREA BOROUGH
DEPAR~.~[NT OF ENVIRONMENTAL QUALL~.~
3500 TUDOR ROAD
ANCHORAGE, ALASKA 99502
CASE
Performed For
Legal Description: Lot.4h_Bl~ck
This Form Reports Soils Log
Date Performed
SubdiviSion C~T V/E~ ~'~.~,~,~,.~,~.
PercOlation Test
Depth
Feet
Soil Characteristics
10----
Was Ground Water Encountered? ~/o
If Yes, At What Depth?
Reading Date Gross Time Net Time Depth to H20 Net Drop
) nute
Proposed Instailatton: Seepage Pit Drain Field
Depth Of Xnlet Depth To Bottom Of Pit Or Trench
COMMENTS: IZ
N
Test Performed By
Data Certified : '
Date:
GRE:a-~er aNChORaGe aRea bOr-~UgH
DEPARTMENT OP ENVIRONMENTAL QUALITY
3500 TUDOR ROAD POUCH 6-650
ANCHORAGE, ALASKA 99502
TELEPHONE 279-8686
SEWAGE DISPOSAL SYSTEM APPLICATION AND PERMIT
INSTALLATION OF: SEPTIC TANK
TYPE AND SIZE OF FACILITY TO BE SERVED
FINANCED THROUGH
SOIL TEST RESULTS
COMP'ET,O" DATE ANT,C,PATED
SEEPAGE PIT K DRAIN FIELD OTHER
NOTEs THIS PERMIT IS NOT VALID WITHOUT ~OII. TEST
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY sY~rEM WITHOUT FINAL INSPECTION BY THE
HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION.
FOUNDATION TO SEEPAGE PIT JZ~
SEPTIC TANK TO SEEPAGE PIT WALL
SEEPAGE PIT
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
. DRAIN FIELD
DRAIN FIELD
!
SEPTIC TANK ~/
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK
DRAIN FIELD
DRAIN FIELD '~-"'--'
SEPTIC TANK ~'~ {~ ~
,_~ -- SEEPAGE PIT
TO RIVER, LAKE STREAM.
ALSO CONSIDER AREA WELLS.
, SEEPAGE PIT ~ ~)
. DRAIN FIELD
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
DIAGRAM OF SYS'r~M
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
AUTHORITY
OR
LICENSED DESIGNER
I CERTIFY THAT IAM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 ~D THAT THE ABOVE
DATE r APPLICANTS SIGNATURE U /' --~ ~_~) ~ ' ~ --