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Home My WebLink AboutALYESKA BASIN #3 BLK 1 LT 4 (~G RE' 'ER ANCHORA6E AREA BOr Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 UGH INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM ~TAN K: DISTANCE FROM W E L L'f't'~~ MAILING ADD RESS~'-~ LEGAL DESCRIPTION MANUFACTURER NUMBER OF MATE RIAL COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH .LIQUID CAPACITYc~OCSO GALLONS. NUMBER OF PITS -- LINING MATERIAL BUILDING FOUNDATION__ ADDITIONAL ABSORPTION DIAMETER CRIB SIZE: OR WIDTH__, LENGTH , DEPTH DIAMETER__DEPTH DISTANCE FROM: WELL TOTAL EFFECTIVE NEAREST LOT LINE__ ABSORPTION AREA (WALL AREA) SQ. FT. WELL: TYPE ~/~~ BUILDING FOUNDATION __ CESSPOOL APPROVED CONSTRUCTION NEAREST , LOT LINE OTHER SOURCES DISAPPROVED DEPTH NEAREST SEPTIC SEWER LINE , TANK__ REMARKS DISTANCE FROM: SEEPAGE SYSTEM DISTANCES: DIAGRAM OF SYSTEM INSTALLED BY: ~ PIPE MATERIAL: LOT SLOPE: REMARKS: Form No. EQ~031 DATE APPROVED G.A.A.B. GREaTEr ANChOraGE AREa BOROUgh DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO. ~ 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 INSTALLATION Of: ~ TAN~ ~ SEEPAGE PIT DRAIN FIELD OTHER / ~ ____ SOIL TEST RESULTS NOTE= THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANk SlZe~:;~-'')00{~) I/~L- MINIMUM DISTANCES, REQUIREMENTS / FOUNDATION TO SEEPAGE PIT SEPTIC TANK TO SEEPAGE PIT WALL ~2;T~ TANK ~ . SEEPAGE PiT TO NEAREST LOT LINE. . RAIN FIELD ~ TA~K, ~ O ., SEEPAGE PIT TO RIVER, LAKE, STREAM. SEEPAGE AREA SIZE DRAIN FIELD , DRAIN FIELD SEEPAGE PIT ALSO CONSIDER AREA WELLS. SEEPAGE Pit DRAIN FIELD TYPE DIAGRAM OF SYSTEM CA-~-~ROi4~iTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXC~VATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FIT~?ED~J~-ITH~IRTIGHt REMOVABLE caps. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. I CERTIFY THAT, AM FAMILIAR WITH THE REQUIREMENTS OF G~EATER DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. BOROUGH ORDINANC//E~28.68 AND THAT THE ABOVE I'K ANLHUKAUI' AKI-A Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 ~J~n INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM ~_~ ,~'~ \\ ~ . :) ,,~.. . NAME"~r, ~-~-<-\ /~,~-k ~ ~ MAILING ADDRESS ~t~'/- /0/~S-~" 1~ - "~{~ ~. PHONE ,~-~;-~ - ~I~-b~ DISTANCE ,/Lx..~.,_....' NUMBER OF FROM WELL'7~'O MANUFACTURER, MATERIAL(I{t'~, '~ COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH .LIQUID CAPACITY;~ OO C, GALLONS. SEEPAGE PIT: NUMBER OF PITS __ LINING MATERIAL BUILDING FOUNDATION ~ ADDITIONAL ABSORPTION DIAMETER ~ OR WIDTH CRIB SIZE: DIAMETER , NEAREST LOT LINE LENGTH , DEPTH DEPTH__ DISTANCE FROM: WELL TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) SQ. FT. WELL: TYPE r?'~'t'~H'd,-'~L CONSTRUCTION BUILDING NEAREST FOUNDATION , LOT LINE CESSPOOL , OTHER SOURCES APPROVED DISAPPROVED NEAREST , SEWER LINE REMARKS DEPTH SEPTIC , TANK DISTANCE FROM: SEEPAGE SYSTEM DISTANCES: DIAGRAM OF SYSTEM INSTALLED BY: LOT SLOPe: REMARKS: /~0 [~j~- DATE ~ '~:~)-) q ;~ "APPROVED ~' . ~)" G.A.A.B. Form No. EQ-031 ., TELEPHONE 274-4561 SEWAGE DISPOSAL SYSTEM, PERMIT NO. APPLICATION AND PERMIT INSTALLATION OF: ~.~l~ ~rAN K TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH SOIL TEST rESULTS SEEPAGE PIT ~ PHONE TO BE INSTALLED BY DRAIN FIELD ~ OTHER COMPLETION DATE ANTICIPATED NOTE: THIS PERMIT IS NOT VALI'D WITHOUT SOIL TEST FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEEPAGE AREA SIZE __ TYPE MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO ~ TANK FOUNDATION TO SEEPAge PIt SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK , SEEPAGE PIT TO NEAREST LOT LINE. WELL TO SEPTIC 'TANK DRAIN FIELD WATER MAIN TO ~,.E-.F~4C TANK DRAIN FIELD TO RIVER, LAKE. STREAM. DRAIN FIELD , 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 EXCAVATION 5 FEET INTO UNDISTURBED 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. OR LICENSED DESIGNER DIAGRAM OF SYSTEM I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCH(~RAgE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DATE ~OP/~3 APPLICANT'S $',NATURE FORM NO. ECI-OI 6 // /