HomeMy WebLinkAboutALYESKA BASIN #6 BLK 7 LT 12
GREA
ANCHORAGE AREA BORr
Department of Environment Quality
3500 Tudor Road
Anchorage, Alaska 99507
',H
INSPECTION
REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
_~C~ ~ ~.. ~,. C.~-S PHONE
MAILING ADDRESS
LEGAL DESCRIPTION
TANK:
DISTANCE
FROM WE LLL (~'YA'¥~
MAN U FACTU R E R
NUMBER OF
COMPARTMENTS
INSIDE LENGTH
INSIDE WIDTH
LIQUI'D DEPTH
LIQUI'D CAPACITY
TILE DRAIN FIELD:
DISTANCE FROM WELL
NUMBER OF LINES
ABSORPTION AREA
DEPTH: TOP OF TILE TO FINISH GRADE
FOUNDATION NEAREST LO~' 'LINP_
DISTANCE BETWEEN LINES TRENCH WIDTH
SQ. FT. LENGTH OF EACH LINE
DEPTH C~,r:' FILTER
MAT;-'RIAL BENEATH TILE
TOTAL LENGTH
.OF LINES
IN. TOTAL EFFECTIVE
IN. ABOVE TILE .IN.
WELL:
TYPE
BUILDING
FOUNDATION
CESSPOOL
APPROVED
· CONSTRUCTION DEPTH
NEAREST NEAREST SEPTIC SEEPAGE
, LOT LINE___, SEWER LINE__, TANK , SYSTEM
, OTHER SOURCES
DISAPPROVED REMARKS
DISTANCE FROM:
DISTANCES:
INSTALLED BY:
SEWER LINE DEPTH:
PIPE MATERIAL:
LOT SLOPE: ~""~_
REMARKS:
DIAGRAM OF SYSTEM
APPROVED
G.A;A.B.
Form PW*027
GreaTEr:'ANChO~aGe AREA Borough
DEPARTMENT OF ENVIRONMENTAI~ QUALITY
3330 "C" STREET ANCHORAGE, ALASKA 99503
TELEPHONE 274-4561
PERMIT NO.
SEWAGE DISPOSAL SYSTEM -- APP'L[CATION AND PERMIT
PHONE
DRAIN FIELD
TYPE ANDS' EOFFAC,L,TY OBESERVED ,2
, OTHER
NOTE: THIS PERMIT IS NOT VALID 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.
TYPE
MINIMUM DISTANCES, REQUIREMENTS
!
FOUNDATION TO ~ TANK ~'
FOUNDATION TO SEEPAGE PIT
DRAIN FIELD
SEPTIC TANK TO SEEPAGE Pit WALL
~ TANK ~ ! , SEEPAGE Pit
TO NEAREST LOT LINE.
/
WELL TO SEPTIC TA4~K
DRAIN FIELD
WATER MAIN TO~L~i~ TANK ~/~'~)
DRAIN FIELD
/
S~.,:"T',g TANK, /~)~ ~ SEEPAGE PIT
TO RIVER, LAKE, STREAM.
r ..... , 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.
DIAGRAM OF SYSTEM
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER~ANCHORAGE AREA//BOROUGH/RDINANCE/ NO. 28-68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. /// / ~/~
l/ /I
//
DATE
FORM NO. EQ-016 -- / '/