HomeMy WebLinkAboutALYESKA BASIN BLK 4 LT 1
GRE '-R ANCHORAGE AREA BORr''
Department Quality
of
Environment
3500 Tudor Road
Anchorage, Alaska 99507
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME-~J,,'f/",~/~Z) ~, ("~-~0,/'~'' MAILING ADDRESS ~./,~- ~E~,,,~,/~/'/~/_~5~ ,.~C/-,
LOCATION'~,/v,,'~/,,~',~"' d?/,gZ~'g~'-- '/?/-'/'~-~-'~,~EGAL DESCRIPTION '"~/~'- /~' "~/'g '~z
DISTANCE
FROM WELL~C;~"~""C//'g~/C/(I~ANUFACTURER ~,,~'~"¢~'-"~
INSIDE LENGTH
INSIDE WIDTH
MATERIAL ~'-.~/~'~'-~ -
NUMBER Of
COMPARTMENTS /
LIQUI'D DEPTH
LII~U/D CAPAC ITM~. '~ g~ GALLONS.
~FIELD: ~
FOUNDATION NEAREST LOT LINE _/ OF LINES
DISTANCE FRO'~~~ L~~ ~T
NUMBER OF LINES ~NCE BETWEEN H___ IN. TOTAL EFFECTIVE
ABSORPTION AREA _~S~H OF EACH LINE ......
~'- DEP~
DE?.~_?L; ~ FINISH GRADE MATERIAL BENEAT ~ IN, ABOVE TILE .~.. IN.
WELL:
T y p E~'~/~//~/. g~4//~/J CONSTRUCTION DEPTH
BUILDING NEAREST NEAREST SEPTIC SEEPAGE
FOUNDATION , LOT LINE__, SEWER LINE__, TANK__, SYSTEM
DISTANCE FROM:
CESSPOOL , OTHER SOURCES
APPROVED DISAPPROVED REMARKS
DiSTANCES: ~ /-/-' "'T'"'~2 A/.~..
INSTALLED BY:
SEWER LINE DEPTH:
PIPE MATERIAL:
LOT SLOPE: L~d~"~
REMARKS:
DIAGRAM OF SYSTEM
Form PW~027
GREATER ANCHORAGE AREA BOROUGH .
DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO.
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
TO BE INSTALLED BY
NOTE: THl~ PERMIT IS NOT VALID WITHOUT II,OIL TE.~
SOIL TEST RESULTS
COMPLETION DATE ANTICIPATED JJ~/7~'~
R.F_r~LY. AL/A_O NEY_eAR
FINAL IN~PECTiON: 24 HOUR NOTI~ REQUIRED, BACKFILLING OF ANY ~Y~TE~ WITHOUT FINAL I~PE~TIOH BY THE
HEALTH DEPARTMENT AUTHORI~ WILL BE ~UBJECT TO pROSECUTIOH.
TYPE
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO ~ANK -
FOUNDATION TO SEEPAGE PIT '~" DRAIN FIELD
SEPTIC TANK TO SEEPAGE PIT WALL ~ . ......
~ANK~~ SEEPAGE PIT ~-, DRAIN FIELD TO N[AREST LOT LINE.
WELL TO ~ T~NK --
DRAIN FfELD ~ ,/ ~ ALSO CONSIDER AREA WELLS.
WATER MAIN TO NK ~. SEEPAGE Pit
DRAIN FIELD
~l~Z/'f;~ TANK, ~ SEEPAGE PIT t~__, DRAIN FIELD
TO RIVER, LAKE, STREAM. ~__'
/~/~ / ~4 !,, ~.",, :'~'-~ ~,'
CAST IRON INTO AND OUT OF :~,,~ ,ANK/ A,~R~mlI~JJ~I3~2~ CROSSING GAP Of
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
--- ~//
~CH DIAMETER CAST IRON SIPHON PIPES ON~ TANK A
FITTED WITH AIRTIGHT REMOVABLE CAPS,
CONFORM TO BOROUGH REGULATION5 REGARDING INSTALLATION.
HEALTH AUTHORITY
OR
LICENSED DESIGNER
4 ]I!CH SE',t~R LIhE.
SI.I-PA('[ Pil EXCAVAIIOlt BASED ON %Eli ~l
hO S;L'I.R t ]I;E.. lO', ~rade: ~',pe~ 163'
[,FJ:!-I'I[[~.I~. j except lO' prece~din
lC) lA' '- ('0" J 0[SE ~nk & tha~ should
l'lH'l lC PISTUPBED~ .... )~ ~ CAST IEON SlPltO~ PIPE
~ SOil / /
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF (:{REATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 2So~B AND THAT THE ALCOVE
DESCRIBED SYSTEM S I~ ACCORDAN~;E WITh SAiO CODE. -- ~ 3 ~~/ ~ -~