HomeMy WebLinkAboutASPEN HIGHLANDS #1 BLK 1 LT 13
GRE/
ER ANCHORAGE AREA BOP' ~JGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME ~/--~ .,~/~e'.~_z'-..,~./'~..,~" MAILING ADDRESS,/e~..~"~,,,/t' ~(--'*'--~"'-/__2_3' PHONE
LOCATION ~~A~ ~~ LEGAL DESCRIPTION ~~/~ ~~/
SEPTIC TANK:
DISTANCE
FROM W E L L/~'~?--/~'"~lA N U FAC T U R E R
INSIDE LENGTH
INSIDE WIDTH
NUMBER OF
MATERIAL COMPARTMENTS
LIQUID DEPTH
LIQUID CAPACITY f~)/~/ GALLONS.
SEEPAGE PIT: /
NUMBER OF PITS , /. DIAMETER ~ OR WIDth /~//', LENGTH"~ ,-~ DEPTH //~//~/--"~ /~7~..
LINING MATERIAL~CRIB SIZE: DIAMETER~ DEPTH ~ DISTANCE FROM:
/ TOTAL EFFECTIVE
BUILDING FOUNDATIO~/, NEAREST LOT LINE~~- ABSORPTION AREA (WALL AREA) ~~ SQ. FT.
A~,t,O.A~ A~SO~,O~
W E L L:
TYPE //~/~/' ~/~/J'~/~ CONST R UCTIO N
BUILDING NEAREST
FOUNDATION_ , LOT LINE
CESSPOOL , OTHER SOURCES
APPROVED DISAPPROVED
DEPTH DISTANCE FROM:
NEAREST SEPTIC SEEPAGE
SEWER LINE TANK __, SYSTEM
REMARKS
DISTANCES:
INSTALLED BY:
~'-x ~,~
PIPE MATERIAL:
LOT SLOPE:
REMARKS:
Form No. EQ~031
DIAGRAM Of SYSTEM
DATE
APPROVED
G.A,A.B.
GReATEr ANCHORAGE ArEa BOrOUgh
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C" STREET ANCHORAGE, ALASKA 99503
TELEPHONE 274-4561
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
PERMIT NO.
INSTALLATION OF: SEPTIC TANK, ~ SEEPAGE PIT_ ~ , DRAIN FIELD ~ OTHER
TYPE AND SIZE OF FACILITY TO BE SERVED E ~J~'~/~ -C'J/~/~/~ :~/~/~--~
FINANCED THROUGH TO BE INSTALLED BY
/
NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIl. TEST
COMPLETION DATE ANTICIPATED /~/~//J //~//~;~
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 SIZE
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
FOUNDAT,ON TOSEEPAGE P,T-d/
SEPTIC TANK TO SEEPAGE PIT WALL
SEPTIC TANK , . SEEPAGE PIT __
TO NEAREST LOT LINE,
DRAIN FIELD / ~ /
WATER MAIN TO SEPTIC ~ANK DRain FIELD ~ /
SEPTIC TANK, ~ , SEEPAGE PIT
, DRAIN FIELD
~d*~ ,, DRAIN fIELD
,SEEPAGE PIT IQ
DRAIN Field
TO RIVER, LAKE, STREAM.
DIAGRAM OF SYSTEM
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
I CERTIFY THAT [ AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 2~B-68 AND THAT THE ABOVE
DESCRibed SYSTEM IS IN ACCORDANCE WITH SAID CODE.
DATE
SI G N ATU R ,._.,..,.,~ /~ - __ ~,.
FORM NO. EQ-016
GREATER ANCHORAG£ AREA BOROUGH
DEPARTMENT OF ENVIRONMENTAL QUA[.iITY Case #
3330 "C" Street
ANCHORAGE, ALASKA 99503
~~ed ~or Legal Description:
This Form Reports Soils Log_~,
- Soil Test Must Be Logged To 4' Below Proposed Seepage System -
Soil Characteristics
Depth
Feet
~/'~-Was Ground Water Encountered?
If Yes, At What Depth?
Performed
Dated ~l~,
Subdivision
Pefco1 at~n
Reading
Date
Gross Time
Net Time
Depth to H20
Net Drop
Percolation Rate Minute
Proposed Installation: Seepage Pit z~<~ Drain Field
Depth of Inlet Depth to Bottom of Pit or Trench
COMMENTS:
Test Performed BY~
Date Certified BY:
Date:
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