HomeMy WebLinkAboutT12N R3W SEC 27 LT 62 REM TER ANCHORAGE AREA BOROI
DEPARTN1ENT OF ENVIRONMENTAL 0. UALI'I
3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
· ·_ADDRESS x /'-" ~
SEPTIC TANK:
NUMBER OF /
DISTANCE FROM WELL~ ~ ~' MATERIAL_ ~'~/-/- COMPARTMENTS
~/
LIQUID CAPACITY.~(~/'~ GALLONS INSIDE LENGTH_ INSIDE WIDTH DEPTH_
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS_'/''~'''/~ 7~1(~' _ OUTSIDE DIAMETER OR WIDTH _ , LENGTH DEPTH
LINING MATERIAL~/~/ DLSTANcE FROM WELL .J~ ~' BUILDING FOUNDATION--
NEAREST LOT LINE ..... TOTAL EFFECTIVE ABSORPTION AREA (wALL AREAl SQ. FT.
TILE DRAIN FIELD:
TOTAL LENGTH
, OF LINES_
DISTANCE FROM WELl FOUNDATION . ,NEARESi LOT LINE
~'~ L~
NUMBER OF LINES ~ DISTANCE BETWEEN __ TRENCH WIDTH. I~ TOTAL EFFECTIVE
DEPTH: TOP OF TILE TO FINISH GRADE
DEPTH OF FILTER MATERIAL BENEAJH TILE__--
IN. ABOVE TILE
WELL:
LOI LINE
DISTANCE FROM · WATER ,
· , FOUNDATION, /(': S AMPLE /~, ~'xr~'= NEAREST
DEPTH BUtLDING -'
· -' SEEPAGE _ OTHER '
NEAREST SEPTIC ~.) SYSTEM . /('i(? CESSPOOk SOURCES
SEWER LINE ' TANK
DIAGRAM OF SYSTEM
GREATER ANCHORAGE AREA BOROUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO.- .
3500 TUDOR ROAD POUCH 6.650
ANCHORAGE, ALASKA 99502
SEWAGE DISPOSAL SYSTEM ~ APPLICATION AND PERMIT
LEGAL DESCRIPTION ....... ~L~/7~ ' l/~ ~
TYP[ AND $1=~ Of FACILITY TO be S -- /' // / -~ ~ ~
SOIL TEST RESULTS ~ NOTE= THIS pERMIT I~ NOT VALIO WITHOUT SOIL TEST
UIRED BACKFILLING OF AN~ ~Y~TEM WITHOUT FINAL IN~PEC~I N BY THE
HEALTH DEPARTMENT AUTHORITY WILL BE ~UBJECT TO p~u~ -
SEPTIC TANK 5lZ[ J ~
DIAGRAM Of SYSTEM
MINIMUM DISTANCES, REQUIREMENTS
F'
FOUNDATION TO SEPTIC TANK
DRAIN FIELD
FOUNDATION TO SEEPAGE pIT-
SEPTIC TANI( TO SEEPAGE PIT WALL
SEpTic TANK . -- SEEPAGE PIT ~ --, DRAIN FIELD --
DRAIN FIELD-
WATER MAIN TO SEPTIC TANK --
DRAIN FIELD
SEPTIC TANK. ~ ~l
__ . SEEPAGE pET
TO RIVER, LAKE. STREAM.
SEEPAGE PIT
DRAIN FIELD-
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
~/// ~LHi~AEL:~DT:s i G i E R
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ORAGE k A Bo UGH ORD~NA O 28 HAT THE
ABOVE