HomeMy WebLinkAboutT12N R3W SEC 22 LT 13 GRE/'~.R ANCHORAGE AREA BOF~-IGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: °,STANCE / NUMBEROF FROM WELL/C~(/ MANUFACTURER -- MATERIAL COMPARTMENTS INSIDE LENGTH / INSIDE WIDTH / .LIQUID DEPTH / LIQUID CAPACITM/~O 0 GALLONS. SEEPAGE PIT: I NUMBER OF PITS / DIAMETER ~' OR WlDT~"'~ LINING MATERIAL -Y /'.~ ~"/- CRIB SIZE:~ DIAMETER BUILDING FOUNDATION ~' NEAREST LOT LINE 3~}/~. ADDITIONAL ABSORPTION LENGTH ~' DEPTH // / DEPTH DISTANCE FROM: WELL/~//~ /''~ TOTAL EFFECTIVE ~'~ .~O// ABSORPTION AREA (WALL AREA) Sq. FT. BUILDING //f') ~ FOUNDATION [ ~' CONSTRUCTION NEAREST ~0 f'~ LOT LINE CESSPOOL OTHER SOURCES APPROVED DISAPPROVED NEAR'EST SEPTIC //?/] ~ SEEPAGE SEWER LINE TANK /,/~,' --, SYSTEM REMARKS DISTANCES: LOT SLOPE: REMARKS: DIAGRAM OF SYSTEM DATF~_~-~'k /.Z/,X~.-2_'Z~ APPROVED/4'' ~ G.A.A.B. Form No, EQ-031 SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PEE~IT ~AGE AREA BOROUGH PERMIT NO. PHONE , SOIL TEST RESULTS ~Olvl ~LET, ON DATE ANTI ~I PATED OTHER NOTE: THl~ 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. DIAGRAM OF SYSTEM MINIMUM DISTAN~E~, RE~UIREMENT~ FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE pIT ~ DRAIN FIELD SEPTIC TANK TO SEEPAGE Pit WALl /~ ) SEPTIC TANK .. SEEPAGE Pit ~ ) DRAIN FIEld TO NEAREST LOT LINE. WELL TO SEPTIC TANK DRAIN FIELD ., seePAGE Pit ALSO CONSIDER AREA WELLS, SEEPAGE PIT /'~)2 , DRAIN FIELD CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UND]STURI~ED SOil. 4 INCH DIAMETER CAST ~RON SIPHON PIPES ON SEPTIC: TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. I CERTIFY THAT I AM FAMILIAR WlTH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE A~OVE GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" Street ~, ~ ~¥~]-/~ ANCHORAGE, ALASKA 99503 Performed For ~ /. /~ Dated Performed Legal Description: XLot /} Block~'~o~ Subdivision This Form Reports Soils Log Percolation Test__ - Soil Test Must Be Logged To 4' Below Proposed Seepage System - Depth Feet Soil Characteristics 2-- 3-- 4~ 6~ 7~ 8~ 9-- lO~ ll-- 12-- 13~ 14~ Was Ground Water Encountered? If Yes, At What Depth? Case # I I_ Reading Date Gross Time Net Time Depth to H20 Net Drop Percolation Rate Minute Proposed Installation: Seepage Pit Drain Field Depth of Inlet Depth to Bottom of 'Pit oP Trench COMMENTS: Date: %~- $,~ ~ L ©o ~0