HomeMy WebLinkAboutT12N R3W SEC 33 LT 208
~GRE~'~ER ANCHORAGE AREA BO' ~UGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME ,zM-e/zZgf/J ~/'~/z/~ZT/' f~ MAILING ADDRESS ~ ~/~F~ ~/ PHONE
SEPTIC TANK:
DISTANCE
FROM WELL /~7
INSIDE LENGTH
MANUFACTURER Z~'Z2
INSIDE WIDTH
M AT E R ~ A L//Z~,~./~¢~.; NUMBER OF
COMPARTMENTS r~'/'/~'
LIQUID DEPTH '~' LIQUID CAPACITY /7~'4~ . GALLONS.
SEEPAGE Pit:
NUMBER OF PITS
LINING MATERIAL ~'~
BUILDING FOUNDATION
ADDITIONAL ABSORPTION
_ /
CRIB SIZE: DIAMETER DEPTH ~ DISTANCE FROM: WELL
~ f-F- TOTAL EFFECTIVE
NEAREST
LOT
LINE
ABSORPTION AREA (WALL AREA) SQ. FT.
WELL:
BUILDING ~,, /
FOUNDATION
CESSPOOL ~'
CONSTRUCTION ~ ~~z/ DEPTH
NEAREST / ~ NEAREST ~- SEPTIC
LOT LINE /~ SEWER LINE /'/J TANK
OTHER SOURCES ~'~ ~/~¢~/
APPROVED DISAPPROVED REMARKS
///~ /
, , DISTANCE FROM:
~/ SEEPAGE ~ / , SYSTEM / ~'
DISTANCES:
INSTALLED BY: .~/~M
DIAGRAM OF SYSTEM
GREATER ANCHORAGE AReA BOROUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
PERMIT NO.
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
' b ;,. 14 soil
COMPLETION DATE ANTICIPATED 6~~---
FINAL INSPECTION: 24 HOUR NOT~CE REQUIRED. BACKfiLLING OF ANY SYSTEM WITHOUT FINAL iNSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PR~
FOUNDatioN TO SEEPAGE PIt ~ ~/ DRAIN FIELD
SEPTIC TANK tO SEEPAGE Pit WALL // ~
_, SEEPAGE PIT DRAIN FIELD
WELL TO SEP,]C TANK (/0 9~ SEEPAGE Pit: (/ ~--
DRAIN FIELD ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK · SEEPAGE PIT
DRAIN FIELD
SEPTIC TANK, , SEEPAGE Pit /P~ , DRAIN FIELD TO RIVER, LAKE, STREAM.
CAST iRON iNTO AND OUT OF SEPTIC TANK AND [NTO CRIB CROSSINg GAP OF
EXCAVATION ~ FEET INTO UNDISTURBED SOIL.
)
4 INCH DIAMETER CAST IRON /~IPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
I CERTIFY THAT ] AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. ~(~' ~/1~j
GREATER ANCHORAGE AREA BorOUGhs} ~
DEPARTMENT OF ENV,RO.MENTAL QUALITY ///~ PERM]THO,
SEWAGE DISPOSAL SYSTEM m APPLICATION AND PERMIT
INSTALLATION OF: SEPTIC TANK SEEPAGE PIT . DRAIN FIELD. , OTHER
FINANCED THROUGH TO BE INSTALLED BY
SOIL TEST RESULTS NOTE= THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
COMPLET]ON DATE ANTICIPATED
FINAL INSPECTION: 24 HOUR NOT~CE REQUIRED, BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
~ DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
FOUNDATION TO SEPTIC TANK
/5-r
DRAIN FIELD
., SEEPAGE PIT
, ALSO CONSIDER AREA WELLS.
WATER Main TO SEPTIC TANK f~/ SEEPAGE PIT.
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
DIAGRAM OF SYSTEM
I CERTIFY THAT [ AM FAMiliar WITH THE REQUIREMENTS OF GREATER~EATER/~ __A RAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
GREATER ANCHORAGE AREA
Department of Environmental q_~lity
3330 "C" Street
Anchorage, Alaska 99503
Performed for~
Legal Description:
This form reports: Soils log
Depth
Feet
1 -
2-
6-
7-
8-
9-
ll -
t2 -
14 .....
Was ground water encountered?
SOILS LOG - PEROLATION TEST
Percolation test
Date Performed o~-/3 -} (/
If yes, at what depth?
Reading Date Gross Time Net Time Depth to Water Net Drop
Percolation rate
mi nute.
-Proposed installat-~-~-n-:--~e~-ge Pit Drain Field
,-~- Depth to bottom ~--pit or trench
~Jepth of Inlet ........... -
COI,II.1EItTS:
Performed By: ....... _~ertlfzed By
EQ 040 (6/74)
It is the res~z.~;~.~; c .... ~, ........
_b_lzlj)der,_prior 'to ¢cf.~L~l.cLui,, ~o veI,i~
proposea building grade relative to
~hed grade and utility connections
~ determ~o ~e ex~tence of any ease-
merits, covenants, or restrlctio~ which
do n~ appear on ~e re~rded subdi~-
non plat.
PREUM NARY
CERTIFICATION
LOT SURVEY
LEGEND:
8ross Cap Monument
Iron Pipe
Steel Pin
Lot ~ BlOck m Survey Hub ~ Tack
Anchorage Recording Precinct, Alaska