HomeMy WebLinkAboutT13N R3W SEC 15 Lot 24
GRE, ER ANCHORAGE AREA BOP UGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
DISTANCE OF
FROM WELL/~¢¢ /¢ MANUFACTURER ~¢/~f~/~¢' ~.~ /~ NUMBER
COMPARTMENTS
INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH ~ .LIQUID GALLONS.
SEEPAGE PIT:
NUMBER OF PITS
LINING MATERIAL'~ ~'.~¢:2 CRIB SIZE: DIAMETER
BUILDING FOUNDATION ~/, ~ I ~t.
NEAREST LOT LINE~O
ADDITIONAL ABSORPTION
DIAMETER OR WIDTH/¢/LENGTH/~,
DEPTH ~'~
D~STANCE EROM= WELL~,~--
ABSORPTION AREA (WALL AREA) . T.
WELL:
TYP ' CONSTRUCTION DEPTH DISTANCE FROM:
BUILDING NEAREST NEAREST SEPTIC - ~ SEEPAGE /~ /
FOUNDATION LOT LINE SEWER LINE TANK///~[) '/; , SYSTEM
CESSPOOL OTHER SOURCES
APPROVED ~ DISAPPROVED
REMARKS
DISTANCES:
INSTALLED
Form No, EQ-O31
DIAGRAM OF SYSTEM
'~~rEATEr ANCHORAGE AREA BOROUGH
SEWAGE DISPOSAL SYSTEM'-- APPLICATION AND PERMIT
TYPE AND SIZE OF FACILITY TO BE SERVED
FINANCED THROUGH
TO BE INSTALLED BY
FINAL INSPECTION: 24 HOUR NOT~GE REQUIRED. BACKFILLING OF ANY SYSTEM W THOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
S PT,O S'ZE Iooo
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT ~ DRAIN FIELD
SEPTIC TANK TO SEEPAGE PIT WALL
SEPTIC TANK ~ SEEPAge PIT
WELL TO SEPTIC TANK '/~--/(~]0
· DRAIN FIELD
SEEPAGE pIT
ALSO CONSIDER AREA WELLS.
., SEEPAGE PIT .
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
4 INCH D[AMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH Al RTIgHT REMOVABLE CAPS.
GR/~VEL BAC:KFILL
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
Legal Description: Lot Bl~ck Subdivision
This form Re~orts Soils Loa
~enth
Feet Soil Characteristics
"On~ tes~ is worth a thousand oI~inions"
Performed For "dt/~x.~.~lUe~ Date Performed
Percolation Test
2
Was Ground Water Encountered?
Ii~ Yes, At what Depth?
Reading Date Gross Time Net Time Depth to H20 Net Drop
Perco'lation Rate )Hnute
Proposed Installation: Seenaoe Pit ~ Drain Field
Depth of Inlet , ' Depth~To Bottom Of Pit Or ~r~!.ch
i'est Performed ay ~ /~d.~-- Data CertiJ~ied