HomeMy WebLinkAboutT15N R1W SEC 4 Lot 1 & 2
GREA-
' ANCHORAGE AREA BOR
Department of Environmental Quality
3500 Tudor Road
Anchorage, Alaska 99507
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME ~'/~¢'~-/~-~? ',./~ ~",'~'~-? MAILING ADDRESS~/~.J/ /-//g) 7 ,'~Z~t~/~,~ .~./~b PHONE
LOCATION~}/Y~ /,_~'.~ ~/~'~)/// _~/~//~ //?/z~: LEGAL DESCRIPTION~2/~/X.~/ ~C'. <~/ ~--/,<7~'~'~
SEPTIC TANK:
DISTANCE
FROM WELL
INSIDE LENGTH
NUMBER OF
, <~'_~/~¢~ MATERIAl ~b/~- /~9'2~,~2/-/ COMPARTMENTS
MANUFACTURER, g~/'~ (~- ~/
INSIDE WIDTH ~ LIQUID DEPTH -- LIQUID CAPACITY~,~ GALLONS.
SEEPAGE PIT:
NUMBER OF PITS /
DIAMETER /~-- ~ OR WIDTH -- , LENGTH ~ , DEPTH -
LINING MATERIAL c'?~2n~FZ[?-//~
BUILDING FOUNDATION ~'/,
CRIB SIZE: DIAMETER ~ DEPTH ~;/ DISTANCE FROM: WELL /./'2('9 '~ /
TOTAL EFFECTIVE
NEAREST LOT LINE 2_~~ / . ABSORPTION AREA (WALL AREA) ~'~) (~ SQ. FT.
ADDITIONAL ABSORPTION
WELL:
TYPE 4:~/2 ~ W/g/~/
BUILDING
FOUNDATION __
CONSTRUCTION
NEAREST
LOT LINE
CESSPOOL '~ OTHER SOURCES
APPROVED
DISAPPROVED
'~ DEPTH ~ DISTANCE FROM:
NEAREST SEPTIC ~/ SEEPAGE /
SEWER LINE TANK ~ , SYSTEM Z~Y~) /
REMARKS
INSTALLED BY:
PIPE MATERIAL-
LOT SLOPE:
REMARKS:
Form PW-026
DIAGRAM OF SYSTEM
/ / r ~
GREATER ANCI-IORAGE AREA BOROUGH
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
NAME oF APPL~¢A"T --
INSTALLATION LOCATION
INSTALLATION OF: SEPTIC TANK
SOIL TEST RESULTS
COMPLETION DATE ANTICIPATED
SEEPAGE PIT---- ~ DRAIN FIELD OTHER
PFRi'4TT VAI Ill ONF YFAR
FINAL INSPECTION~ 24 HOUR NOTIC~ REQUIRED. BACKFILLING OF ANY SYSTI':-M WITHOUT FINAl. INSPECTION BY Th:
MINIMUM DIBTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT 20 ~=[* , DRAIN FIELD [0
SEPTIC TANK TO SEEPAGE PIT WALL 15
SEPTIC TANK ~ ~$9 SEEPAGE PIT ~, DRAIN FIELD
DRAIN FIELD ALSO CONSIDER AREA WELLS.
TYPE
DIAGRAM OF SYSTEM
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PiT
q)- u " ALT"Ao T"O'"TY
ROUSE
CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE /~/~EA E~OROUGH ORDINANCE NO, 28-68 AND THAT THE ABOV£
DESCRtBEO SYSTEM IS IN ACCORDANCE WITH SAID CODE, .