HomeMy WebLinkAboutKNIK HEIGHTS BLK F LT 18LoT
1
¢;017
IF'
oGRL
/ER ANCHORAGE AREA BO' hUGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME 7z~~:~'''/ ..3T z4'.~/~/2'~:~'/'_ MAILING ADDRESS 'Zz~--~Pd) (/'-'~,//./"~'r'-f/:m-~'.'~
L.OCA-FION/~/7~'~.?Z'~-Z'5"/-~~'O-//'~:~-r' LE GAL DESCRIPTION
SEPTIC TANK:
DISTANCE
FROM WELL
INSIDE LENGTH
M AN U FAC T U R E R -~:~"~'~-~-"-?~ MATERIAL
NUMBER OF
COMPARTMENTS
INSIDE WIDTH
LIQUID DEPTH '~-- ,LIQUID CAPACITY ~...'~-'2_/'2_..-2 GALLONS.
SEEPAGE PIT:
NUMBER OF PITS--,/ DIAMETER ~
LINING MATERIAL ~ ~')/'-~ CRIB SIZE:
BUILDING FOUNDATIONr-~ ~;'
/ /
OR WIDTH -/~, LENG-FH'/~/, DEPTH ~..~:-.~</.~v../-,
DIAMETER~/" DEPTH ~ DISTANCE FROM:
/ ~.-~..~./~'~ .5~. TOTAL EFFECTIVE
NEAREST LOT LINE.~'~> "-~.. ABSORPTION AREA (WALL_ AREA) .:~--~6'-: .SQ. FT.
ADDI-FIONAL ABSORPTION
WELl_:
TYPE ..~//~5~./~//~..~:~.~.-..-./~r:.~ CONSTRUCTION
BUILDING NEAREST
FOUNDATION_ LOT LINE
CESSPOOL OTHER SOURCES
APPROVED DISAPPROVED
NEAREST
SEWER LINE
REMARKS__
DEPTH DISTANCE FROM:
SEPTIC SEEPAGE
TANK .__ SYSTEM
PIPE MATERIAL: ~ /'/~'c'~-/ _
LOT SLOPE:
REMARKS:
DIAGRAM OF SYSTEM
Form NO. EQ-031
GREATER ANCHORAGE AREA EIOROUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C" STREET ANCHORAGE, ALASKA 99503
TELEPH(DNE 274-456 I
SEWAGE DISPOSAL SYSTEM ---- APPLICATION AN[) PERMIT
INSTALLATION OF: SEPTIC TANK
~YPE AND SIZE OF FACILITY TO BE SERVED
FINANCED THROUGH
MAILING ADDRESS /¢/'~' g} ~'~
PNONE
., OTHER--
TO BE INSTALLED bY ~-~ L'/%
NOTE: THI~ PERMIT tS NOT VALID WITHOUT SOIL TEST
COMPLETIDN DATE ANTICIPATI::D '--'YGZ /°"//g'/tc-~/Z'~ /~ ~ ......
FINAL INSPECTION: 24 IqOUr NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION,
SEPTIC TANK SIZE /~) ~b~ TYPE ~d"~t;~' ~/Z -~'SEEPAGE AREA SIZE ]YPE
DIAGRAM OI~ EYSTE~
MINIMEJM DIS'rAI~i<2ES, REOUIREMEN'rS
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT
SEPTIC TANK TO SEEPAGE PIT WALL
DRAIN FIELD /0~ /
- ' ., DRAIN FIELD
SEEPAGE PIT / L~-¢ /
ALSO CONSIDER AREA WELLS.
"~FF-.SEFTIC TANK, ;'~'~-' / ., SEEPAGE PIT
· SEEPAGE PIt
TO RIVER, LAKE, STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP Of
EXCAVATION 5 FEET INTO UNDISTURBED SOIL,
4 INCN DIAMETER DAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GI~IAVB g BAC;KFILL
CONFORM TO BOROUGH REGULA'rlONS REGARDING INSTALLATION.
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO, 28-68 AND THAT THE ABOVE
GREATER ANCHORAGE AREA BOROUGH
DEPARTMENT OF ENVIRONMENTAl. QUAI..ITY
3330 "C" Street
ANCltORAGE, ALASKA 99503
Performed For d ~'~l ri 'F~f {; %
Legal Description: Lot Block
This Form Reports Soils Log__y
Case
Dated Performed__. ~/~
Subdivisi°n_-J~-~lW ~[~_]~LqZ~
Percolation Test
Soil Test Must Be Logged To 4' Below Proposed Seepage System
Depth
Feet
6--
7--
8~
11--
12--
13~
Soil Characteristics
Was Ground Water Encountered?__/~C>
If Yes, At What Depth?
Reading Date
Gross Time I Net Time
L
1
Depth to H20
Net Drop]
Percolation Rate Minute
Proposed Installation: Seepage Pit Drain Field
Depth of Inle~ Depth to Bottoln of Pit or Trench-
COMMENTS: ~~_~,~., _
Date Certified BY: Date:
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 274-4561
Date Received
Time of Inspection
Date of Inspection
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER:FACILITIES
FOR
1. Approval requested
Mailing Address:
2. Property.Owner: J',~?/~:'~_~
Mailing Address:.
3. Legal Description:
4.
5.
6.
Phone:
Phone:
Location:
ype o+ +acility to be inspected
Well Data:
A. Type
C. Construction
Sewage Disposal System:
A. Installed
C. Septic Tank: 1. Size
No. of bedrooms
B. Depth
D. Bacterial Analysis
B. Installer
/.,~_~,..~q~.~_ 2. Manufacturer
D. Seepage Pit: 1. Absorption Area ~f~/ 2. Material
E. Disposal Field: Total length of lines
Distances:
A. Well to: Septic tank 7 , Absorption area /~/ , Sewer Lines /¢.,
Nearest lot line /~/~, Other contamination
B. Foundation to septic tank ~/ , Absorption area
C, Absorption area to nearest lot line ~d~z
EQ-034 (1174) Page 1 of two pages
?age 2 of two pages - Re ~.st for Approval oi~ Individual
Legal Description
er & Water Facilities
Approved Disapproved ,~ ,,~.~
Approval Valid for one year from date signed
Greater Anchorage Area Bor. ough, Department of Environmental Quality
Date
DIAGRAM OF SYSTEM
certify that the information contained in this request for approval to be a true and
accurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED
Date
EQ-034 (1/74)