HomeMy WebLinkAboutMCKINLEY HEIGHTS BLK 2 LT 8
GRE ER ANCHORAGE AREA BO! :',UGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCATION
MAILING ADDRESS /~/( '~1¢¢/~ C~/'~/(' PHONE
LEGAL DESCRIPTION ~'~ ~'~ ''~ /~/~/~/~
SEPTIC TANK:
DISTANCE ~ / ,/~/,, NUMBER OF
FROM WELL ~¢ MANUFACTURER /~.-~'""'l~,/~ MATERIAL ~(-"~-~"/'~ COMPARTMENTS /
INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY /~ GALLONS.
SEEPAGE Pit:
NUMBER OF PITS __
DIAMETER__OR WIDTH , LENGTH ? DEPTH
LINING MATERIAL CRIB SIZE: DIAMETER DEPTH__ DISTANCE FROM: WELL
TOTAL EFFECTIVE ~ ¢¢
BUILDING FOUNDATION__ NEAREST LOT LINE__ ABSORPTION AREA (WALL AREA) SQ. FT,
ADDITIONAL ABSORPTION '~O/'~~v~/ '~/~' ¢ ¢ (~ ~¢~ ¢
WELL:
TYPE
BUILDING
FOUNDATION __
CESSPOOL
APPROVED
NEAREST
LOT LINE SEWER LINE
OTHER SOURCES
DISAPPROVED REMARKS
DEPTH DISTANCE FROM:
SEPTIC SEEPAGE
TANK __ SYSTEM
DISTANCES:
INSTALLED BY:
PIPE MATERIAL:
LOT SLOPE:
Form No. EQ-031
DIAGRAM OF SYSTEM
APPROVED/~ /~"~ ~--~
~' G.A.A.B.
NAME Of APPLICANT
GrEa'rEr ANCHOrage AREA BOROUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3500 TUDOR ROAD POUCH
ANCHORAGE. ALASKA 995'02
TELEPHONE 279-8686
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
INSTALLATION LOCATION
iNSTALLATION OF: SEPTIC TANK ~ SEEPAGE Pit , DRAIN FielD
SOIL TEST RESULTS
. OTHER
NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
COMPLETION DATE ANTICIPATED
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK ~
FOUNDATION TO SEEPAGE Pit _'~
SEPTICTANKTOS~PITWALL~
SEPTIC TANK ~ SEEPAGE PIT
TO NEAREST LOT LINE.
WELL TO SEPT'C TANK
SEPTIC TANK, /~ SEEPAGE Pit
TO RIVER, LAKE, STREAM.
DRAIN FIELD
, DRAIN FIELD
SEEPAGE PIT
ALSO CONSIDER AREA WELLS.
SEEPAGE PIT _~
~/~ , DRAIN FIELD
CAST iRON iNTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP Of
EXCAVATION 5 FEET INTO UNDISTURBED SOil.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE P~T
FITTED WITH AIRTIGHT REMOVABLE CAPS.
DIAGRAM OF SYSTEM
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
~ ~-- H~-~L~{ AUTHOI~ITY OR
LICENSED DESIGNER
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
DATE _ .~- __J~ ~ -- APPLICANT'S SIGNATU
GREATER ANCHORAGE AREA BOROUGH
DEPARTMENT OF ENVIRONMENTAl QUALITY
3330 "C" Street
ANCHORAGE, ALASKA 9950S
Performed For
Legal Description: Lot ~ Block
This Form Reports Soils Log
Depth
Feet
11--
12--
13--
Case #
Dated Per.formed S-
Subdivision ~VI ¢/~;~/~y
Percolation Test
Soil Test Must Be Logged To ~' Below Proposed Seepage System -
Soil Characteristic~
Was Ground Water Encountered?
If Yes, At What Depth?
Reading
Date
Gross Time I Net Time I Depth to H20
Net Dro
Percolation Rate Minute
Proposed Installation: Seei~age Pit Drain Field
Deoth of Inlet ............................ Depth to Bottom of Pit or Trench'
COM~[NTS:
Test Performed BY ,~_~_~_~_. _ .......... Date~ Certified ~Y:.,
Date:
700 "t~" St~reet
Anchoro~e, Mesk~
Block ~ - ~nl~ Het~h~$ Sul~vtslon.
are very 9oo~.
JgL/sh