HomeMy WebLinkAboutMCKINLEY HEIGHTS #1 BLK 7 LT 6
/
DEPART~EI~T 0F ENVIR0~E~TAL QUALITY
350(} TUDO~ l~OAO ANCHORAGE, ALASKA 99507 279-8586
INSPECTION REPORT ON-SITE SEWAGE DISPOSAl.. SYSTEM
SEPTIC TANK:
. , ~ ' NUMBER OF
DISTANCE
FROM
LIQUID C~P~C~rY ~yR~ GALLONS INSIDE LENGTH~_~,~L ....... ~ INSIDE WIDTH._ _/ LIQUID
DEPTH.
SEEPAGE SYS] EM: SEEPAGE
NUMBER Gl: PIIS .............. OUfSIDE DIAMETER__ __ ..... OR WIDTH ................ LENGTH ..... DEPTH__
LINING MATERIAL ...... ,-~ .............. DISTANCE FROM WELL .............. BUILDING FOUNDATION
NEAREST LOT LINE ............... 1ORAL EFFECTIVE ABSORPTION AREA (WAH. AREA)
SQ, FT.
TILE DRAIN FIEI.D:
DISTANCE FROM WELLX;~[~'? :~--/--~-[~, FOUNDAIION.__
NUMBER OF LINES ___f: .......... DISTANCE BETWEEN LINES
ABSORPTION A R E A. _~ ~-~:.'_i: ~'~
DEPTH: TOP OF TILE TO FINISH GRADE
/ TOTAL LENGTH
~('' 1RENCH WIDTH IN. TOTAL EFFECTIVE
' // IN.
DEPTH OF FILLER MATERiAl BENIA[H I'IIE (% ABOVE TILE
WELl_:
LOT LINE
DISTANCES:
':~i :" i,'i,
'~i, ~~, ~.~, ,.,~., ~,
........ DEPTH
NEAREST
SEWER LINE
DISTANCE FROM , WA[ER
, BUILDING FOUNDATION ........... SAMPLE._
SEPTIC , ~ SEEPAGE --. ,
., TANK ' ,t~ x-',. ,',- sYSrEM_._~_~(£d~J~__, CESSPOOL
DIAGRAM OF SY,"~TEM
., NEAREST
OTHER
____, SOURCES __
' '?~' APPRO\/ED___~ ............. t _r
DATE "'
G.A.A.B.
GREATER ANCHORAGE AREA BOROUGH
DEPARTMENT OF ]ENVIRONMENTAL QUALITY
3500 TUDOR ROAD POUCH 6~650
ANCHORAGE, ALASKA 99502
SEWAGE DISPOSAL SYSTEM APPLICATION AND PERMIT
LEGAL DESCRIPTION
INSTALLATION OF: SEPTIC TANK r~
TYPE AND SIZE OF FACILITY TO BE SERVED.
SEEPAGE PIT , DRAIN FIELD , OTHER
TO SE ~NSTALLED BY
NOTE: THiS PERMIT IS NOT VALID WITHOUT SOIL TEST
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
HEALTH DEPARTMENT AUTHORITY WILL SE SUBJECT TO PROSECUTION.
/ .!;-'/ ,:' TYPE ' t " ? ,:',/
SEPTIC TANK SIZE TYPE ' ¢ SEEPAGE AREA SIZE / .' .
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
WATER MAIN TO SEPTIC TANK
DRAIN FIELD
SEEPAGE Pit
TO RIVER, LAKE, STREAM.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO E~oROUgH REGULATIONS REGARDING INSTALLATION.
HEALTH AUTHORITY
OR
LICENSED DESIGNER
DIAGRAM OF SYSTEM
/ /
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS Of GREAT,ER ANCHORAGE A~,~A,~ORCUGH
ORDINANCE
NO.
28-68
AND
THAT
THE
ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE, /' /----' /
/
GREATER ANCHORAGE AP,.EA BOROUG.
tIEALTii DEPAI::TNENT
32? EAGLE STREET
ANCtIORAGE~ ALASKA~99501
CAS£; g
Depth
'Fee v.
Was Ground Water EncOuntered?
if Yes, AU Wha~ D,~p~h ~
Reading i Date
Gross Time
Location Sketch
[t
I
Depth To H20 1 Net
....... jZ i .......
Proposed Instal~a{ion: Seepage PiT Dmain Field
Deoth'Of inlet Depth To Bottom Of Pkt Or
~, , ,~ .-
_ , ,, ,, __u ,, , , , .~d g~: ~-=Ag~/'"~/-~4 ~' '