HomeMy WebLinkAboutSUMMIT ESTATES BLK 2 LT 18Bloc, K-
:ER ANCHORAGE AREA
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME (//~)~, J~/~//*/'/~/'~'~(' MAI~LdNG ADDRESS/~/~ ~/ PHONE~ ~ ~-~
LOCATION ~ ~/~/~ LEGAL DESCRIPTION ~ //~/~-~ ,/////A/~/~/
SEPTIC TANK:
DISTANCE / ~/~/~/~-.~:,- NUMBER OF
F RD M W E L L/'~/~M AN U FACT U R E R/~?~(--~--"~J~;'~~'~ MATERIAL ~-~'/~- COMPARTMENTS /
INSIDE LENGTH ~ INSIDE WIDTH ~L'/' LIQUID DEPTH ~"~'~--LIQUID CAPACITY/~)~Z~2 GALLONS.
SEEPAGE Pit: /
NUMBER OF PITS / DIAMETER /OR WIDTH
LINING MATERIAL ~,~ CRIB SIZE: DIAMETER~:~DEPTH ~ DISTANCE FROM: WELL./'~/----~) :// .
/'L~,/:'/-'~/-~f: TOTAL EFFECTIVE
BUILDING FOUNDATION~/~ ~ NEAREST LOT LINE~'~ "/~, ABSORPTION AREA (WALL AREA)'~'<:/~- SQ. FT.
ADDITIONAL ABSORPTION
WELL: ///~///"~ (-/~---
TYPE CONSTRUCTION
BUILDING NEAREST ~-~/
FOUNDAt,ON/ LOT L,NE
NEAREST
SEWER LINE
DISTANCE FROM:
SEPTIC / SEEPAGE
TANK ~'~
SYSTEM
CESSPOOI/L//~/~" , OTHER SOURCES /~/~/--/~'~: .A~/'/~-//
APPROVED DISAPPROVED REMARKS
DISTANCES:
INSTALLED
PIPE MATERIAL:
LOT SLOPE: ~
REMARKS: -J~/~-
Form No~ EQ-031
DIAGRAM Of SYSTEM
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GREATER ANCHORAGE AREA BOROUGH
DEPARTMENT OE ENVIRONMENTAL QUALITY
3330 'C" STREET ANCHORAGE, ALASKA 99503
TELEPHONE 274-4561
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
PERMIT NO.
NAME OF APPLICANT
[NSTALLAT[ON LOCATION
LEGAL DESCRIPTION
PHONE
FINANCED THROUGH TO BE INSTALLED BY
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK .
LL TO SEPTIC TANK /~ /
~R^iN FIELD {~ /
~ / , DRAIN F]ELD //~ /
/
SEEPAGE PIT
ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK ~--~/ , SEEPAGE PiT
DRAIN ~
TO RIVER, LAKE, STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEET IN~O UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON S~PHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT ReMOVAbLE ~APS.
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
OR
I CERTIFY THAT [ AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 20-68 AND THAT THE ABOVE
gPr~TER ANCRORAGE AREA BOROUGH
De ant of EnviYonmental Quality.~
'~-~-~ 3330 "C" Street
Anchorage, Alaska 99503
;' ~? fc,.-~ ~eixrts: Soils log ~ Percolatio~fi ~est
8-
~s ~round water encountered?
If yes, at what de~th?
R=,dding i Date Gross Time
Net Time
Depth to H20 !'~et Drop
~ ..... rn!et _] ................... , De~}th to bottom of sie~ or trench ....................... , ' '
..... Ct., ~I,1C~ ~, ---~- ................. . ~