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GRE -''' ANCHORAGE AREA BOR""'"H
Q Department of Environmental quality
3330 C Street
Anchorage, Alaska 99503
LOCAT,ON ~/~ Z-F/~/
MAILING ADDRESS
LEGAL DESCR,PT,ON fl/~^;72~ P~,
PHONE
X/o/J,2
SEPTIC TANK:
DISTANCE
FROM WELL
MANUFACTURER
MATERIAL
NUMBER OF
COMPARTMENTS J
INSIDE LENGTH
INSIDE WIDTH
LIQUID DEPTH __
.LIQUID CAPACITY/<~)OO
GALLONS,
SEEPAGE PIT:
NUMBER OF PITS / . DIAMETER OR WIDTH__ LENGTH DEPTH __ ?
LINING MATERIAL/_..]p/~(~J~J~7£. ~)/~.~'B~SIZE: DIAMETER DEPTH DISTANCE FROM: WELL
BUILDING FOUNDATION ~-g~'/ TOTAL EFFECTIVE
, NEAREST LOT LINE~///?~/U.~.~)g'/DABSORPTION AREA (WALL AREA) 3 ?¢
SQ. FT.
ADDITIONAL ABSORPTION
WELL:
TYPE D.,~'~'//~'-~) __CONSTRUCTION ~), ~,', DEPTH C DISTANCE FROM:
BUILDING /~ 2__, NEAREST ~)~ NEAREST SEPTIC ]
FOUNDATION LOT LINE // 7C 20 SEEPAGE ¢3.)
SEWER LINE ~'/~/'I/~L TANK SYSTEM
CESSPOOL
APPROVED
DISTANCES:
~ __, OTHER SOURCES
L.-"~D i'~A pp R OV ED
INSTALLED BY: ¢.,' . _
PIPE MATERIAL:
LOT SLOPE:
REMARKS:
Form No, EQ-031
DATE
_ REMARKS /(*,,,,,.
DIAGRAM OF SYSTE
I :),~/~/'~'"/~'
J
, ,
.~,xz. ~,z APPROVED --:~/.P'~/~Z/'F "' ¢'
GREATER ANCHORAGE AREA BOROUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C" STREET ANCHORAGE, ALASKA 99.503
TELEPHONE 274-456!
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
pERMIT NO..
NAME Of APPLICANT __~/L.~ Z~-~,~?~t~
MAILING ADDRESS
PHONE
INSTALLATION LOCATION
OTHER.
NOTI[: TH15 pERMIT I.~ NOT VALID WITHOUT SOil TEST
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACI(FIL, LING OF' ANY SYSTEM WITHOUT FINAL INSPEC:TION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTRORITY WIL[~ BE SUBJECT TO pROSECUTIOIq.
SEPTIC TANK SIZE ...... TYPE
MINIMUM DISTAN~:E~,, RE~UIReMD'NTS
WATER MAIN TO SEPTIC TANK ~W ' SEEPAGE PIT
DRAIN FIELD { 0 }
SEPTIC TANK, ~ ~ , SEEPAGE PIT DRAIN FIELD
SEEPAGE AREA SIZE
GBAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION,
TYPE
DIAGRAM OF SYSTEm
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OP' GREATER ANCHORAGE AREA ~IOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
DATE APPLICANT'S SIGNATURE
GREATF. R AI,ICttORAGE AREt\ BOROUGH
DEPART[?IENT OF ENVTRONMENTAL QUALITY
3330 "C" Street
ANCHORAGE~ ALASKA 99503
Legal Description: L o t__/~ ...... Block ~
This Form Reports Soils Log__~.
Case #
Dated Perfom~ed
Perco'lation Test
.~ Soil Test Must Be Logged To 4' Below Proposed Seepage System
Depth
Feet Soil Characi:eristics
4~
5--
6~
7~'
8~
9~
lO~
ll--
12--
13~
Was Ground Water Encountered?
If Yes, At What Del)th?
L_I ,i $_.J__JJJ .....
Reading [)ate Gross Time Net Time Depth to lt2D Net Dro~
ercolation Rate Mi n u [;e
Proposed Installation: Seepage Pit Drain Field
Depth of Inlet Depth to Bottom of Pit or Trench
Da te:
1'0:
6RLAFf:R ANCHOk,NCE AREA '3rj!~C'Ugll.
Department o'f Environmental Quallt,y
F. I£ i,i 0 R A ~.: i) U M
Hovmiiber.3, '19/¢
Attorney
'Fii P,U:
C.P. dudkins, R.S.
bi rector
Les L~uchilo'l z
~:nvi rOlll~iei'l~al Control Of'fi cer
Car/ ' ' ~
Ixaf c~r
SkA i~ox '1~6
S.b. Corner of i/iar,y Avenue h 121st St.
Anchor,~ge, Alaska
l. egal:
Lot '10, '3lock ?.
ilori;on Park SubUivision
H o o 1
t\cc'c. ,~ 3'16-2'1 i .-49
Vi o'1 ali on:
91 Z9/72:
'10/2/72:
lO/'l 7/'/~::
'10/27/72:
'11/3/72:
11/3172
Open cesspool 'in v'iolacion o? GAJ~,i$ Ordinance
[SeC~.lul/ J-dY paragraph (i\)
Issued warnin? &'Fld 'Jei:t Oil door'.
P, egi s'Lc~red '1 e'~ter start nC vi ol ati Oil aflo t*c(]L~i red
correcti ye ,I)rOCC{iU t'l)S .
Le'Lter
'ihm,edie,~c'ly aS tiii,C ~'l]OWed, (l~_) days l"rol;~ '1U/2/12)
has ~'1
Observed open s.ys'bum 'Chat is vio'tation o'F bOrOLJ!'jII
OI"diil~liiCt~$ ,
I init'iat(:d act'ion ~owards sut,run~ and ccI,,t)la'in'~.
J) J',,