HomeMy WebLinkAboutPARKSIDE BLK 1 LT 4I
GRE~,~ER ANCHORAGE AREA BOI~UGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION
OCATION//¢¥xri,*
/
REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
MAILING ADDRESS /2L~'. ,.~.ZC, ~/7/~'2" PHONE("~/
SEPTIC TANK:
DISTANCE /-/L___ ~ /~// NUMBER OF
FROM WELL %~'~ MANUFACTURER ~"~/~'?~-~ MATERIAL
"~-'---~- ~- ALLONS.
INSIDE LENGTH ' INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY/~f'~'
DISTANCE FROM WELL ./~ j ''~ 'x,-~g / '~/~ '¢- TOTAL LENGT~ /
. FOUNDATION NEAREST LOT LINE ~ OF LINES ~/
NUMBER OF LINES / DISTANCE BETWEEN LINES .... TRENCH WIDTH'~
IN. TOTAL EFFECTIVE
ABSORPTION AREA ~d. g; SQ. FT. LENGTH OF EACH LINE
DEPTH OF FILTER
--y' MATERIAL BENEATH TILE--~/X IN, ABOVE TILE ¢~ ,..
OEPTH:
TOP
OF
TILE
TO
FINISH
GRADE
BUILDING
FOUNDATION
CESSPOOL
APPROVED
CONSTRUCTION
NEAREST
LOT LiNE .
OTHER SOURCES
DISAPPROVED
DEPTH
NEAREST SEPTIC SEEPAGE
SEWER LINE TANK , SYSTEM
DISTANCE FROM:
REMARKS
DISTANCES: /J {"~ ~
INSTALLED BY:
SEWER LINE DEPTH:
PIPE MATERIAL:
REMARKS (
Form EQ-032
DIAGRAM OF SYSTEM
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Department of Environmental Ouality
3330 C Street
Anchorage, Alaska 00503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TAN K;to~
FROM WELL
INSIDE LENGTH INSIDE WIDTH
MATERIAL
NUMBER OF
COMPARTMENTS
LIQUID DEPTH
LIQUID CAPACITY/(~ (~)~'} GALLONS.
SEEPAGE l~' ~"~~
NUMBER OF PITS ·
LINING MATERIAL
BUILDING FOUNDATION
ADDITIONAL ABSORPTION
DIAMETER --
OR WIDTH
CRIB SIZE: DIAMETER___
NEAREST LOT LINE__
LENGTH DEPTH
DEPTH DISTANCE FROM: WELL ~/~' ~ ·
TOTAL EFFECTIVE
ABSORPTION AREA (NN~d~L...A'I~A) ~_~-%-'~ SQ. FT.
WELL:
TYPE .~& t~, CONSTRUCTION
BUILDING NEAREST NEAREST
FOUNDATION -- LOT LINE SEWER LINE
CESSPOOL OTHER SOURCES
APPROVED DISAPPROVED REMARKS
DEPTH DISTANCE FROM:
SEPTIC SEEPAGE
TANK __ SYSTEM
STANC ES: '~2J~O ~
INSTALLED BY: ~
PIPe MATE RIAL: (~--'~-'
Form No. EQ.031
DIAGRAM OF SYSTEM
F'O E:O::':: E;::L7 .ER:
FIIC'F'L I I:Z:I'*"INT ['_::t;:iE] HI::IMFII"~t",t
L. OCFf'I' I ON M'-/I;:'.Tt...E E:'F.':
L. EGFtI,~ I._EFf'd. 131....I<::L F'F:II;.'.I'(S I DE' . L.O'T' S I ZtE
Th"F'E CtF' '/:i;O :t: L FIB:5;I:]II;~:IBT I ON ,[.E;'9:E;"I'Et't I E; '
I"'IFt;:':; I I"t1..11"'1 i'.,II.Ji"IE',[::F.'. OF I..:.',[EI]:'f;.:(](]lq'-'~ =: :}i; :~.;EI I L RFtT I t",tG ': ':2 :~ FT',."Ei~F.: ::
........ *' -~ .:, r ::, I I::.t i
THE I:;.:E':E!IJ .1: F.':EI]' 5 .[ ,::,E [" THE ~::';O I L. FtF '::;OI:;::F'T I ES! .............. " :
THIE LENGTH .F.:, I I"lEi',l'.i; I O1'-,t I E; 'THIE LEi'qEiTH ,:7 t N F:EET ) OF THE 'TF..:IENE:I..t O1~: [)[;?.FI I I'-,!,l::' I EZL.I:;,.
THE DEPTH Eft: FI TRENCH ,OR PIT I$ "rile [.".,:ISTRNC'E EflETI4EEI'-,I THE '.:.:;URFFICE OF THE
GROUND f-"ll",tD '1"HE BOTTCIM OF THE EXE:Fi'v'FfTIOi'.4 ,:::r.N FEET::,.
THEF,'E; IS NO SE"F 14ID"f'H FOR TRENCHES.
THE GI:;::FIVEI... DE:I::"TI'"I I?.'; THE I"IINIMLtM E:'EF'TH OF (:~F.:Ft","E'L. BETWEEN THE: OUTI::"FII..,.I.... t:::':[F'E
FIND THIE E~O"I"TOM [:if: 'THE EXCFIVRT I Ot".! ':: I N FEE:T.':'.
E~'.' E:E ,2:-.711......11 ]E 11:;?.: fEE EZ:, ."EE; IE~ F" 'qP a:: ,LC:: "'IF" FIt R-,~ E,.:::: E-E; ]E. ;.E'." fEE: '== :'dL t(EJ~ ir?7, EF$ ,:]:i3 I[:::~ I1..._ L.. lC) Ii"-,,It .".Ei::';;
-IF" Ldt CZZ, ,::: ;2.". ::,, :E It"dt ."_~..,, F' EE: ,%:: '"'IF Z ,.":."~ Ii'dj ~Ei;
BFiCKF ILL. I i'.,IE-i ElF I::tN'¢ %'-r'STEM I.,I t THOUT F ]: I'.,!I.':IL I i'-,I':':]PECT!' O1'.,I FII',I[:, FiI::'F:'I:;::O',/FIL. E:"r' 'TH I Si;
E:,EF'F:IF.'.TMEI",I"f' 14ILL BE '.E;UIF.':JECT TO F'F:.:OSECLrY:[ON.
I'Il NZI:I'ILIM E:,I:~;TI::II'..ICE BE'T'I.,.IEEN Ft I.,.IEL. L FIN[':, Ri'.4V Oiq-E;:[TE
::t. OO I:.--EET F..'OI:~'. R F'R]:',,,'FITE WEL.L (IR :200 F'EET F:'OF.'. FI F'UE',LIC I.,.IEI_L..
SPEC ]: F .T. E:I::IT '[ ON:E; F:INI], C'ONSTI-::.:UCT I ON [.'-" I RGI:;?.I:IFIS I:~F.~:E FI',.,'FI I LFIE:LE TO I 1'4%IJI~'.IE PIT:.'X]F'EF?.
I N S TRL..L.FFI' I ON.
F::::" EEC li::,~: Ibll ."E 'T' ".,," F:I! L... ]E §Z:, F~ E2)t Ilx~: ItZ:~ li".-.~ EEi:: "-,-" E-}] ll::'-'~ ~-" Lf.='' F.F:.." {]]lt Ih"l] ]E ::!~.::':;; '.:E..E.;; L.il EE
I C:EZRTIF"r' THRT '
::L: I FIM I'--'FII"'I:[ I_ I RE: 141 'T'H THE: REQU I REZMENTS FOE'. ON-S I TE :E;EI.,.!EI;.::Ei RIqE:, I.,JELI....S R:i~, :E;E:'T'
FORTH B'-r' ']"HE I"'IUN I E: I F'FII... I T"r' OF RNE:HOIT:FtGE.
2: :[ 14ILL IN'Z'-';TRI_L THE S'gSTEM IN RCC'OR[:'FII',ICE 1.4ITH THE CO[:'EE;.
Z.::: I UNB, ERSTFII',I[:' THFIT THE: ON-E;]:TE %EWEI:;:: '.:.:.;'¢::T.,TIEFI I'"lla'¢ F..'IEQU:[RIE ENI_RI:;.':GEMENT IF:' 'THE:
F.':EE;I[:,ENCE IS; RE'I"IOE:,E:I....EI], 'T(] INCI....UDE MORE THFtI'.,I ~: BEiDROOI"I:~.
PIERM I ]" t'.,I EL
F:IP F'L ~' Ci=INT
LOCFIT I ON
I_E(]il=lb
DEPI=IR'FHENT .~_,.~ HERLTH RND EN'v'I ROI'.~MENTFIL. "_" TECT I ON
'251E1 E. TIJE:,OR RE:,.., FtNC:FIOF.'R SE., i~K. :9~ 5El7
· ~,"~,¢.~ ,";,C,
r- '= .z. E i.-4t Er'- F:. F' E F: Ir'-1% '"F
.,.iii 4i----. Z T~: " ....... "
( 76273: )
BO::.:: 6i7 E. R.
HFI,Mf:tNN P.F NSTRIJL;T I ON,
i't~RTLE [. F.. I ,, E
Lq- B:]. FHF..k=tE.E SUEDE:,
=., T F..EIq ...H
T%'F'E Eft: SOIL hE,:,_F..E, TION :,T:,TEH I :
694-2:776
SIZE 8'?:].20 SF..:!LIRRE FEET
MRXIMUM NUMBEF.: OF' BEDROOMS = 3: SOIL RR"FING (SQ FT/BR)= 85
'~r'~ I L FIE:SOR~'~'~ ON ~'¢STEH I S:
THE RE~i!IJIRE[:' SIZE OF ]"HE _~
'file LENGTH [:,~F1ENSZCff'~ ZS THE LENGTH (ZN FEET) OF THE qREN_.H OR E:,RFtINFIELD.
THE [:,EF'TH OF Ft TRENCH OR F'ZT ~S THE [:,ZSTRNCE E:ETHEEN THE 5URFFICE OF THE
GROUND FIND THE EiOTTOM OF THE E~-::CRVRTZON (ZN FEET.':'.
THERE ZS NO SET HZDTH FOR [REN_.HE=,.
r""""",'*'' E.E. F1H Z=, THE [,1Z[.~Z['lI_I['l DEFfH OF =R.H¢E[_ E:ETHEEN THE OUTFRLL PZF'E:'
THE ~P.n,~ -""
RND THE BOTTOM OF' THE E::.:',CFI',/RTZON (ZN FEET).
BRCKF'ILL. ZNG OF RN¥ S'¢STEM HZTHOUT F[NRL ZNSPECT[ON RND RPPROVRL D%' THZS
DEPRRTMENT HZLL BE SUBJECT TO PROSEE:UTZON.
f,IZNZMUM DZS'I"RNCE BETHEEN R HELL RND
~00 FEE'I" FOR R PRI'v'RTE HELL OR '::2C~O FEET FOR R pI.IBL. ZC HEL. L.
SPEC Z F I CFITZ ONS RND CONSTRIJCT~ ON E:,Z RGRFI/'IS RRE R',/R Z LRBLE' TO Z NSURE F'R: F'ER
Z NSTRLL[~T [ ON.
I CER'f'IF'¢ THFIT -- .,-
i: I Rf'l FRMILIRR HI'TH THE REL;!UIREMENTL=.; FOR ON-SITE :,EHER= FINE:, HELLS R'S SE:]"
FORTH B'¢ THE M_NtL:IFHLIT OF RNCHOF.:RGE.
2: I HILL INSTRLL THE =,~:,TE.H IN FiCCOF.:£.,I-.]I.&]IE HITH THE RFiE:,ES.
3:: I UN[:,ERSTRN[:, THFIT THE ON-SITE _,EHEF.. S'¢STEM MR'¢ REI;!I_IIRE ENLFIRGEMENT IF THE
RE~; I [:,EI'.~CE 12; REMO[:,ELE[:' TO I NCLI_IDE t"1] F.'.E THFIN =' E:E[:,ROOMS.
S I GNEI}: ~P,PL I CRI.4T ~r, lRN. ]:: · S .._ -: . · ...........
. !
.~' DeparLinent of [nviroruuenLal%,,~JaliL
333D "C" Street
Anchorage, Alaska 99b03
.,. SOII~S I,()G -' PI';ROI,ATION TEST
Performed for ~ ~ ~ ~ ~~~ ..... Date
This form reports: Soils log ~ ...... Percolation Lest / "
Dep th
Feet
5-
6 -
7-
8-
9
ll -
12-
13-
Was ground wa~er encountered? __~k~
Reading Date Gross Time
If yes, at what depth?
Net Time
Depth to Water
· ~' ..... ~,--- ' Drain Field
-Proposed ~nstallatlon: aeepaqe Pit
I)upth of Inlet '. Depth to ]~f pit
Net Urop
°'0.. {all h worth · tho~a#d opi.ians"
2204 Cleveland Anchorage, Alaska 99503 .- 277-0231
/
l~ca_t ion d-D ir ~-~ ./j/~5~/< /
Top Bier , .~ ~/5 7-¢ ~'~
DBPTH CLASSIP ICAT ION SAI~PI.~
DATA LBGK NI)
4
67 ~ ~P-~ ~d~¢~sand ''''''0f~,- "" '
Clay