HomeMy WebLinkAboutKRAMP BLK 1 LT 4
GI~"~.TER ANCHORAGE AREA BORO' ',H .....
HEALTH DEPARTMENT N? 779
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
W/ ~//.__/.,~ ,~).~ ' * MAILING c:~/.~' -~,"~?-,::~.-.~--~b4/~'''-,
NAME '(~.~/,/7//2 ' /~/~]]~ ADDRESS ~ ~ ~/~-~ PHONE
SEPTIC TANK:
DISTANCE FROM WELL ~d'- MATERIAL ,"~",.~=,~:'/- NUMBER OF
_
LIQUID CAPACITY ~ _GALLONS. INSIDE LENGTH INSIDE WIDTH. DEPTH
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PiTS / .OUTSIDE DIAMETER ~- OR WIDTH ~.CO , LENGTH ,~'/ , DEPTH S
LINING MATERIAL ' S/~.''tI/ DISIANCE FROM WELL . BUILDING FOUNDATION ,.
TILE DRAIN FIELD:
DISTANCE FROM WELl
NUMBER OF LINES ~
ABSORPTI~EA
, F O U N D A TI O~-N-'~"'~--..
DISTANCE BEIWEEN LINES
, NEAREST LOT LINE
'~'~'~- TRENCH WIDTH
SQ. FT. LENGTH OF EACH LINE
TOTAL LENGTH
, OF LINES
~N.~r'~TA L EFFECTIVE
DEPTH: TOP OF TILE TO FINISH GRADE
DEPTH OF FILTER MATERIAL BENEATH TILE
IN. ABOVE TILE
WELL: TYPE /)t"~,~/,/ , DEPTH
LOT LINE ,~,c0/'2J~ /¢C.; NEAREST
· , SEWER LINE
· _ DISTANCE FROM
, BUILDING FOUNDATION
SEPTICo~ / SEEPAGE /";"/ /
__ TANK__ '~r > , SYSTEM
WATER
SAMPLE ,,P~//~/I2'Z-- , NEAREST
~ OTHER
, CESSPOOL , SOURCES___
DISTANCES:
DIAGRAM OF SYSTEM
DATE
HEATAUTHORi1Y
GREATER ANCHORAGE AREA BOROUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3500 TUDOR ROAD POUCH 6-650
ANCHORAGE, ALASKA 99502
TELEPHONE 279-8686
SEWAGE DISPOSAL. SYSTEM -- APPLICATION AND PERMIT
NAME OF APPLICANT ~/ ~/~ · ~ -J\ MAILING ADDRESS
INSTAllatiON LOCATION (, /~ / '
INSTALLATION OF: SEPTIC tANK ~ S~EPAGE PIt ~ , DRAIN FIELD
FINANCED THROUGH .~ TO BE INSTALLED BY '
PERM,TNO.,
PHONE
., OTHER
NOTE= THIS PERMIT IS NOT VALID WITHOUT BOIL TEBT
COMPLETION DATE ANTICIPATED
FINAl. INSPECTION{ 24 HOUR NOTICE: REQUIRED, BACKFILLING OF ANY BYBTEM WITHOUT FINAL INBPECTION BY THE
HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROBE{::UTION,
DIAGRAM OF ~Y~TEM
MINIMUM DISTANCEB, REQUIREMENTS ;~/
FOUNDATION TO SEPTIC TANK J)
/5- '
FOUNDATION TO SEEPAGE PiT DRAIN FIELD
SEPTIC TANK TO SEEPAGE PIT WALL /)
;Z,(;I '
TO NEAREST LOT LINE.
~ 1
WELl TO SEPTIC TANK , SEEPAGE PIT
DRAIN FIELD ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK ,SEEPAGE Pit
DRAIN FIELD
~. / /00 ~
SEPTIC TANKi if SEEPAGE PIT , DRA,N FIELD
TO RIVES, LAKE. STrEAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER C~R~L~IPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE.
/
_; ~. ,o /-/7
,~'~' GREATER A~CHORAfiE AREA BOROUGH
IIEALTIi DEPAkTHENT CASS
327 EAGLE STREET ---': ..... ' '
ANCHORAGE, ALASKA 99501
Performed For --- Date P~rformed
Thzs Form Reports a~ bozls Log ~ '
Depth
Fee~ Soil Characteristics Location Sketch
WaS Ground Wate~ Encountex,ed?_ ::/Tz~
..~ Yes, At Wha~ Depth
Gross Time
Net Time
Depth To H20
Net Drop
Proposed Instal~Seepage Pit Drain Field
oep~n ~f znle~ Depth To Bottom Of Pzt Or Trench
Data Certified By: W, F. At~ood ' '~ / ~'
Date:_~une 7, 197i ~ .