HomeMy WebLinkAboutMCMAHON BLK 1 LT 13
Gp~'~\TER ANCHORAGE AREA BOROI~H
HEALTH DEPARTMENT ~'? 8~5
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-25! 1
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME ~
LOCATION
ADDRESS ~ C/Z ~ '~ ~2 '7 PHONE
LEGAL DESCR,PT,ON '~ f ''-~/~ / /?~ Y;'~' 4 ~> '~
SEPTIC TANK:
DISTANCE FROM WELL
LIQUID CAPACITY
/0 7'
GALLONS.
INSIDE LENGTH
NUMBER OF
COMPARTMENTS
INSIDE WIDTH
LIQUID
DEPTH
SEEPAGE SYSTEM: SEEPAGE PIT:
NEAREST LOT LINE
OUTSIDE DIAMETER
OR WIDTH
DISTANCE FROM WELl /'~'~
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)
, LENGTH , DEPTH
BUILDING FOUNDATION
TILE DRAIN FIELD:
TOTAL LENGTH
DISTANCE FROM WELL FOUNDATION ~-~-~.-~.~.NEAREST LOT LINE ..~.~OF~LLINES ,
'~/"~ ~TR E-~Ix~[CFt~WIDI~/~ ~"~IN. TOTAL EFF~TI VE
NUMBER OF LINES ~ DISTAN~C.~E~BI~TvwEN LINES
ABSORPTION AREA SQ. FT. LENGTH OF EACH LINE
DEPTH: TOP OF TILE TO FINISH GRADE
DEPTH OF FILTER MATERIAL BENEATH TILE
IN, ABOVE TILE
,~: .~, DISTANCE FROM WATER
WELL: TYPE ~' ~ DEPTH /~'? ~ , BUILDING FOUNDATION. SAMPLE NEAREST
NEAREST SEPTIC SEEPAGE OTHER
LOT LINE , SEWER LINE , TANK , SYSTEM , CESSPOOL , SOURCES
DISTANCES:
4~,,~q ?"
O ~-/07'
DIAGRAM )F SYSTEM
DATE
NAME OF APPLICANT
Greater ANCHORAGE AREA Borough
DEPARTMENT OF ENVIRONMENTAL QUALITY
3500 TUDOR ROAD POUCH 6-650
ANCHORAGE. ALASKA 99502:
TELEPHONE 279-8686
SEWAGE DISPOSAL SYSTEM m APPLICATION AND PERMIT
PER.ITNO.
INSTALLATION LOCATION
2~-~ ~ , DRAIN FIELD OTHER
INSTALLATION OF: SEPTIC TANK ~ SEEPAGE PIT '
TYPE AND SIZE OF FAC'LITY TO BE SERVED ;3 ~.~ '/~ )~
SOiL TEST ..SULTS ,~/ .A~'.,7 NOTE, THIS ~lT IS NOT VALID WITHOUT SOIL TEST
FINAL INSPECTION:
HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE TYPE, / AREA SIZE
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
FOUNDATION TO SEEPAGE P[T
SEPTIC TANK TO SEEPAGE PIT WALL
, SEEPAGE Pit
TYPE
DIAGRAM OF SYSTEM
SEPTIC TANK
TO NEAREST LOT LINE,
· DRAIN FIELD.
. DRAIN FIELD
DRAIN FIELD ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK /~ SEEPAGE Pit
DRAIN FIELD
SEPTIC TANK, SEEPAGE PIT /~! ~ t
., . DRAIN FIELD
TO RIVER· LAKE, STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION S FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE Pit
FITTED WITH AIRTIGHT REMOVAI3LE CAPS.
GRAVEL BACKFILL
CONFORM TO BOROUGH F~EGULATIONS REGARDING INSTALLATION.
HEALTH AUTHORITY
OR
LICENSED DESIGNER
GR~*%ER ANCHORAGE AREA BOROUGH'
DEPAR .ENT OF ENVIRONMENTAL QUALI,~
3500 TUDOR ROAD
ANCHORAGE, ALASKA 99502
CASE #
Performed For ]lPk '~ro~,~ Date Performed
Legal Description: Lotl~ Block ~ Subdivision IM~~?~
This Form Reports Soils~g ~ P~lation T~st
Depth
Feet
Soil Characteristics
~'q L
Ground Water Encountered?
--'es, At What Depth?
Reading Date Gross Time Net Time Depth to H20 Net Drop
N
.~ nute
Proposed Installation: Seepage Pit Drain Field
Depth Of Inlet Depth To Bottom Of Pit Or Trench
COMMENTS: Z..(~ ¢ ,'7"'[.,,~¢/,. ~C-'¢~"m~ ,~ b,,I,:,,.o -¢,~'r-.
Test Performe'~-z. --r~/L ~ ~--%%__' Certified By:
/ /7 ~'[D>I~ Da'ta Date: