HomeMy WebLinkAboutHIGHLAND PARK BLK 2 LT 6
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GR""?ER ANCHORAGE AREA BOROI?TM
Dm, MTMI:NT OF EN¥1RONMENTAL 0. UALI,.
3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
N AM E ~)./1l';/~
SEPTIC TANK:
LEGAL DESCRIPTION~d; 7
DISTANCE FROM WELL
CAPACITY__. '
LIQUID
GALLONS.
NUMBER OF
MATERIAL : ~ ~/'~c! 1( ~/2 ~- Z._ COMPARTMENTS
LIQUID
INSIDE LENGTH_ ' - INSIDE WIDIH_. _DEPTH
SEEPAGE SYSTEM: SEEPAGE
NUMBER OF P~TS_
LINING MATERIAL~.~
NEAREST LOT LINE__
OUTSIDE DIAMETER OR WIDTH
/C2 hl¢"t .~-~ ...... DISTANCE FROM WELt
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREAJ
LENGTHZ)"/ '?-C'~ DEPTH. d'~:.
BUILDING FOUNDATION
TILE DRAIN FIELD:
DISTANCE FROM WELL
NUMBER OF LINES___
ABSORPTION AREA___
DEPTH: TOP OF-TIEE~O FINISH GRADE_
TOTAL LENGTH
, FOUNDATION__ , NEAREST [DJ LINE OF LINES
.DISTANCE BETWEENJANE-S-~-~- ......... TRENCH WIDTH__ IN. TOTAL EFFECTIVE
LENGTH OF EACH LINE
-~__ SQ. FT.
DEPTH OF FILTER MATERIAL BT!NEATH llLE
IN. ABOVE TILE
WELL:
LOT LINE
TYPE ~.- /:}.L.(. DEPTH
,~- NEAREST
, SEWER LINE ~--
DISTANCE FROM ~._- WATER _
,BUILDING FOUNDATION._ SAMPLE , NEAREST
SEPTIC SEEPAGE .~- ,f~'/l~ OTHER
., IANK .... ~' , SYSTEM_. CESSPOOL_ , SOURCES___
DIAGRAM OF SYSIEM
DISTANCES:
/:~/L d~l-~T If~fvv
P~Opcs~ b
rI'
GAAR
GREA.ER ANCHORAGE AREA BOR~dGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3500 TUDOR ROAD POUCH 6-650
ANCHORAGE. ALASKA 99502
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
INSTALLATION OF: SEPTIC TANK
TYPE AND SIZE OF FACILITY TO 13E SERVED
NAME OF APPLICANT///~//,~/~/~-4~/
INSTALLATION LOCATION ~/////~/~
SEEPAGE PIT , DRAIN FIELD OTHgR .
so~ ~s~ ~su.~s /~/~ '/~~4
NOTE~ THIS PER~IT Iff NOT VALID WITHOUT fiOIL 'rest
COMPLET,ON DATE ANTICIPATED
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM wrrHOUT FINAL INSPECTION BY THE
HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE
MINIMUM DISTANCES, REQUIREMENTS
WATER MAIN TO SEPTIC TANK
SEPTIC TANK.
DIAGRAM OF SYSTEM
. DRAIN FIELD
· DRAIN FIELD
SEEPAGE PIT
ALSO CONSIDER AREA WELLS.
SEEPAGE PIT
., SEEPAGE PIT ·//Z~)~'2 , DRAIN FIELD
TO RIVER, 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 CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION,
- HEALT~ AUTHORITY
OR
LICENSED DESIGNER
I CERTIFY THAT i AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SA,D CODE. dT~.~.'. :~/~'~V ~.7-- ~///~ /~:/~)
APPLICANT'S SIGNATURE ~ ~' ~ :~"~' ~ (- ~ ~ ..... ~ ....