HomeMy WebLinkAboutHIDDEN HILLS BLK 1 LT 35
GRr 'ER ANCHORAGE AREA BOROU'"'
DL. MTMENT OF ENVIRONMENTAL QUALli
3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
MAILING
ADDRESS '"'~z"'~XZ'2d) ,,~,,,f.-'d~-~:- -/:~ '~z'~'.~S' PHONE
SEPTIC TANK:
DISTANCE FROM WELL ~7_~,,c' /
LIQUID CAPACITY_.//~') O O GALLONS.
NUMBER OF
MATERIAL~ .7'2:::--~:~:-~ COMPARTMENTS
INSIDE LENGTH. ~"~'~ INSIDE WIDTH z~
LIQUID
DEPTH
SEEPAGE SYSTEM:
NUMBER OF PITS
SEEPAGE PII':
/
OUTSIDE DIAMETER
NEAREST LOT LINE
~'- OR WIDTH , LENGTH__ __, DEPTH.
DISTANCE FROM WELL~-,~~:'''') , BUILDING FOUNDATION-"~,"~'%'~";
TOTAL EFFECTIVE ABSORPTION AREA (WALE AREA) --~' SO, FT.
TILE DRAIN FIELD:
DISTANCE FROM WELL_ ..,,----"'~', I-"OUNDATION.
NUMBER OF LINES ..~'''''''''''~ DISTANCE BEIWEEN LINES
ABSORPTIOI>(~REA_____ SQ. FT. LENGTH OF EACH LINE
, NEA R~'~:~N E
TRENCH WT~'H
DEPTH: TO[) OF TILE TO FINISH GRADE
DEPTH OF FILTER MATERIAL BENEATH TILE
TOTAL LENGTH
OF LINES
IN. TOTAL EFFECTIVE
IN. ABOVE TILE
WELL: "?'<'"'~>':'~-- , DISTANCE FROM
TYPE~L~'~~ , DEPTH ~.,2~' , BUILDING FOUNDATION.a -~'~L'~
LOT LINE ~ /~ NEAREST ~ SEPTIC ~. ~ SEEPAGE
.. SEWER LINE ~2 , TANK , SYSIEM
WATER
SAMPLE_./'(/~_z'v~_~' NEAREST
OTHER
, CESSPOOL_/f/~,4-~- , SOURCES~''¢¢~°~M'~/
DIAGRAM OF SYSTEM
DISTANCES:
DATE
/?,~ :~ -' _
APPROVED
SEWAGE
GREAh-~R ANCHORAGE AREA BORudGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3500 TUDOR ROAD POUCH 6-650
DISPOSAL SYSTEM -- APPLICATION AND PERMIT
SOIL TEST RESULTS ~¢~ ~~~ NOTg, THIS PERMIT IS NO.VALID WITHOUT SOIL
FINAL INSPECTION= 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY ,SYSTEM WITHOUT FINAL INSPECTION BY THE
HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZEi/ TYPE -~ SEEPAGE AREA SIZE TYPE ~--~/
MINIMUM DISTANCES. REQUIREMENTS
SEPTIC TANK-- ~'--/ , SEEPAGE Pit
K
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK
DRAIN FIELD
?
WATER MAIN TO SEPTIC TANK
DRAIN FIELD_
· SEEPAGE Pit /~ ~ /
ALSO CONSIDER AREA WELLS.
, SEEPAGE PIT
SEPTIC TANK, 2~2~/'
SEEPAGE PIT /~:~ , 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 ~OROUGH REGULATIONS REGARDING INSTALLATION.
HEALTH AUTHORITY
OR
LICENSED DESIGNER
DIAGRAM OF SYSTEM
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF G~EAT~R ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE' ~.U/..4/
DATE '~ .~//~----~' APPLICANT'S SIGNATURE