HomeMy WebLinkAboutHILLCREST BLK 2 LT 8L, Cj GP""ATER ANCHORAGE AREA BOROI"~H HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 N.o 518 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM ~,s~.c~ ~o~ w~ ~-~' ~,A~r~"C~'~:~ ~C~co~s~U~ o~ J LIQUID CAPACIW '~ ~f INSIDE WIDTH ~' DEPTH SEEPAGE SYSTEM: NUMBER~ LINING MATERIAL NEAREST LOT LINE SEEPAGE PIT: ___OUTSIDE DIAMETER OR WIDTH ~~LL TOTAL EFFECIIVE ABSORPTION AREA (WALL AREA) ,LENGTH__ , DEPTH , BUILDING FOUNDATION SQ. FT. TILE DRAIN FI, ELD: DISTANCE FROM W[[[~'~ NUMBER OF LINES ABSORPTION AREA DEPTH: TOP OF TILE TO FINISH GRADE , FOUNDATION ~WEEN LINES LENGTH SQ. FT. ~ DEPTH OF FILTER MATERIAL BENEAIH TILE , NEAREST LOT LINE TRENCH WIDTH TOTAL LENGTH OF LINES IN. TOTAL EFFECTIVE IN, ABOVE TILE WELL: TYPE ~//;//[~(/ , DEPTH !0~ NEAREST SEPTIC LOT LINE , SEWER LINE ., TANK DISTANCE FROM WATER , BUILDING FOUNDATION.___SAMPLE__ SEEPAGE , SYSTEM , CESSPOOL. , NEAREST OTHER , SOURCES DIAGRAM OF SYSTEM DISTANCES: 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 P ERM,T NO. NAME OF APPLICAN [NSTALLAT]ON LO CAT~ON LEGAL DESCRIPTION ~,~ ~"'~' ~ ¢~Z- ~' PHONE INSTALLATION OF: ~ TANK TYPE AND SIZE OF fACiLITY TO SE SERVED FINANCED THROUGH SOIL TEST RESULTS COMPLETION DATE ANTICIPATED SEEPAGE PIT , DRAIN F'IeLD ., OTHER TO BE INSTALLED BY FINAL INSPECTION= 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE HEALTH DEPARTMENT AUTHORITY WILL BE SUBJEC:'r TO PROSECUTION. MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT. SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK , SEEPAGE PIT TO NEAREST LOT LINE. WELL TO SEPTIC TANK DRAIN FIELD WATER MAIN TO SEPTIC TANK DRAIN FIELD SEPTIC TANK SEEPAGE PIT TO RIVER, LAKE, STREAM. DRAIN FIELD SEEPAGE PIT ALSO CONSIDER AREA WELLS. SEEPAGE Pit. DRAIN FIELD CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF SEEPAGE AREA SIZE TYPE DIAGRAM OF SYSTEM 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 INSTALLAT]ON. HEALTH 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 DATEDESORIBED SYSTEM I$ IN ACCORDANCE WITH SAID OODE,/~,~¢.,~ ~-~'//FT/' APPLICANT'S SIGNATURE ~/~~ '~ ~' *--"'""~'¢~ 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 PERM,T NO. /h--d/ PHONE INSTALLATION OF; SEPTIC TANK SEEPAGE PIT , DRAIN FIELD TYPE AND SIZE OF FACILITY TO BE SERVED ~'¢ SO,L TEST RESULTS ~4 '¢~7 ~4 ~'~/ ~ NOTE, T"'S PE""'T 'S "CT 'A''D W'T"O"' 'O'L ~'ES' COMPLETION DATE ANTICIPATED FINAL INSPECTION= 24 HOUR NOTICE REQUIRED, BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE HEALTH DEPARTMENT AUTHORITY WILE BE SUBJECT TO PROSECUTION, /~ TANK SIZE ~¢.~--- TYPe FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT , DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK , SEEPAGE PIT TO NEAREST LOT LINE, WELL TO SEPTIC TANK DRAIN FIELD GRAVEL BACKFILL DRAIN FIELD SEEPAGE PIT ALSO CONSIDER AREA WELLS. SEEPAGE PIT · DRAIN FIELD HEALTH AUTHORITY OR LICENSED DESIGNER SEEPAGE AREA SIZE TYPE DIAGRAM OF SYSTEM I CERTIFY THAT [ AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHO/RAGE AREA E~OROUGH ORDINANCE NO, 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. '~/i / / ,~-/?//'¢ ; X/ ; .3REATER ANCHORAGE AREA BOROUGH ttEALTH DEPARTI,!EI,IT CASE 3~7 EAGLE STREET ANCHORAGE, ALASKA 99S01 Performed For ~ , ~ ~'~'~ Date Performed Legal Description. Lot~ Dloc~ ~ Subdl ~s~on ~'~,~%~[%~~ Th~s Fomm Reports a: Soils 5og__~~~colatlon lest ...... Depth Feet Soil CharacterisTics Was Ground Water Encountered?~(~ ...... ¢<oooI if Yes, At What Depth.~j~.~_.-~--- '-- Net 'Time Location Sketch Depth To H20 ?roposed nstallat~on: Seepage Pit Drain ~eld Depth Of Inlet COMME~,~c. ~ ¢ , ,)eptn To Bottom Of Pit Or Trench 'i,~°.._.~_~ ~c~ ~-'~n,~ I ~ w--:~--, ' ~ ~ ..~' --~ .... --2~k_~~~ C~ ~c'c' ~X ~ c, ~ ~ , ' -' ' ~' ;~e. Drop