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
