HomeMy WebLinkAboutHILLCREST BLK 3 LT 7
'~ATER ANCHORAGE AREA BORC
ARTMENT OF ENVIRONMENTAL QUAL ,'
3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM__
MAILING ~,~/P ,,~ ,fl // ¢-~? ~2
__ADDRESS_,~';Z',~ .,/....~_ ~..~ _,~. ~'~ PHONE
LEGAL DESCRIP'[ION-~-'~/~'~ ,~//~~-"
'-'5-E~:~+C-- TANK:
~' / ~/~'~Z;~z/ COMP ARTMENT S
DISTANCE FROM WELL~ /~/~/~' MATERIAL
LIQUID CAPACI1Y /~d;~_~GALLONS. INSIDE LENGIH_ ~/ INSIDE WIDTH
LIQUID
DEPTH_
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS ____OUTSIDE DIAMETER____
LINING MATERIAL____./~
NEAREST LOT LINE__ --
__OR WIDTH. , LENGTH DEPTH
DISTANCE FROM W~~./..~-~7~, BIJ[LDING FOUNDATION
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) __ __ SQ. FT.
DISTANCE FROM WELL_
NUMBER OF LINES~
ABSORPTION AREA ......
DEPTH: IOP OF TILE TO FINISH GRADE
TILE DRAIN FIELD: /,x~/~:-j
FOUNDATION , NEAREST LOT LINE.__
__DISTA ~iC ~ __TRENCH WIDTH _ __
.~/~FT. LENGTH OF EACH LINE'~-~I~ -.---"~/-.~_-
TOTAL LENGTH
OF LINES
TN. ~TOTAL EFFECTIVE
DEPTH OF FILTER MATERIAL BENEAIH fILE_
IN. ABOVE TILE_--
~,,~ '~.~ ~- ~..~'~,'7.~-~'~'~' ~/ DISTANCE FROM
WELL: TYPE ~:/~-'?:~?/~,/~'~"~r~',/~)EPTH , BUILDING FOUNDATION. SAMPLE_
NEAREST SEPTIC SEEPAGE
~ k---~-~ ~ SYSTEM .... CESSPOOL
LOT LINE SEWER LINE TANK
DIAGRAM OF SYSTEM
DISTANCES:
NEAREST
OTHER
SOURCES ~
GRE.,.-,l'ER ANCHORAGE AREA BOROUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3500 TUDOR ROAD POUCH 6-650
ANCHOBAGE. ALASKA 99502
TELEPHONE 279-8686
PERMit NO. /~'7¢5/
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
INSTALLATION LOCATION
LEGAL. DESCRIPTION ~- ~'' /~
///."/
INSTALLATION OF: 'SEPTIC TANK
TYPE AND SIZE OF FACILITY TO BE SERVED
FINANCED THROUGH
SOIL TEST RESULTS
SEEPAGE PIT DRAIN FIELD
, OtHer
NOTE= THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
COMPLETION DATE ANTICIPATED ~/ /' /
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPEGTION BY THi=,
HEALTH DEPARTMENT AUTHORITY WILL me SUBJECT TO PROSECUTION.
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT
SEPTIC TANK TO SEEPAGE PIT WALL
~EPTIC; TANK - ~ SEEPAGE PIT
/ TO NEAREST LOT LINE.
DRAIN FIELD
DRAIN FIELD ,
SEEPAGE Pit
ALSO CONSIDEr AREA WELLS.
WATEB MAIN TO SEPTIC TANK -- ./'~'¢'~ , SEEPAGE Pit
DRAIN FIELD
CAST iRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND S~EPAGE PIT
FITTED WVFH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
H ~ALTH AUTHORITY
LICENSED DESIGNER
DIAGRAM OF SYSTEM
] CeRTIfY THAT I AM FAMILIAR WITH THE REQUIREMENTS Of GREATER ANCHOR, AGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. ',L - '
DATE /.~'//,,~'D APPLICANTS SIGNATURE