HomeMy WebLinkAboutHILLCREST BLK 8 LT 1
GREA/~:R ANCHORAGE AREA BORuuGlt
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
~'~/" ( MAI LING /ADDRESS PHONE
· EGAL DESCRIPT,ON
NAME, !N~ ~.'~{~. ki
LOCATION
$1~ TAN K~
DISTANCE
FROM WELL
INSIDE LENGTH
M A N U FAC T U R E R ~/t.~----L~--~
INSIDE WIDTH
· ~ -*~ NUMBER OF
MATERIAL ~. COMPARTMEN-FS __
LIQUID DEPTH LIQUID CAPACITY. GALLONS.
SFEPAGE PIT:
NUMBER OF PITS__
LINING MATERIAL
BUILDING FOUNDATION____
ADDITIONAL ABSORPTION
DIAMETER .... OR WIDTH
CRIB SIZE: DIAMETER
NEAREST LOT LINE
LENGTH DEPTH
__.DEPTH DISTANCE FROM: WELL
TOTAl._ EFFECTIVE
ABSORPTION AREA (WALL AREA)
_SQ. FT.
WELL:
'TYPE CONSTRUCTION
BUILDING NEAREST NEAREST
FOUNDATION LOT LINE_ _, SEWER LINE
CESSPOOL O-rHER SOURCES
APPROVED DISAPPROVED REMARKS
__ DEFIH
SEPTIC
TANK ....
DISTANCE FROM:
SEEPAGE
SYSTEM
DISTANCES:
INSTALLED BY: ~
PIPE MATERIAL:
LOT SLOPE:
REMARKS:
DIAGRAM OF SYSTEM
_ APPROVED
G,A,A,B.
GREATER ANCHORAGE AREA BOROUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C" STREET ANCHORAGE, ALASKA 99503
TELEPHONE 274-4561
SEWAGE DISPOSAL SYSTEM m APPLICATION AND PERMIT
PERMIT NO
NAME OF APPLICANT
MAILING ADDRESS
PHONE
INSTALLATION LOCATION
'-EDAL. DESCR,PT,O,,
IN$TAI-LATION OF: 8EP~ ~ANK
SEEPAGE PIT , DRAIN FIELD ., OTHEr
TYPE AND SIZE OF FACILITY TO BE SERVED
EINANCED THROUGH
TO BE INSTALLED bY
SOIL TEST RESULTS
NOTE~ THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
DOMPLETION DATE ANTICIPATED __
FINAL. INSPECTION: 24 HOUR NOTICe REQUIRED. BACKFILLING Of ANY SYSTEM WITHOUT FINAL INSPECTION bY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
~EPTIC TANK SIZE tYPE (" ' SEEPAGE AREA SIZE TYPE
MINIMUM DISTANCES REOUIREMEHTS
FOUNDAT,ON~O ~ ~^NK '.%
FOUNDATION TO SEEPAGE P}T
_, DRAIN FIELD
SEPTIC TANK TO SEEPAGE Pit WALL
K --,SEEPAGE PIT
TO NEAREST CT LINE.
WELL TO ~'~'P'PI'C TA~R [ 'OO DRAIN FIELD
· DRAIN FIELD
, SEEPAGE PIT
ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK
DRAIN FIELD
SEPTIC TANK, (~_ ~ , SEEPAGE PIT
TO river, LAKE, STREAM.
., SEEPAGE PIT
/ O
., DRAIN FIELD
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIBCROSSING 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.
¢';RAVE L BACI(FILL
CONFORM TO BOROUGH REGULATIONS R~A~DING INSTALLATION.
,:,/.:
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 2S-Se AND THAT THE ABOVE
DESCRIBED SYSTEM is IN ACCORDANCe WITH SAID CODe.
M-W DRILLING, Inc.
P.O. Box 4-1224 . !310c International Airport Road
(907) 274:45! ]
ANCHORAGE, ALASKA 99509
DRILLING LOG
Well Owner
Use of Well
Location (address of: TownshiP, Range, Section, if known; or distance main road
Size of casing. ~ _Depth of Hole ~.' feet Cased to : feet
Static water level ~ ~ .ft. (above) (below) land surface. Finish of well (cheek one) open end
Screen ( ); Perforated ( ).
Describe screen or perforation. '~ ~ ' '~' ' :'~' ~ =' :' :; ~ ' ' =
Well pumping test at ,' gallons per (hour)
of drawdown from static level. ;
Date of completion i ... ,, ;, i
(minute) for , : hours with
WELL LOG
ft.
Depth in feet from
ground surface Give details of formations penetrated, size of material, color and hardness
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2 -- STATE
Mu ~e
DATE:
TO~
FROMz
SUBJECT:
ipaJity of Ancho
MEMORANDUM
June 24, 1976
Building Department
Health & Environmental Protection
Lot 1 Block 8 Hillcrest Subdivision
The water supply and sewer system is
by this department on the subject lot.
Les N. Buchholz
Sanitarian
LNB/ljh
approved for use
5,"'