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HIDEAWAY HILLS General Information
OAAB-HD-1 G! ;TER ANCHORAGE AREA BORO:" 1i trEliARTMENT OF ENVIRONMENTAL O.UAL)Ti/ 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME e� LOCATION_ SEPTIC TANK: MAILING sa`���. ADDRESS Z.5©X� I ; PHONE Iv6GS- LEGAL DESCRIPTION,';4 Ao- NUMBER OF DISTANCE FROM WELL • "SI• ' 442 MATERIAL ST COMPARTMENTS / -.—' l/i;- 7e.;)7_2_.. LIQUID CAPACITY 7,5Z> GALLONS. INSIDE LENGTH ./INSIDE WIDTH DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS OUTSIDE DIAMETER OR WIDTH aia74A V LENGTHDEPTH / LINING MATERIAL .•••97).'1,%7 ~-1-��Z-- DISTANCE FROM WELL C',61'ar-- "� BUILDING FOUNDATION: NEAREST LOT LINE' f 2' `reg. TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) 'l7CS G� SQ FT TILE DRAIN FIELD: /(//"P DISTANCE FROM WELL NUMBER OF LINES : TANCE BETWEEN LINES FOUNDATION , NEAREST LOT LINE TOTAL LENGTH OF LINES TRENCH WIDTH IN TOTAL EFFECTIVE ABSORPTION AREA SQ FT LENGTH OF EACH LI E DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN ABOVE TILE DISTANCE FROM �_ WATER WELL: TYPE .r'y ' - j -r- DEPTH �� , BUILDING FOUNDATION SAMPLE _ NEAREST NEAREST SEPTIC .— SEEPAGE OTHER LOT LINE , SEWER LINE , TANK SYSTEM CESSPOOL , SOURCES DISTANCES: DATE d� G7r -/eY7/ APPROVED G.A.A.B. GrE;a~ER ANCHORAge AREA BON--0UGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3500 TUDOR ROAD POUCH 6-650 ANCHORAGE. ALASKA 99502 TELEPHONE 279-6666 SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT PERMIT NO. Name Of aPPLiCaNT _.~'/~//~*L~/~ iNSTALLATION LOCATION { ~__£ ii/() ~'/~)~} EGAL ESCRiPTIGN t :.' INSTALLATION OF: SEPTIC TANK TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH SOil TEST RESULTS SEEPAGE PIT , DRAIN Field TO SE INSTALLED BY ~2~ A. i-- OTHER NOTE; THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED FINAL INSPECTION~ ~:4 HOUR NOTICE RE(3UIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL iN~F£C, TION BY THE HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK - / FOUNDATION TO SEEPAGE Pit. , DRAIN FIELD SEPTIC TANK TO SEEPAGE PiT WALL */ ~( SEPTIC TANK --~ SEEPAGE PIT . '[-' (? ., DRAIN FIELD TO NEAREST LOT LINE. WEgLTO SEPTIC TANK ~ /(/~' /'(/ ' SEEPAGE PIT DRAIN FIELD ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK //~/~ SEEPAGE Pit DRAIN FIELD SEPTIC TANK, ~ ~ ., SEEPAGE PIT //~) (') DRAIN FIELD TO RIVER. LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 ~EET-INTO-UNDISTURBED SOtL, 4 inCH DIAMETER CAST IRON SIPHON PIPES ON SePTiC TANK AND SEEPAGE Pit Fitted WITH A~RTiGHT REMOVABLE CAPS. DIAGRAM OF SYSTEM GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING iNSTALLATION. I CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DATE l~!~a~r.m ~u!uFl .sUOlle~ '&!~d~.p!nbH 'laoj "tlld~o 'la~j 'Jl~;~l [] 'ap!s [] '$uoJJ [] lB OU![ 1()1 l$.~Jl~gitl '.333J uo!lepunoj 'SUOlle,~ · laaj 'qldap p!nbFl '1*~ ~q~pya ap!suI smatmJ~dtuo> jo JaquJnN 'loodss~D [] WIJ. SAS 1VSOdSIQ-3OYM:IS 1VrlQIAlaNI~NOII~3dSNI :10 IIlOdtil iiiiiiiiillliiiiiiiiiiii'iiiiiiiiiiiiiiiiiiiilll~l~lllllll~l[llll I i i ~lllllllllllll]llllllllllll[llll ! I I Iglllllllll I IIIIIlltlll IIIIIIIIIId I I Illlllllllllllllll ! I III IIIIIIIIII II lliillii I II I I I I I I i I I.I_LI I I I I Illllllllllllll[ll 'l I I IIIIIlilllllllllllll Irlllilrlllllllllllll I IIIIIllil [ I I Illlllllllt IIIIIlil / I I Illlllll IIIII I IIll Ill I I I I I I IIIIii11111111111111 I I Illlllllllll Illl[ Illll Illllll Illllllll I I I LI I I I I I I I I II I I I I I I I I II I I I'1 I I Iillllll IIIII IIIIIlil I ! I Illll I I I I IIIIIIllll[llllilll I I I IIll I I I I I I II ] I I I I II I II Illl I Il I I I II I I I Illllll I II II I I I I ] I I I II IIIIll IIIII II1'111 I I I 111111111111111111111 I . IIIlllllllllllllllllllllll I I I I Ill Illllll Il I I I I II I II II I II Il IIII I I I I I I I II I I I II I11 I I I II I I I I I ' I IIIIII Ill Ill IIII I ]1111111111111111111 I I I I I I I I I I I I I I I I. I I I I I I I I I I I I I I I I I I I I I I I I I I i I I I I I II I I I I I I I I I I I I ] I I I I I '1 I H'D.I.:J)4c~ $,ItOLD:tdgNI J. NflWJ.~Vd::i(] H/I¥~H J,N:IWJ. UVdlQ HIlly:tH X" al/lldWOD ag 01--'1" lllVd wso,sm ,ov.vo l"np!a'IpuI F-] ma~sxs Xl!unmmoD [] MOl Q]NOISlQ WlJ. SXS ' tuo~sXs 2!Iqnd ~ :,kg XlddnS tFuYM L W:IISAS 1YgOdC31O :19¥M:1S QNY k'lddflS B:IIYM IYrlQIAIQNI lYAOltddv X.LlUOH.Ln¥ H/Iy:IH t~ GREATER ANCHORAGE AREA BOROUGH'~'~ DEPARTMENT OF ENVIRONMENTAL QUALITY 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686 DATE RECEIVED: TIME:. REQUEST FOR APPROVAL OF INDIVI'DUAL SEWER AND WATER FACILITIES FOR 1. APPROVAL REQUESTED BY: ADDRESS: ~ ~ PHONE: 2. PROPERTY OWNER: ~/~ PHONE: 3. LEGAL DESCRIPTION: ~ 4. TYPE FACILITY TO BE INSPECTED: /~/~ STREET:~~/~~.. NUMBER OF BEDROOMS: 5. WELL DATA: A. TYPE ~~ ~, B. DEPTH C. SIZE D. CONSTRUCTION E. BACTERIAL ANALYSIS 6. SEWAGE DISPOSAL SYSTEM: A. SEPTIC TANK (IF HOMEMADE, SHOW DIAGRAM ON BACK) 1. S~ZE ~5'~ 3. MANUFACTURER ~(~ 4. INSTALLER ~~ 't APPROVAL REQUEST FOR SEWER & WATER FACILITIES PAGE TWO SEEPAGE PIT 7. SIZE 2. LINING C. DISPOSAL FIELD 1. NUMBER OF LINES 2, TOTAL LENGTH REQUIRED MEASUREMENTS A. WELL TO SEPTIC TANK B. WELL TO SEEPAGE PIT C. WELL TO SEWER LINE D. F. G. H. WELL TO PROPERTY LINE WELL TO OTHER POSSIBLE CONTAMINATION------- FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT SEEPAGE PIT TO PROPERTY LINE~; 8. COMMENTS:~ APPROVAL VALID FOR ONE YEAR FROM DATE SIGNED. GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY June 16~ 1971 ~ox ~80 ~ncho~a~ Alaska Sills Sulxlivtston. Case #013-0[0. Public sewers ~e not avmila~e~o the a~jec~ 1o'~ so disposal mast he by sep~i~ tank - soil ahso~ptiom system. ~es~s .ff~om adJ~en~ lo~a l~lca~e accep~le eond£~£ons sewage disposal and t~ l~ p~obable that an appz, oved sewage disposal ~aB can be installed on ~he sub~ect lo~. Central ~.[aska U~lll~ies wate~ is aveilav~le to ~he lo~. John R. Lee~ R.S. Sanlta~'lan