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HomeMy WebLinkAboutBOULDER SPRINGS LT 29 GRE '=.R ANCHORAGE AREA BOP- Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: DISTANCE FROM WELL INSIDE LENGTH MANUFACTURER MATERIALCIQ~/4 ~-~ NUMBER OF COMPARTMENTS INSIDE WIDTH LIQUID DEPTH_ .LIQUID CAPACITY (o~-' ~7_~ GALLONS. SEEPAGE PIT: NUMBER OF PITS LINING MATERIAL BUILDING FOUNDATION__ f ,. DIAMETER--OR WIDTH g)( (~'~g CRIB SIZE: DIAMETER__ NEAREST LOT LINE "¢'2.~:~ . ADDITIONAL ABSORPTION DEPTH .DEPTH . DISTANCE FROM: WELL TOTAL EFFECTIVE ! ABSORPTION AREA (WALL AREA) }_'~ '2~, SQ. FT. WELL: BUILDING FOUNDATION __ CESSPOOL APPROVED CONSTRUCTION NEAREST LOT LINE OTHER SOURCES DISAPPROVED NEAREST SEWER LINE DEPTH DISTANCE FROM: SEPTIC SEEPAGE , TANK __ , SYSTEM REMARKS LOT SLOPE: REMARKS: Form No. EQ-031 DIAGRAM OF SYSTEM DATE APPROVED G.A.A.B. GreaTEr ANCHORAGE Area BorouGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 PERMIT NO. __, SEWAGE DISPOSAL SYSTEM m APPLICATION AND PERMIT INSTALLATION OF; SEPTIC TANK ~ii~i~ ~) SEEPAGE PIT OTHER FINANCED THROUGH SOIL TEST RESULTS DRAIN FIELD TO BE INSTALLED BY NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION 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. MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK ___ FOUNDATION TO SEEPAGE PIT _ , DRAIN FIELD sePtiC TANK TO SEEPAGE Pit WALL .... DRAIN FIELD _., SEEPAGE PIt _ L ~3 ( ALSO CONSIDEr AREA WELLS. , SEEPAGE PIT , DRAIN FIELD SEPTIC tANK U , SEEPAGE PIT TO NEAREST LOT LINE. WELL tO sePtiC TANK ~,~, c~ '~ DRAIN FIELD WATER MAIN TO SEPTIC TANK /0~ DRAIN FIELD ~4~ __ SEPTIC TANK, ,SEEPAGE PIT TO RiVEr. LAKE. STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING 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. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. G ,A.A .B. OR LICENSED DESIGNER DIAGRAM OF SYSTEM I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS Of GREATER ANCHORAGE AREA BOROUGh ORDINANCE/NO. 28.68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. / ~, /' / FORM NO. EQ-OI 6 / /