HomeMy WebLinkAboutLot 121"//" O!
GREA'-R ANCHORAGE AREA BOR "GH
Department of Environment Quality
3500 Tudor Road
Anchorage, Alaska 99507
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME "~~ -.-~'Eb',e/*J(7 MAILING ADDRESS /'~X
LOCATION /~i~,./~OL~) /~2~i--l. rZ~ LEGAL DESCRIPTION
SEPTIC TANK:
DISTANCE
FROM WELL
MANUFACTURER
MATERIAL
NUMBER Of
COMPARTMENTS /
INSIDE LENGTH.
INSIDE WIDTH
LIQUID DEPTH
LIQUID CAPACITY /~ GALLONS.
TILE DRAIN FIELD:
I-~
DISTANCE FROM WELL /~
NUMBER OF LINES
ABSORPTION AREA
DEPTH: TOP OF TILE TO FINISH GRADE
FOUNDATION
NEAREST LOT LINE
TOTAL LENGTH
OF LINES
,~.,.~Co,,/~/~.¢~-c~_~ t..~ ~'"/ ("~27'~-/~RENCH WIDTH '~' IN.
' u~51ANCE BETWEEN LINES / I /
'/"'e-~'T[I-~--,.-~ SQ. FT. LENGTH OF EACH LINE /'/~ l'/~l'
DEPTH OF FILTER
MATERIAL BENEATH TILE
TOTAL EFFECTIVE
IN. ABOVE TILE ~c/ IN.
WELL:
TYPE
CONSTRUCTION ~ DEPTH
DISTANCE FROM:
BUILDING NEAREST
FOUNDATION.~, LOT LINE.__
NEAREST SEPTIC SEEPAGE
SEWER LINE TANK o~D I~-
, , , SYSTEM
CESSPOOL , OTHER SOURCES
APPROVED ~ DISAPPROVED
REMARKS
DISTANCES:
INSTALLED BY:
SEWER LINE DEPTH:
PIPE MATERIAL: ~$'/"
LOT SLOPE:
REMARKS: ~~'~
DIAGRAM OF SYSTEM
DATE / 0~ ~l-74APPROVED
G.A.A,B.
Form PW.027
GREATER aNChOraGE AREa BOrOUgh
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C"STREET ANCHORAGE, ALASKA 99503
TELEPHONE Z74-4561
PERMIT NO,
SEWAGE DISPOSAL SYSTEM APPLICATION AND PERMIT
PHONE
LEGAL OESOR,PT,ON /__ ,:' 7- /.~. / ,~'z'/~"// ~~~ ~~.
INSTALLATION OF: SEPTIC TANK /' SEEPAge PIT . DRAIN FIELD ~ OTHER
SOIL TEST RESULTS JJ~ j ~~~ /.~ ~ NO~: THIS PERMIT I~ NOT VALID WITHOUT ~OIL
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.
SEEPAGE AREA SIZE
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK ~ ~
FOUNDATION TO SEEPAGE PIT ~-~ /i , DRAIN FIELD
SEPTIC TANK TO SEEPAGE PIT WALL 'f'~
SEPTIC taNK J , SEEPAGE Pit r, DRAIN FIELD
TO NEAREST LOt LINE. ~_~.g.:2~/,~,,~,~/(;///.~,,,~ ~/~-,,,~___.
WELL TO sePtiC TANK C~ / SEEPAGE PIT ~J~
DRAIN FIELD .~ '/ , ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK ~*'~ , SEEPAGE PIT
DRAIN FIELD / ~?
(
SEPTIC TANK, /~'~ , SEEPAGE PIT. - I ,DRAIN FIELD /~ '/
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
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER AN(;HORAGE AREAl BOROUGH ORD NANCE NO. 28-68 AND THAT THE ABOVE
DESCRIBED SYSTEM~/IS IN ACCORDANCE WITH SAID CODE. ~/~ /
FORM NO. EQ-016
GREATER ANCttORAGE AREA BOROU6"
Department of Environmental Qu~
3330 "C" Street
Anchorage, Alaska 99503
SOILS LO(} - PEROLATION TEST
Performed for ~ _~~_~.~/ Date Performed
Legal. _Description':"" ~~~~ J~ .... /~~/"~
Th~s form reports: So~ls log_y Percolation test
Depth
Feet
6-
7-
8-
9-
13-
Was ground water encountered?
If yes, at what depth?
Reading Date Gross Time Net Time Depth to Water
Net Drop
Percolation rate minute.
'Proposed installa~n' Seepage Pit Drain Field
)epth of Inlet . Dept~--t-o-'}J-O~-t~--o]f])it or trench ....................... ]
_?_~ /,..~. ~ ~_~.-.x<: ~ C~'r_-'~ -___~_?._.__~_-_~?L___] .............................
E~--040 (~/?~)
HOT LINE
Greater Anchorage Area Borough
Department of Environmental Quality
COMPLAINT AND ACTION FORM
HOUSING AIR POLLUTION CASE NO.
PUBLIC FACILITIES JUNK AUTOS DATE
NOISE NUISANCE INVEST:
V SEWER & WATER OTHER
COMPLAINTANT:
ADDRESS:
NATURE OF COMPLAINT:
LOCATION OF COMPLAINT:
RESPONSIBLE PARTY ADDRESS PHONE NUMBER
RECORD OF CONTACTS AND CORRESPONDENCE
Date Time Comments
TIME & DATE COMPLAINTANT CALLED BACK
EQ-045(9-74)
Use Reverse Side of Form for Further Comments
HOT LINE
~ 'ATER ANCHORAGE AREA BOROU~
Depa~,cment of Environmental Qua,,[y
Complaint and Action Form
HOUSING AIR POLLUTION
PUBLIC FACILITIES JUNK AUTOS
NOISE ~ NUISANCE
~ SEWER & WATER OTHER
ADDRESS:
CASE # /&J/~ .....
DATE ~-/~ - ~~~-
INVEST:
NATURE OF COMPLAINT:
LOCATION OF
RE, SPONSIBLE PARTY
ADDRESS
PHONE NUMBER
RECORD OF CONTACTS AND CORRESPONDENCE
D~ATE I TIME
:l
COMMENTS
TIME & DATE COMPLAINTANT CALLED BACK ~. '~/~'~ 79t~_~. ~,-' ,.V.
USE REVERSE SIDE OF FORM FOR FURTHER COMMENTS:
EQ-045 (9-74)