HomeMy WebLinkAboutBROOKWOOD BLK 2 LT 3 81- Z
GRE/ -_-R ANCHORAGE AREA
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME J~"¢;~-~ )1/lO,{:t'-')'''~pJ) MAILING ADDRESS
LOCATION !~10 ~Ol'/y ~,],'~'~iz,:N' LEGAL DESCRIPTION
SEPTIC TANK: .~e-- ,,(C~',~/C.~
DISTANCE ~;~7~r~
FROM WELL ' MANUFACTURER
INSIDE LENGTH
INSIDE WIDTH
MATERIAL
LIQUID DEPTH
NUMBER OF
COMPARTMENTS
LIQUID CAPACITY__
GALLONS.
TILE DRAIN FIELD:
/~
DISTANCE FROM WELL _/~/~/'~¢;M¢ FOUNDATION
NUMBER OF LINES '/ DISTANCE BETWEEN LINES
/~) / TOTAL LENGTH /
OF LINy ~'"~Ca
NEAREST
LOT
LINE
TRENCH WIDTH,,~'~-* IN. TOTAL EFFECTIVE
/
ABSORPTION AREA /~"L~ SQ. FT. LENGTH OF EACH LINE ~'~C')
(' ( DEPTH OF FILTER
DEPTH: TOP OF TILE TO FINISH GRADE 4 ~' MATERIAL BENEATH TILE
IN. ABOVE TILE ~ IN.
WELL:
TYPE 5F?{~ ¢
BUILDING
FOUNDATION
CESSPOOL
APPROVED
CONSTRUCTION
NEAREST NEAREST SEPTIC
LOT LINE____, SEWER LINE , TANK ....
OTHER SOURCES
DISAPPROVED REMARKS
DEPTH
SEEPAGE
SYSTEM
__ DISTANCE FROM:
DISTANCES:
INSTALLED BY: ,,_J~'~/O l.cF__',/<'¢..~
SEWER LINE DEPTH:
LOT SLOPE:
REMARKS:
DATE ~"~/9~P/?¢ APPROVED
G.A.A.B.
Form EQ-O32
GReATeR ANCHORAGE ArEA Borough
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C" STREET ANCHORAGE, ALASKA 99503
TELEPHONE 274-4561
PERMIT NO.
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
NAME OF APPLICANT. ~//J) //// '~;'
INSTALLATION LOCATION /'~' / ~
LEGAL DESCRIPTION ~ ~r7 ';"
MAILING ADDRESS ":~ / /7/
PHONE
,?_~,
INSTALLATION OF: SEPTIC TANK
TYPE AND SIZE OF FACILITY TO Be SERVED
FINANCED THROUGH
SOIL TEST RESULTS /"?~ ./2'//'~"/~ /,. '
COMPLETION DATE ANTICIPATED
SEEPAGE PIT DRAIN field OTHER
TO BE INSTALLED BY ~,/t5 /-/~/
NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
FINAL INSPECTION: ~4 HOUR NOTIg~ R~QUIR~D. BA~KFILLIN~ O~ ANY SYSTEM WITHOUT FINAL
D~PARTM~NT OF ENVIRONmeNTAL QUALITY AUTHORITY WILL B~ SUBJgCT TO P~OSgCUTION,
SEPTIC TANK SIZE TYPE
MINIMUM DISTANCES, REC)UIREMENTS
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT
SEPTIC TANK TO SEEPAGE Pit WALl
SEPTIC TANk , SEEPAGE PIT
TO NEAREST LOT Line.
WELL TO SEPTIC TANK
DRAIN FIELD
WATEr MAIN TO SEPTIC~TANK DRAIN FIELD'//
SEPTIC TANK, , SEEPAGE PIT
TO RIVER, LAKE, STREAM.
SEEPAGE AREA SIZE
),.'1 '//_ z,L
DRAIN FIELD
., DRAIN FIELD
SEEPAGE PIT
ALSO CONSIDER AREA WELLS.
SEEPAGE PIT
1(.~/ /
, DRAIN FIELD
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
TYPE
DIAGR ~M 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.
'/ ' · /,: ~- i ) ,< '~ (. .: . ' "
FORM NO. EG-O! 6
1
t! I