HomeMy WebLinkAboutT15N R1W SEC 5 LT 20
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G~ ~ER ANCHORAGE AREA BORO!
B~.,~ARTI~IENT OF ENVIRONMENTAL I~UALI'i (
3500 TUDOR F~OAD ANCHOFIAGE, ALASKA ggs07 27g-8586
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME ~'OJ'J~J .~..r, ~6/C/('F',*~ MAILING .~ADDRESS/~Az ,~-~/, (~,~'/~://gX" ~/'g~'7 PHONE.
LOCATIONZ~'~,~SS /:'~A'/H ,~/R~/~'(-6/~D /c~/~,'~'~7~' LEGAL DESCRIPTION'Z~7"'~/J/ ¢'~"~-
SEPTIC TANK:
DISTANCE FROM WELl
NUMBER OF
MATERIAl ¢~"~ ~'~/ "~ 7~" ~'~ ~-J~'T/~'(~ COMPARTMENTS /
LIQUID
GALLONS. INSIDE LENGTH INSIDE WIDTH DEPTH
LIQUID CAPACITY // ~)~ ~)
SEEPAGE SYSTEM:
NUMBER OF PITS
LINING MATERIAL
NEAREST LOT LINE
SEEPAGE PIT:
.OUTSIDE DIAMETER_
OR WIDTH /'~'~ , LENGTH /~-~ ., DEPTH
· DISTANCE FROM WELL //~) , BUILDING FOUNDATION
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)
SQ, FT.
TILE DRAIN FIELD:
DISTANCE FROM WELL / ,~F UNDATION . NEAREST LO~ LINE ~
ABI~NUMBER OF LI S DISIANCEs~.C~ii~CH LiN~BET EEN LINES TRENCH H
DEJ:~H: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH IlL _
TOTAL LENGTH
O F ~d-N.F..S _
IN. TOTAL EFFECTIVE
IN, ABOVE TILE.--
WELL:
TYPE DEPTH
,~.P~,~O X NEAREST SEPTIC
LOT LINE ~..q,~l , SEWER LINE , TANK
DISTANCE FROM /,)~ / (..~ '~' WATER
, BUILDING FOUNDATION._ SAMPLE
~ 0 / SEEPAGE /
· SYSTEM //0 , CESSPOOL
NEAREST
OTHER
SOURCES
DISTANCES:
DIAGRAM OF SYSTEM
ANCHORAGE Area B }UGH
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
CONP;.ETION DATE ANTICIPATED /
NOTB~ THIB F,ERMIT IS NOT VALID WITHOUT ~OIL TEST
FINAL IN~PEGTION: ~14 HOUR NOTICE REQUIRED. BACKFILLING OF' ANY EYBTEM WITHOUT FINAL INBpECTION BY THE
HEALTH DEPARTMENT AU~ONI~ WILL BE SUBJECT TO PROSECUTION.
I/I
MINIMUM DI~'rANCES, REQUIREMENT~
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT
SEPTIC TANK TO SEEPAGE PIT ~ALL
DRAIN FIELD
DRAIN FIELD
GRAVEl,, BACKFILL
CONF~RM TO BOROU~I.ELREGULATIONB RE~IN~ INETALLAT:ON, ~
/ .
DIAGRAM OF GYP'rEM
.I
GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.88 AND THAT THE ABOVE