HomeMy WebLinkAboutT15N R1W SEC 30 Lot 97
GAAB-HD.J
GR. .:R ANCHORAGE AREA BOROI;-'-''x
DEPARTMENT OF ENVIRONMENTAL QUALIiT
3500 TUDOR ROAD ANCHORAGE, ALASKA 05507 279-8685
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME
SEPTIC TANK:
DISTANCE FROM WELL
LIQUID CAPACITY /,~/~c~ ~/.) GALLONS.
MAILINGADDRESS ~'s~;~'~,-~';"~- ,;_
LEGAL DESCRIPTION
NUMBER OF /
MATERIAL ~-~_/~/f/~-~'~b--' ~'~",~./~-~ COMPARTMENTS
INSIDE LENGTH ¢:~ / / LIQUID ~"
INSIDE WIDTH c~ DEPTH
SEEPAGE SYSTEM: SEEPAGE PIT
NUMBER OF PITS / OUTSIDE DIAMETER
LINING MATERIAl ~'
, LENGTH , DEPTH
DISTANCE FROM WELl /~"~'~ , BUILDING FOUNDATION
TOIAL EFFECTIVE ABSORPTION AREA (WALL AREA) ~ '~>~/)'~- SQ. FT.
NEArest LOT LINF
TILE DRAIN FIELD:
DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL'~L~F.~FH~ILE
iOTAL LENGTH
, OF LINES
IN. TOTAL EFFECTIVE [
IN. ABOVE IILE
W E L L:
TYPE ."/~..'~//~-'"~'~ , DEPTH /'/~'"~,~ /
LOT LINE ,-'~,(~';' ~..~ NEAREST -" SEPTIC
, SEWER LINF ~.~"'"=~ ~ . TANK
DISTANCE FROM
· BUILDING FOUNDATION. /~ ~ WATER
. SAMPLE "'~/~--/'/'~"~'~, NEAREST
/ SEEPAGE ~ / '~ OTHER
..'~".,~ , SYSTEM__/-~''~ , CESSPOOL //~.~" , SOURCE~''~-
DISTANCES:
DIAGRAM OF SYSTEM
DATE
GREATER ANCHORAGE AREA BOFtOUGH
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
NAME OF APPLICANT
INSTALLATION LOCATION
LEGAL DESCRIPTION
INSTALLATION OF: SEPTIC TANK
TYPE AND SIZE OF FACILITY TO BE SERVED
FI NANCED THROUGH
COMPLETION DATE ANTICIPATED
MAILING ADDRESS
, OTHER
FINAL INSPECTION= 24 HOUR NOTICE REQUIRED.
HEALTH DEPARTMENT AUTHORITY WILL BE SUEIJECT TO
SEPTIC TANK TO SEEPAGE PIT WALL
, DRAIN FIELD
TO NEAREST LOT LINE. ~.
WELL TO SEPTIC TANK ~"~'~/~ , SEEPAGE PIT
DRAIN FIELD ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK 1(--~ SEEPAGE Pit
DRAIN FIELD
SEPTIC TANK, ~) ~} -, SEEPAGE Pit /~;'O , DRAIN ]FIELD
TO RIVE~, LAKE, STREAM.
C~.S.~T IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION ~ FEET INTO UNDISTURBED SO]L.
PITTED WITH AIRTIGHT REMOVABLE CAPS.
H BALTH ~URTHOR
] CEF~TIFY 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.