HomeMy WebLinkAboutT15N R1W SEC 30 LT 101
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GI/~TER ANCHORAGE AREA
DE?AFITMENT OF ENVIROBIME~TAL g. UALITY
3500 TUDOR ROAD Ar',ICHOFIAGE, ALASKA 99507 279-8685
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
ADD RESS.5~~,
SEPTIC TANK:
/
DISTANCE FROM WELL MATERIAL ~'~::'2=,;Z COMPARTMENTsNUMBER OF ...,/
LIQUID CAPACITY ~/~') ~'.i GALLONS. INSIDE LENGTH .INSIDE WIDTH DEPTH__
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS / OUTSIDE DIAMETER
NEAREST LOT LINE ,~]() t' ~'~ ~':
/ /
"- OR WIDTH_ /~ , LENGTH /~ , DEPTH
DISTANCE FROM WELL /~- ~ BUILDING FOUNDATION
/
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) , ~) ,~ ~-(~ SQ. FT.
TILE DRAIN FIELD:
TOTAL LENGTH
DISTANCE FROM WELL ,/ ,FOUNDAIION ~ NEAREST LOT LINE ,OF LINES__ .,
ABSORPTtON/~REA SQ. FT. LENGTH OF EACH LINE
DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE
/ · DISTANCE FROM WATER ..
WELL: TYPE~/~//~// , DEPTH. ,BUILDING FOUNDATION .... _SAMPLE/Z'~/~,/ , NEAREST
/ ! ~ NEAREST SEPTIC /~- / SEEPAGE OTHER
LOT LINE //~; ~ '~' /~'~ /
, SEWER LINE. , TANK. ., SYSTEM . CESSPOOL , SOURCES
DISTANCES:
-~/ 7~,h~ /.?'~
/, ,
Gcc ~
DIAGRAM OF SYSTEM
Grl~aTEr ANChORAge AREA BOROUgh /~
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
SOIL TEST RESULTS ~/~~/] NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT '~/~ ~' , Drain FieLD
SEPTIC TANK TO SEEPAGE Pit WALL /~-
DRAIN FIELD ~/~'~ ·
SEPTIC TANK, , SEEPAGE PIT
TO RIVER, LAKE, STREAM.
., DRAIN FIELD
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP Of
~0N 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.
OR
LICENSED DESIGNER
I CERTIFY THAT I AM FAMILIAR WITH THE REC:UIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
DE SCRIBE SY~/~ STEM IS IN//~?AC//~7~ppCORD~A~NCE WITH SAle) CODE, d~i ? /~/J)~/]~ ~
Yh / LICA. 'SSI,.AT=
CREATER ANCHORAGE AREA BO..3UGH
HEALTH DEPAkT~ENT
327 EAGLE STREET
AMCHORAGE, ALASKA 99501
Was Gl~ound Water Encountered
if Yes, At What
Reading
Date
Depth To H20
Net Drop