HomeMy WebLinkAboutTHOMAS W SPERSTAD #1 BLK 1 LT 30
GF'""TER ANCHORAGE AREA BOROI' '-I
HEALTH DEPARTMENT '~'0
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME
LOCATION
SEPTIC TANK:
MAILING ..~,,~ ,~.~
_ADDRESS . . PHONE
DISTANCE FROM WELl
LIQUID CAPACITY
.GALLONS. INSIDE LENGTH ~ '-~' '''/ INSIDE WIDTH
LIQUID
_ DEPTH..~
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PiTS // OUTSIDE DIAMETER / OR WIDTH_ ~/I~)
NEAREST LOT LINE ¢~' ~,') TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)
BUILDING FOUNDATION
TILE DRAIN FIELD:
DISTANCE FROM WELl
NUMBER OF LINES
ABSORPT[O~"~BEA_
, FO~U~NDA~ION_-- -~.. NEAREST LOT LINE
//~ISTANCE BETWEEN LINES TRENCH WIDTH
__SQ. FT. LENGTH GE I=ACH LINE
TOTAL LENGTH
, OF LINES
__IN. TOTAL EFFECTIVE
DEPTH: TOP OF TILE TO FINISH GRADE
_DEPTH OF FILTER MATERIAL BENEATH TILE
IN. ABOVE TILE
~ ~ - ,* '~.~; /~ ~.]/~,/Z(2x. ~c DISTANCE FROM
WELL: ~.>-~x~J /~ ~-
~YPE~;~'//~'~"~:~ , DEPTH //~//~, ~, BUILDING FOUNDATION
LOI LINE /~ ~ , SEWER LINE ~ ~", TANK. ///~'~ , SYSTEM__/Z/
WATER
SAMPLE ,'/:v"/'),":/~/:-., NEAREST
. C E S S p O O b ~/~//~'~,~'~/'7'~) / S O U R C E S-'~'~-
DISTANCES:
//:://~-/r:') '
DATE
DIAGRAM OF SYSTEM
HEALTH AUTHORIIY
G1RE:ATER ANCHORAGE'" AREA BOROUGH
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
INSTALLATION LOCA~N
FINANCED THROUGH
SEEPAGE PIT ~/ --, DRAIN FIELD OTHER
NOTE= THIS PERMIT IS NOT YALID WITHOUT SOIL TEST
COMPLETION DATE ANTICIPATED
FINAL INSPE(:TION~ 24 HOUR NOTIGIE REQUIRED. BACKFILLING ¢)F A~Y ~Y~TEM WITHOUT FINAL INSPECTION BM THE
HEALTH DEPARTMENT AUTHORIT~ WILL BE ~UBJE~T TO PROSECUTION.
SEPTIC TANK SIZE 7FY TYPE ~--~ ~ SEEPAGE AREA SIZE
DIAGRAM OF SYSTEM
MINIMUM DISTANCI"'S, REQUIREMENTS
FOUNOATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT /5'
SEPTIC TANK TO SEEPAGE PIT WALL.. /~ I
SEPTIC TANK __~r~~''l SEEPAGE PIT
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK
BRAIN FIELD
WATER MAIN TO SEPTIC TANK /~ I
DRAIN FIELD //~ I
SEPTIC TANK, '~--" , SEEPAGE PIT
., DRAIN FIELD
/o~' ,DRA,N ~,ELO ~3~/
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP Of
4 INCH DIAMETER CAST lEON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PI']'
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL 13ACKFILL
CONFORM TO ~]OROUGH REGULATIONS REGARDING INSTALLATION.
LICENSED DESIGNER
[ CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
DESG~SYSTE M: I ~/;;: DANCe WITH SAID CODE.
DATE ? ~,/ APPLICANT'S SIGNATURE : ~/~'/~'~/ g" ~-~L~'" ¢'~/~"~ V
--/ F
Was Ground Water Encourll:ered?_,~"~ ...........
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