HomeMy WebLinkAboutTURNAGAIN BLK 4 LT 8B
G?'6,TER ANCHORAGE AREA BORO"'~'H
HEALTH DEPARTMENT
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
636
NAME
LOCATION
SEPTIC TANK:
DISTANCE FROM WELl
LIQUID CAPACITY /~,~2r, '¢~g2 GALLONS,
NUMBER OF /
MATERIAL ~-~/-~-/~ ~'~'~' ~' -~g~ COMPARTMENTS
J~' °'~'~ ~/~'~/~/~f~'~f~)//~';~;~ '~'~/ LIQUID
INSIDE LENGTH INSIDE WIDTH DEPTH__
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS
LINING MATERIAl ~'~
NEAREST LOT LINE
OUTSIDE DIAMETER
, LENGTH /',~ /, DEPTH
DISTANCE FROM WELL //~2~'2 / , BUILDING FOUNDATION
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ~>-~ ~ SQ. FT.
TILE DRAIN FIELD:
TOTAL LENGTH
DISTANCE FROM WELL ~ON .NEAREST LOT LINE ,OF LINES
.---//~DJSTANCE BETWEEN LINES TRENCH WIDTH ~AL
NUMBER/OF LIN E.~ E~
ABSORPTI/~'AREA SQ. FT. LENGTH OF EACH LIN
/
DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE
£FFF. C:TIVE
IN. ABOVE TILE
/'/~'. //x-~/~g~ / DISTANCE FROM WATER
WELL:
TYPE ,~/~'-~ DEPTH ..~,~2 , BUILDING FOUNDATION. ~"~'~SAMPLE...x/~) ,, NEAREST
NEAREST SEPTIC / SEEPAGE OTHER
LOT LINE ~ SEWER LINE ~"~,TANK ~'~ , SYSTEM /'/~ / , CESSPOOl / , SOURCES
DISTANCES:
DIAGRAM OF SYSTEM
APPROVED ~ '/'HEALTH· AUTHORITY-
GRE~JER ANCHORAGE AREA BO~"~UGH
DEPARTMENT OP' ENVIRONMENTAL QUALITY
3500 TUDOR ROAD POUCH 6-650
ANCHORAGE, ALASKA 99502
TELEPHONE 279.8686
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
Type AND SIZ~ O, FACILITY TO BE S~ ED
PHONE
· OTHER
NOTE: THIS PERMIT IS ROT VALID WITHOUT SOIL TEST
FINAL INSPECTION: 24 HOUR NOTICE REC/UIRED, BACKFILLING OF ANY !SYSTEM WITHOUT FINAL INSPEC:TION BY THE
HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION,
DIAGRAM OF SYSTEM
MINIMUM DISTANCES, REQUIREMENTS
y--
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT
SEPTIC TANK TO SEEPAGE PIT WALL
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK
DRAIN FIELD
WATER MAIN TO SEPTIC TANK
DRAin FIELD
, SEEPAGE PIT ., DRAIN FIELD
ALSO CONS[DER AREA WELLS.
SEEPAGE PiT .
SEPTIC TANK,, ., SEEPAGE PIT DRAIN FIELD ~
TO RiVER, LAKE, STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEETINTO UND[STURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE P]T
FITTED W]TH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO BOROUGH ~:~EGULATIONS REGARDING INSTALLATION.
OR
LICENSED DESIGNER
CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA bOROUgH ORDINANCE NO. 28-68 AND THAT THE ABOVE
D APPL[CANT'S SIGNATURE -~ ..... ~ ~.~ ...-"'C~ ~