HomeMy WebLinkAboutT12N R3W SEC 4 LT 48 LESS S 180'
~.~ GREAr'R ANCHORAGE AREA BORr"GH
(~ Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCATION
LEGAL DESCRIPTION_
SEPTIC TANK:
DISTANCE '
FROM WELL
INSIDE LENGTH
MANUFACTURER ~ ~/:'.~("/7--- MATERIAL
INSIDE WIDTH LIQUID DEPTH
~-~ ~ , NUMBER OF
,/Z/~ ~z/~'Z/~.,~_~COMPARTMENTS ~_~
LIQUID CAPACITY~' ~F) ~ GALLONS.
SEEPAGE PIT: \
NUMBER OF PITS~/ . DIAMETER. OR WIDTId //~/', LENGTH /~T' DEPTH ';~'~ (P
.-~ ...... ~
LINING MATERIAL ~¢Y~/ _ CRIB SIZE: DIAMETER DEPTH _ DISTANCE FROM: WELL
BUILDING FOUNDATION ~ NEAREST LOT LINE ~ ~ TOTAL_ EFFECTIVE
. . ABSORPTION AREA (WALL AREA) ~
ADDITIONAL ABSORPTION
_SQ. FT.
WELL.:
TYPE,I.~/?/~ P.
BUILDING ~/.~/.~ '~
CESSPOOL
APPROVED
NEAREST '~ NEAREST SEPTIC
LOT LINE /~.~.2 SEWER LINE TANK
OTHER SOURCES
_ DISAPPROVED__
REMARKS
DISTANCE FROM:
SEEPAGE
SYSTEM ,'
DISTANCES:
LOT SLOPE:
REMARKS:
Form NO, LQ-031
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
GRE'A' :~ ANCHORAGE` ARE,A BORr
DEPARTMENT OF' ENVIRONMENTAL QUALITY
:~3~0 IICI' STREET ANCHORAGE, ALASKA 9950:~
TELEPHONE 274-456!
LEGAL DESCRiPTiON J-- L//-~'~
COMPLETION DATE ANTICIPATED
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING CE ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL E~E SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE/ ~ ~/-~/ ~ TYPE )~ c~:-~% ~ SEEPAGE AREA SIZ/- ~/ /~
MINIMUM DISTANCES, REQUIREMENT~
SEPTJC TANK TO SEEPAGE PIT WALl_ / ~- /
sept C TANK -2 _ SE~AG~ ~lT DRAIN field
WATER MAIN TO SEPTIC TANK
DRAIN FIELD-
SEEPAGE PIT ~
CAST IRON INTO AND OUT OF SEPTIC TAN)( AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEet INTO UNDiSTURBed SOIL.
4 iNCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC: TANK AND SEEPAGE PIT
FITTed WITH Airtight REMOVABLE CAPS.
/ ,/ --):'::"'--------
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION,
LICENSED DESIGNER
I CERTIFY THAT I AM FAMILIAR wrrH THE REQUIREMENTS OF GREATE]:~ ANC/~ORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS ]N ACCORDANCE WITH SAID CODE.
S()II,S I,O(', tH,~ROI,ATION TEST
lhis form reports: Soils log .... _~_~_~__ ........... Percolation test .......................
Del)th
Feet
2-
3-
4-
5-
6-
7-
8-
lO.--
ll
12~
13-
4/
'~a~jrooifd waC~'f e~{countered?
__./~/_.? .... If .ye.s, at what de;~th?
Reading [)ate Gross Time Net Time _Uepth_~o Wate~_ I~et tiro?
Percol ali on -r¢~-e- .n nute.
Proposed i stalla~{~-~ge Pit Urain Field
I)epLh of Inlet . Depth-~"}]~C~:[-pit or trench
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