HomeMy WebLinkAboutWALTER G PIPPEL ADDITION BLK 10 LT 4I0
GAAB-HD.I
Gl TER ANCHORAGE AREA BOROL.. ?!
0F r V..0Nr Er T, L
31~00 TUDOR ROAD ANCHORAGE, ALASKA g9507 27g-8686
iNSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME
LOCATION
SEPTIC TANK:
ADDRESS /~-~'/-~ q' ('-'//~" ~ r' ,' ~//~~ PHONE_
DISTANCE FROM WELL,//;:x~'/,',',~
LIQUID CAPACITY. /~.)~(-' GALLONS.
<~,,/~/' NUMBER OF
MATERIAL "~
COMPARTMENTS
LIQUID
INSIDE LENGTH INSIDE WIDTH DEPTH__
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS / OUTSIDE DIAMETER OR WIDTH
LINING MAJERIAI L~J(~ '~ . DISTANCE FROM WELl
/
NEAREST LOT LINE ~']/ /~('~ ~-
LENGTH
·
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)
, BUILDING FOUNDATION~.
~'~'- ~'~ ~J' .SQ. FT.
TILE DRAIN FIELD:
~E~ NEAREST LOT LINE
DISTANCE FROM WELL ~-~ ·
NUMBER OF LINES / LINES ~-~_ TRENCH WIDTH
.~ DISTANCE BETWEEN
ABSORPTION A,R~A SQ. FT. LENGTH
OF
EACH
LINE
TOTAL LENGTH
, OF LINES
/~IN. TOTAL EFFECTIVE
DEPTH: TOP OF TILE TO FINISH GRADE
DEPTH OF FILTER MATERIAL BENEATH TILE
IN. ABOVE TILE
· DISTANCE FROM
WELL:
TYPE/~'?(,~" , DEPTH '-~ ·BUILDING FOUNDATION..
NEAREST SEPTIC ~.,.__,/ SEEPAGE ., ,t
-- . SEWER UNE ' .,TANK :~ er ~'~ ,SYSTEM ./~ ['/U..~. ,
LOT LINE
DIAGRAM OF SYSTEM
DISTANCES:
WATER
SAMPLE ., NEAREST
OTHER
CESSPOOL '~- , SOURCES__
L_J
DATE
APPROVED ~ )4 ~
· - ' G .A.xA(.B.
GRE~"F~R ANCHORAGE AREA BO'R""~UGH
DEPARTMENT OF ENVIRONMENTAl- QUALITY
3500 TUDOR ROAD POUCH 6-650
ANCHORAGE, ALASKA 99502
TeLePHoNE 279-8686
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
!
PERM'TNO.
INSTALLATION OF: SEPTIC TANK
TYPE AND SIZE OF FACILITY TO BE SERVED
FINANCED THROUGH
COMPLETION DATE ANTICIPATED
SEEPAGE PIT
DRAIN FIELD , OTHER
PHONE
NOTE: THIB PERMIT IS NOT VALID WITHOUT BOIL TEBT
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INBPECTION BY THE
HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO pROSECUTION.
TYPE
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
fOUNDATION TO SEEPAGE PIT ~U , DRAIN FIELD
SEPTIC TANK TO SEEPAGE PIT WaLL
SEPTIC TANK
SEEPAGE PIT ~ / DRAIN FIELD
TO NEAREST LOT LINE.
DRAIN FIELD ALSO CONSIDER AREA WELLS.
WATER maiN TO SEPTIC TANK /~/~ ., SEEPAGE PIT
DRAIN FIELD
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 FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE Pit
FITTED WITH AIRTIGHT REMOVABLE CAPS.
DIAGRAM OF SYSTEM
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
H EALT~AU~OR~TY
OR
LICENSED DESIGNER
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
DATE ~//~//~/'/ APPLICANT'S SIGNATURE