HomeMy WebLinkAboutWESTGATE PARK BLK 2 LT 5LoT
QGR,"~r~:'R ANCHORAGE AREA BOI~GH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCATION ~C~ O~"~' ~-~'~'~?" LEGAL DESCRIPTION
~ TANK:
DISTANC Et'_' Oil/)'t1
FROM WELl
INSIDE LENGTH
MANUFACTURER
INSIDE WIDTH
NUMBER OF
COMPARTMENTS
LIQUID DEPTH
LIQUID CAPACITY ,~, *'~ [J ~-~ GALLONS.
SEEPAGE PIT:
NUMBER OF PITS
LINING MATERIAL
BUILDING FOUNDATION__
ADDITIONAL ABSORPTION
DIAMETER ~R WIDTH
C IZ . IAMETER
, NEAREST LOT LINE
LENGTH DEPTH
DEPTH DISTANCE FROM: WELL
TOTAL EFFECTIVE
ABSORPTION AREA (WALL AREA)
.SQ. FT.
WELL: ~¢/~/'Z~ ~','~ ~ ~c~
TYPE CONSTRUCTION
BUILDING NEAREST
FOUNDATION LOT LINE
CESSPOOL
OTHER SOURCES
APPROVED
DISAPPROVED
DEPTH
NEAREST SEPTIC
SEWER LINE TANK
REMARKS
DISTANCE FROM:
SEEPAGE
SYSTEM
DISTANCES:
INSTALLED BY:
PIPE MATERIAL: ~"~'~,.
LOT ~.OPE:
~£MARKS~
Form No. EQ-031
DIAGRAM OF SYSTEM
OATE ?~1~ ~
APPROVED~
G.A.A.B.
GReater ANChOrage Area Borough
DEPARTMENT OF ENVIRONMENTAL QUALITY
5330 "C" STREET ANCHORAGE, ALASKA 99503
TELEPHONE 274-456!
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
NAME OF APPLICANT
INSTALLATION LOCATION
LEGAL DESCRIPTION
iNSTALLATION Of: SEPTIC TANK
TYPE AND SIZE OF FACILITY TO BE SERVED
FINANCED THROUGH
SOIL TEST RESULTS
Z o 7-
SEEPAGE PIT
., DRAIN FIELD
NOTE: THIS PERMIT l$ NOT VALID WITHOUT SOIL TEST
EPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
rDIAGRAM OF SYSTEM
, DRAIN FIELD
DRAIN FIELD .
., SEEPAGE PIT
ALSO CONSIDER AREA WELLS.
SEEPAGE PIT
-, DRAIN FIELD
CAST IRON INTO AND OUT OF SEPTIC TANK AND [NTO 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 AIRTIGBT REMOVABLE CAPS.
I CERTIFY THAT IAM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
DATE APPLICANT'S SIGNATURE ,/ ~
FORM NO. EQ-016