HomeMy WebLinkAboutGREGG Block 2 Lot 5
GAAS HD-I
GF TER ANCHORAGE AREA BOROI'-H
D~¢AflTMENT OF ENVIRONMEEITAL QUALI,,
3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
DISTANCE FROM WELL
LIQUID CAPACITY /__~/---//--~ GALl ONS.
NUMBER OF
MATERiAL,.,~.~-'~.r~..~,~..(~~'-- ~"-,~')~4'-~,'~.~-- COMPARTMENTS
INSIDE LENGTH ~' INSIDE WIDTH ~----
LIQUID
DEPTH ~ ......
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS_ // OUTSIDE DIAMETER /'~'~ OR WIDTH
LINING MATERIAL .~d~",~ d~-~r.~f",~ --~ / ~
. DISTANCE FROM WELL_~
NEAREST LOT LINE .~,....//',..~'"/f,.z.~,.<~.)...~' TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)
, LENGTH ~/'/'~' , DEPTH~
BUILDING FOUNDATION
SQ. FT.
TILE DRAIN FIELD: /9",,~'~
DISTANCE FROMWELL ~N.
NUMBER OF LINES__ _//'~DI~TANCE BETWEEN LINES
ABSORPTIO E~A~ SO. FT. LENGTH OF EACH LINE
'~ST LOT LINE_
TOTAL LENGTH
, OF LINES
IN. TOTAL EFFECTIVE
DEPTH: TOP OF TILE TO FINISH GRADE
DEPTH OF FILTER MATERIAL BENEATH TILE
IN, ABOVE TILE__
W E L.L :'~/~'s~'~z"~':~': ~'~,~/
TYPE ,,*~,~./'-z~~ , DEPTH
NEAREST
LOT LINE ~ , SEWER LINE
SEP11C
TANK
DISTANCE FROM /_~ WATER ~.~
,BUILDING FOUNDATION ........ SAMPLE , NEAREST
SEEPAGE z~- ~_ OTHER
~ , SYSfEM . __, CESSPOOL , SOURCES
DIAGRAM OF SYSTEM
DISTANCES:
GREATER ANCHORAGE AREA BOROUGH
DEPARTMENT OF ENVIRONMENTAL. DUALITY
3500 TUDOR ROAD POUCH 6-650
ANCHORAGe, ALASKA 99502
TELEPHONE 279-8686
SEWAGE DISPOSAL SYSTEM M APPLICATION AND PERMIT
PERMIT NO
NAME OF APPLICANT
INSTALLATION LOCATION
LEGAL DESCRIPTION %_.{~. Z:,)/ (¢!)
INSTALLATION Of: SEPTIC TANK
TYPE AND SIZE OF FACILITY TO BE SERVED
FINANCED THROUGH
SO,L TEST RESULTS ' '
COMPLETION DATE ANTICIPATED
MAIL,NG ADDRESS ,~,, '? L'-? 1!~/'/- ~ /";'t :'-: PHONE ~ - / 2V
SEEPAGE PIT-- ~ , DRAIN FIELD , OTHER
/Z'¢'~ NOTE THIS PERMIT iS NOT VALID WITHOUT SOIL TEST
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED, BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPEGTION BY THE
HEAL.TH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION,
DIAGRAM OF SYSTEM
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SePTiC TANK
FOUNDATION TO SEEPAGE PIT ~2~-. / , DRAIN FIELD
SEPTIC TANK TO seEPAGE PIT WALL
SEPTIC TANK -¢2 , SEEPAGE Pit , DRAIN FIELD
TO NEAREST LOT LINE,
WELL TO SEPTIC TANK :2~ (¢-: SEEPAGE Pit
DRAIN FIELD ALSO CONSIDER AREA WELLS.
· SEEPAGE PIT
WATER MAIN TO SEPTIC TANK
DRAIN FIELD
SEPTIC TANK, ~' ~ / SEEPAGE PIT ¢//~ ~: /
TO RIVER, LAKe· STREAM.
· DRAIN FIELD
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP Of
FITTED WITH AIRTIGHT REMOVABLE'C/(I~S[
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
'' H~ALTH AUT ' RITY
LICENSED(/DESIGN ER
] CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE