HomeMy WebLinkAboutGREGORY TR 14
GREA'! ANCHORAGE AREA BORO )H
Department of Environment Quality
3500 Tudor Road
Anchorage, Alaska 99507
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME [¢/'~/~3/ ,/(]~.,/}ZZ.~_:,,x,~TM MAILING ADDRESS ~'-~-~
LOCATION 6:~,~3z"_-~.,..~;~-~ y'- //d~',/~/~'//'.i/~.-//LEGAL DESCRIPTION
SEPTIC TANK:
DISTANCE
FROM WELL,-:"~ //
INSIDE LENGTH__
_ MANUFACTURER¢.~2'Z?-C /.~//.e:~A-FERiAL
NUMBER OF
COMPARTMENTS
INSIDE WIDTH
LIQUID DE'PTH
LIQUID CAPACITY'/'~'2't2 GALLONS.
TILE DRAIN FIELD:
DISTANCE FROM WELL
NUMBER OF LINES
ABSORPTION AREA
DEPTH: TOP OF TILE TO FINISH GRADE
/ :¢ .- / / TOTAL LENGTH ~¢ /
~-) ~ _ NEAREST LOT LINE :/'~' ~..._O..F// LINES
FOUNDATION
/ / ,~..,
DISTANCE BETWEEN LINES _~Y('' , ~ __TRENCH WIDTH.;Z-¢~'? IN. TOTAL EFFECTIVE
SQ. FT. LENGTH OF EACH LINE /~/'~ >-'/ ~ ~'-',,
// DEPTH OF FILTER , .~,
MATERIAL BENEATH TILE ~' IN. ABOVE TILE ~ IN.
WELL:
TYPE ·
BUILDING
FOUNDATION
CESSPOOL
APPROVED
NEAREST NEAREST SEPTIC
LOT LINE ____, SEWER LINE____, TANK
OTHER SOURCES ____
DISAPPROVED REMARKS
_DEPTH
SEEPAGE
SYSTEM
DISTANCE FROM:
INSTALLED BY: :~'?/?//
SEWER LINE DEPTH:
DIAGRAM OF: SYSTEM
~,/}t t-q-t~hi 71-14~ ~
Form PW-027
GRE/.....ER ANCHORAGE AREA BOROLJGH .,~'/
SEWAGE DISPOSAL SYSTEM ..... APPLICATION AND PERMIT
INSTALLATION OF: SEPTIC 'rANK ~- SEEPAGE PIT '/ , DRAIN FIELD
FINANCED THROUGH tO BE INSTALLED bY ¢()f,,~ ~
COMPLETION DATE ANTICIPATED
PERMIt NO. ·
· OTHEr
NOTE: TBl~ PERMIT I~ NOT VALID WITHOUT ~OIL
FINAL IN~3PECTION= ,~,q. HOUR NOTICE FIEQUIR!~'D. BACKFILLING OF ANY ~Y$"rE:~ WITHOUT FINAL INBPECTIOH ~Y THE
HEALTH 13EPARTMENT AUTHO~I~ WILL BE SUBJECT TO PROSECUTION.
SEPTIC
MINIMUM D ISTANCI~5,
~/
FOUNDATION TO SEPTIC TANK
--~, DRAIN FIELD_
SEPTIC TANK ..... SEEPAOE PIT
TO NEAREST LOT LINE. /
DRAIN FIELD /~() / ALSO CONSIDER AREA WELLS.
WATER MAle TO SEPTIC TANK
SEEPAGE PIT
TO RIVER, LAKE. STREAM.
CAST~.IRON INTO ~-AN~D~O~I'T'~OF:SEPTr~: TANK AND INTO CRIBCROSSING GAP OF
EXCAVATLON-~FEE~T..INTO UNDISTURBED SOIL.
4 INCH ,DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED W,I~'TI~ A.~I~TIGHT REMOVABLE CAPS.
CONFORM TO BORDUGH REGULATIONS REGARDING INSTALLATION.
DIAGRAM OF' ~,Y~.TEM
I CERTIPY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHDRAGE AREA E~OROUGH ORDINANCE NO. 2S-80 AND THAT THE ABOVE
DESCRIBED SYSTEM IS JN ACCORDANCE WITH SAID CODE.
3500 TUDOR RDAi]
A~iCHORAGE, AI..ASKA 99502
:~-'i Date Per !'om}ed
Ledal Description: Lot Block ....... SuDdivision (,._.~(C.t[_j_~_.~..._(&LL~,_,~_:,.~/__u'/~_,/_;.<[,,/,:,,,.,__.__
This Form Reoorts Soils Lop ......... k' Percolation Test'._~
qe~th
Feet Soil Characteristics
3--
6
7
Was Ground Water Encountered? _!/J&2~ %
I¢ Yes, At what Denth? ....... <_).'~ ...... °e
Readin¢l Date Grnss Time Net Time ! !)~nth to tl20 Net Dr'on;
ercolation Rate '!inure
Prnpose4. IrlS tal 1 a ti '.7~n: Fe, :,4 qq, Pit-.
Oe~th of Inlet ___
Cn~4,~EN TS: