HomeMy WebLinkAboutCAMPBELL HEIGHTS #1 BLK 8 LT 22I. o7-
07 '
GR~'TER ANCHORAGE AREA BOROUGH
DL, ARTMENT OF ENVIRONMENTAL QUALh.
3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
ADDRESS ~ '-.'
LEGAL DESCRIPTION .~/z"..'~" .-?/ ..r'~.,_?.-.,
SEPTIC TANK:
DISTANCE FROM WELL ~:s,~.',/.,~/~.;~/~.....~.-~
LIQUID CAPACITY "7 -~'~? GALLONS.
NUMBER OF
MATERIAL -'~'/'~'--"J~-/~ -/2~"~/~-t~-~--"~'~ COMPARTMENTS /
,~-../'"/~'./""~'~"=~---'~""~'"~//" ~'"~"~--'~"~"~':" LIQUID
INSIDE LENGTH / INSIDE WIDTH, ~ DEPTH
SEEPAGE SYSTEM: SEEPAGE P, IT-/~'//~'
NUMBER OF PITS '~ ~ ORWIDT..
LINING /~~ . DISTANCE FROM W~.~..~
NEAREST LOT UNE
J
TOTAL EFFECTIVE ABSORPTION AREA (V/ALL AREAl
.. LENGTH . DEPIH
, -*'_'" nI,~LG FOUNDATION
,SQ. FT.
TILE DRAIN FIELD:
DISTANCE FROM WELl ~,~"~/"~'//'"~' FOUNDATION
NUMBER OF LINES // DISTANCE BETWEEN LINES TRENCH WIDTH
ABSORPTION AREA '~'~'~'~' SQ. FT. LENGTH OF EACH LINE.
DEPTH: TOP OF TILE TO FINISH GRADE ~
· DEPTH OF FILTER MATERIAL BENEATH TILE
NEAREST LOT LINE .'/Te'~ / TOTAL LENGTH
OF LINES ~--<~ ,.
IN. TOTAL EFFECTIVE
IN. ABOVE TILE
WELL:
LOT LINE
~YPE z~'~ / ~'/~'- ~'//.'~'-'~ DEPTH /
NEAREST i,/ SEPTIC
/ SEWER LINE TANK
DISTANCE FROM WATER
· BUILDING FOUNDATION..~J~__~SAMPLE / , NEAREST
SEEPAGE /"/ , CESSPOOl / OTHER ...-----
/ , SYSTEM , SOURCES__
DISTANCES:
DIAGRAM OF SYSTEM
DATE *,"'/' "::;/?'~' ~ APPROVED
G.A.A.B.
GREA,Er ANCHORAGE AREA BORuUGh
DEPARTMENT OF ENVIRONMENTAL GUALITY
SEWAGE DISPOSAL. SYSTEM -- APPLICATION AND PERMIT
MAILING ADDRESS .l~_ .~ -',' PHONE
ROTE~ THIS PERMIT IS HOT VALID WITHOUT SOIL TEST
FINAL INSPECTION~ 24 HOUR NOTIC~ REQUIRED.
HEALTH DEPARTMENT AUTHORITY WILL BE
ILLING OF ANY SY=,ir-M WITHOUT FINAL INSPECTION BY THE
DIAGRAM OF SYSTE:M~'//v~'''/
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
]EXCAVATION 5 PEE?F INTO UNDISTURBED SOIl.,
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
CONPORM TO BOROUGH REGU[.ATIONS REGARDING INSTAI. LATION.
OR
GR~EATER ANCHORAGE ArEa Borough
LEGAL DESCRIPTION
PINANCEC THROUGH
~1.~
THIS PERMIT IS NOT VALIO WITHOUT !l~:)lL TI='ST
COMPLETION DATE ANTICIPATED .
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
DIAGRAM OF SYSTEM
I I t
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO, 28-68 AND THAT THE ABOVE
Del':~rtmc,lt of llealth :.~d Environment,~l Protection
2516 E. Tudor Road
Anchornge. Alaska 99507
276-222!
Depth
Feet
SOlI,S 1.0{; I'I.;I:~)I.A'I'I~},~,' TI:ST
This furm repor~s.--~}{ils-l'og- " ~' __ Pei:colJtion ~,est ._ ,
2
3
4-
5-
6-
7-
10-
ll -
12-
13-
Was
round water encountered? ~_,J/~_~ ._. 'If yus, at what ,le;,th? ~__7_.:..~'. .......
l(cading Date Gross Tinm Ilct Time Uepth to Water ftet Drop
· Proposcd h~talla~"~f.""~-e~:le Pit Urai. I'icld
Dcp[h of Inlet ................ . ~ept[~]~B~'m-i[r"iHt or tre.ch .......................
~OI.III[IiIS: ..............................................................................
Perfon,~d ed By baLe:
040 (6/741 ~g.