HomeMy WebLinkAboutPREUSS #2 BLK 2 LT 9
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GRE. ,IER ANCHORAGE AREA B0r UGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME "'~f2/~-A/c~E'~ ~E4/~:L. MAILING ADDRESS
LOCATION /~/~L~--/J'-~//~J/~'~ll/~ ~:~/~: LEGAL DESCRIPTION
SEPTIC TANK:
DISTANCE I
FROM WELL /0OO
INSIDE LENGTH
MANUFACTURER
INSIDE WIDTH
NUMBER OF
MATERIAL /~'"~ Z%~-~'/'~ '~ COMPARTMENTS
LIQUID DEPTH
LIQUID CAPACIT/~I GALLONS.
TILE DRAIN FIELD:
DISTANCE FROM WELL
NUMBER OF LINES / DISTANCE BETWEEN LINES
ABSORPTION AREA
DEPTH: TOP OF TILE TO FINISH GRADE
NEAREST LOT LINE /O /'/" TOTALOF LINES LENGTH ~ /
~/4 TRENCH WIDTH 3~ IN. TOTAL EFFECTIVE
!
SQ. FT. LENGTH OF EACH LINE / ~-~ ~
/~// DEPTH OF FILTER
MATERIAL BENEATH TILE._~ O IN. ABOVE TILE Z/ IN.
WELL:
TYPE_~-'-~/0 I~/. CONSTRUCTION ~ II ;D/~/LL~O
BUILDING :~.E.i' NEAREST /~ /./~, NEAREST
FOUNDATION. LOT LINE SEWER LINE__
__DEPTH ~J-/'7 ~ DISTANCE FROM:
SEPTIC /~ I SEEPAGE /./..,
TANK , SYSTEM
CESSPOOL , OTHER SOURCES
APPROVED DISAPPROVED
REMARKS
DISTANCES:
INSTALLED BY: /~00 01~ ~'/~J'
SEWER LINE DEPTH:
PIPE MATERIAL: (.~ ~-r'"
LOT SLOPE:
REMARKS:
Form £Q-032
DIAGRAM OF SYSTEM
o'~ GRE;.,.ER ANCHORAGE AREA bO~/~!~ ~ .~ \~'~
/~"~ I~EPARTMENT OF ENVIRONMENTAL QuALi~'Y ,~"'e ~1~F~ERMIT N~~~
INSTALLATION OF: SEPTIC TANK
TYPE AND SIZE OF FACILITY TO I)E SERVED
P,.ANCED T. ROUGH /S--P
So,L TEST .ES.LTS
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.
.EPT,C TANK S'.E TYPE '
MINIMUM DISTANCE:S. RE:QUlREMENTS
FOUNDATION TO SEPTIC TANK
/
SEPTIC TANK TO SEEPAGE PIT WALL
SEPTIC TANK
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK DRAIN FIELD
WATER MAIN TO SEPTIC TANK
DRAIN FIELD ' ~
SEPTIC TANK. , SEEPAGE PIT
TO RIVER. LAKE, STREAM,
DRAIN FIELD
SEEPAGE PIT DRAIN FIELD
/00 ,SEEPAGE. PIT / 0~ I
ALSO CONSIDER AREA WELLS.
SEEPAGE PIT
DRAIN FIELD
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP DF
EXCAVATION S FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
DIAGRAM OF SYSTEM
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
GREATER ANCtIORAGE AREA BOROW'~I
Department of Environmental Qk.,'ity
3330 "C" Street
Anchorage, Alask~ 99503
SOILS LOG - PEROLATION TEST
Performed for ~. ~c'~(-
Legal Description. 1,..~:-. 9' ~ ~
This form reports:
SOil~ log ~
Date Performed ~-/- Ys-
PercOlatiOn test
Depth
Feet
2-
3-
4-
6-
7-
8-
10-
12-
13-
14 - '~.
Was ground water encountered?
IL ,
If yes, at what deptll?
Reading
Date
Percolation rate
· Proposed installa~:
Depth of Inlet__
CO[.IIIEIITS:
Gross Time
Net Time
Depth to Water
Net Drop
mi nu te.
Seepage Pit Drain Field
Depth to bottom of pit or trench .~.''
EQ-040 (6/74)
Certified
__Uate:_~ .,
NAME OF APPLICANT
GREATEr ANCHORAGE AREA BoR'OuGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 'C" STREET ANCHORAGE, ALASKA 99503
TELEPHONE 274-456!
PERMIT NO.
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
' NSTALLATION LOCATION L ~/ ~ 2
OTHER
NOTE~ THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
LEGAL DESCRIPTION
INSTALLATION OF: SEPTIC TANK
TYPE AND SIZE OF FACILITY TO BE SERVED
FINANCED THROUGH
COMPLETION DATE AN~TICIP(~ATED .
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. DACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SE~IC TANK SIZE TYPE SEEPAGE AREA SIZE TYPE ~
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT
SEPTIC TANK TO SEEPAGE P~T WALL,
SEPTIC TANK
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK
DRAIN FIELD
· SEEPAGE PIT :
WATER MAIN TO SEPTIC TANK
DRAIN FIELD .
SEPTIC TANK. . SEEPAGE PIT
TO RIVER, LAKE. STREAM.
DRAIN FIELD
DRAIN FIELD
SEEPAGE PIT /
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO C~RIR
EXCAVATION 5 FEE"T INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO BOROUG~:L~EGULATIONS REGARDING INSTALLATION.
DIAGRAM OF SYSTEM
I
FORM NO. EQ'016