HomeMy WebLinkAboutSNOW VALLEY LT 23DSNo�J LL&
r GRi. -TER ANCHORAGE AREA BO" HUGH
� Department of Environmental Quality
e��:.e�� 3330 C Street
d Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME MAILING MAILING ADDRESS ��•o� J�� pPHONE
LOCATION l LEGAL DESCRIPTION �C2XG`3 D
SEPTIC TANK:
DISTANCE i NUMBER OF
FROM WELL` MANUFACTURER —MATERIAL% COMPARTMENTS
INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY ����- GALLONS.
SEEPAGE PIT:
NUMBER OF PITS DIAMETER OR WIDTH—, LENGTH—, DEPTH
LINING MATERIAL CRIB SIZE: DIAMETER1—DEPTHb DISTANCE FROM: WELL 4(4c '
` TOTAL EFFECTIVE
BUILDING FOUNDATION_, NEAREST LOT LINE ABSORPTION AREA (WALL AREA)SQ. FT.
ADDITIONAL ABSORPTION
WELL: e n.
TYPE �` CONSTRUCTION
BUILDING NEAREST
FOUNDATION LOT LINE
CESSPOOL OTHER SOURCES
NEAREST
SEWER LINE
APPROVED DISAPPROVED REMA
DISTANCES: b1`.
INSTALLED BY: "x
PIPE MATERIAL:
LOT SLOPE:
REMARKS:
Form No. EQ -031
DEPTH% 1 bU DISTANCE FROM:
SEPTIC_ SEEPAGE
TANK SYSTEM
DIAGRAM OF SYSTEM
G.A.A.B.
GREATER ANCHORAGE AREA BOROUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO.
3330 "C" STREET ANCHORAGE, ALASKA 99503
Y E TELEPHONE 294-45561
Y•�x¢eo im•. `oe. a�/ ��`�j SEWAGE DISPOSAL SYSTEM - APPLICATION A1�6.eD��
p r
NAME OF APPLICANT w - MAILING ADDRESS PHONE`'
INSTALLATION LOCATION. ,�'L2
LEGAL DESCRIPTION
INSTALLATION OF: SEPTIC TANKy SEEPAGE PIT_ —y,�DRAIN
FIFIELD
J�� OTHER ,
TYPE AND SIZE OF FACILITY TO BE SERVED
FINANCED THROUGH �/ TO BE INSTALLED BY
SOIL TEST RESULTS--'�-S ���"�'�4J ������ NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
COMPLETION DATE ANTICIPATED
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WIT14OUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
iii
SEPTIC TANK SIZE TYPE
SEEPAGE AREA S
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
i
�—
FOUNDATION TO SEEPAGE PIT D DRAIN FIELD
SEPTIC TANK TO SEEPAGE PIT WALL
i -
SEPTIC TANK i SEEPAGE PIT �ry� D/R�AI%N FIELD
,(��y/
TO NEAREST LOT LINE.✓` / �y/`/I L./V 2
WELL TO SEPTIC TANK SEEPAGE PIT
DRAIN FIELD -"L� ALSO CONSIDER AREA WELLS.
L�
WATER MAIN TO SEPTIC TANK SEEPAGE PIT /
DRAIN -FIELD Z-0 -
SEPTIC TANK, �`� SEEPAGE PIT DRAIN FIELD
TO RIVER, LAKE, STREAM. - - ---- - ------_---
CAST IRO --INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING�-
EXC ATION 5 FEET INTO UNDISTURBED SOIL.
INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PST
FITTED WITH AIRTIGHT REMOVABLE CAPS.
G AVEL BACKFILL
CONF TO BOROUGH REGULATIONS REGARDING INSI,�_LL ION.
G.A.A.B.
OR
LICENSED DESIGNER
I CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE.
DATE APPLICANT'S SIGNATURE
FORM NO. EQ -016
TYPE
DIAGRAM OF SYSTEM
ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE