HomeMy WebLinkAboutLot 04
'N? 690
HEALTH DEPARTMENT ~
~ 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
¥ .. INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
MAILING
LEGAL DESCRIPTION ~,~'
PHON E~)?
SEPTIC TANK:
· ' ~ C) I(/~2J:RIAL ~?~%Z'. COMPARTMENTsNUMBER OF
DISTANCE FROM WELL/~'~/~ {~Y)?//)~ '- / ...... ~%'/-~¢'~'/~=~ (~J~J'
HQUlD
LIQUID CAPACITY /~)~)(') GALLONS. INSIDE LENGTH. .INSIDE WlDTJ~~DEPTH
SEEPAGE SYSTEM: SEEPAGE PiT:
NUMBER OF PITS / OUTSIDE DIAMETER
LINING MATERIAl L~(~" (
NEAREST LOT L NE
/
OR WIDTH '] ~ , LENGTH / 7 , DEPTH
DISTANCE FROM WELL /~-~.~//~L: /~)(;)~*~/~- , BUILDING FOUNDATION
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ~) SQ. FT.
TILE DRAIN FIELD:
DISTANCE FROM WELL
NUMBER OF LINES.//
A SORPp®
~ , FOUNDATION ~ , NEAREST LOT LINE
DISTANCE BETWEEN LINES ~'~ TRENCH WIDTH
SQ. FT. LENGTH OF EACH LINE
DEPTH: TOP OF TILE TO FINISH GRADE
TOTAL LENGTH
, OF LINES
IN~.~T~)TAL EFFECTIVE
DEPTH OF FILTER MATERIAL BENEATH TILE
IN. ABOVE TILE
WELL:
TYPE/~>'~IZ"Z~-~I~L~Y'/~'~' , DEPTH
NEAREST ~
LOT LINE ~ , SEWER LINE
DISTANCES:
h) "l
DISTANCE FROM WATER
'~ ,BUILDING FOUNDATION. ~ SAMPLE , NEAREST
SEPTIC //~ e'(.,~ S EEPAG E , ~¢.,~.,~ OTHER __
., TANK ~-~ . , SYSTEM /~.,() - , CESSPOOL '~ , SOURCES.__
DIAGRAM OF SYSTEM
?~..; :, ~ ~ : - . . ~ :.~
~, :~,.'/-.~-~ . , . - ~ . : : . : ~ : -
DATE
GRE~-~ER ANCHORAGE AREA BO~'~UGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3500 TUDOR ROAD POUCH 6-650
ANCHORAGE. ALASKA 99502
TELEPHONE 279-8686
SEWAGE DISPOSAL SYSTEM m APPLICATION AND PERMIT
,NSTALLAT,ON LOC*T,O" :/ l /J
'EGAL DESCR,PT,ON ¢ .
INSTALLATION OF: SEPTIC TANK
TYPE AND SIZE OF FACILITY TO BE SERVED
FINANCED THROUGH ~~
SOil TEST rESULTS
COMPLETION DATE ANTICIPATED
SEEPAGE Pit X DRAIN FIELD . ., OTHER
?.~/~jXl~ NOTE, THIsCERMIT IS NOT VALID WITHOUT SOIL
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION.
DIAGRAM OF SYSTEM
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
SEPTIC TANK TO SEEPAGE PIT WALL
5'~
SEPTIC TANK , SEEPAGE PIT ,DRAIN FIELD
TO NEAREST LOT LINE.
WELL TO SEPT,C TANK D~
SEEPAGE PIT
DRAIN FIELD ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK , SEEPAGE Pit
DRAIN FIELD
BEPT,O TANK. '~ ¢ ' I~ '
TO RIVER, LAKE. STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION S FEET 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 BOROUGH REGULATIONS REGARDING iNSTALLATION.
g4EAL:~TH~0 R ITY
~ICENSED DESIGNER
CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCH~AGE AREA BOROUGH ORDINANCE N(~ 28-68 AND THAT THE ABOVE
DESCR~2~ SYSTEM IS IN ACCORDANCE WITH SAID CODE. ~/~ / ~ ':/ .