HomeMy WebLinkAboutELLEN COURT LT 4
~AA~-'D-' ' GR[~"~;ER ANCHORAGE AREA BOROU~'"~
DEI*~RTMENT OF ENVIRONMENTAL QUALI'I~
3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCAT,ON
ADDRESS - ~' PHONE
SEPTIC TANK:
LIQUID CAPACITY
GALLONS.
NUMBER OF 1
COMPARTMENTS.
7' e / L,OU,D
INSIDE WIDTH DEPTH____
SEEPAGE SYSTEM: SEEPAGE PIT:
' W~D~.~H f
NUMBER OF PITS OUTSIDE DIA~T'L~''~''- ~_........._ OR
~...---..~ /
LINING M~A_~ V DISTANCE FROM WELL
, LE~,,~,~,~ DEPTH
BUILDING FOUNDAII~N--''/'
NEAREST LOT LINE
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)
SQ, FT,
TILE DRAIN FIELD:
DISTANCE FROM WELL_ ~,~, FOUNDATION '~ , NEAREST LOT LIN~i~.~-"~ '"
NUMBER OF LINES_ ~ DISTANCE BETWEEN LINES ' TRENCH WIDTH
ABSORPTION SQ. FT. LENGTH OF EACH LINE
TOTAL LENGTH
DEPTH: TOP OF TILE TO FINISH GRADE
DEPTH OF FILTER MATERIAL BENEATH TILE
IN. ABOVE TILE ,
WELL: ;'"';~? z,'7 ~ ,
TYPE ~Jl/'i'l~d DEPTH //--~ / DISTANCE FROM
' ~ BUILDING FOUNDATION.
NEAREST SEPTIC SEEPAGE
LOT LINE , SEWER LINE. , TANK , SYSTEM
WATER
SAMPLE NEAREST
OTHER
, CESSPOOL. SOURCES.__
DISTANCES:
DIAGRAM OF SYSTEM
.....
APPROVE~'~~~G .A~~~
GrEATEr ANCHORAGE AREA BorOUGh
DEPARTMENT OF ENVIRONMENTAL QUALITY
3500 TUDOR ROAD POUCH 6-650
ANCHORAGE, ALASKA 99502
TELEPHONE 279-8686
SEWAGE DISPOSAL SYSTEM m APPLICATION AND PERMIT
,.BTALLAT'ON 'OCAT'ON ~
TYPE AND SIZE OF FACILITY TO BE SERVED
FINANCED THROUGH
SOIL TEST RESULTS
COMPLETION DATE ANTICIPATED
PErmit NO. /~/
PHONE
DRAIN FIELD , OTHER
NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION,
SEPTIC TANK SIZE/-~7 ~C~O TV SEEPAGE AREA SiZe TYPE
FOUNDATION TO SEPTIC TANK
POUNDATION TO SEEPAGE PIT
DRAIN FIELD
SEPTIC TANK TO SEEPAGE PIT WALL
SEPTIC TANK - , SEEPAGE PIT
TO NEAREST LOT LINE.
DRAIN FIELD
WATER MAIN TO SEPTIC TANK
DRAIN FIELD
., DRAIN FIELD
SEEPAGE PIT
ALSO CONSIDER AREA WELLS.
SEEPAGE PIT
SEPTIC TANK, , SEEPAGE PIT
TO RIVER, LAKE STREAM.
., DRAIN FIELD
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 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 F;~EGULATIONS REGARDING iNSTALLATION.
~ ~/ HEALTH AUTHORITY
OR
LICENSED DESIGNER
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 aND THAT THE ABOVE
DESCRIbED/~YS~M IS IN ACCORDANCE WITH said CODE.
~REATER ANCHORAGE AREA BOROM~H
,ltEALTH DEPAkTMENT CA~E
32? EAaLE STREET .......
A~CHORAaE~ A~A~KA' 99501
Depth
Feet Soil Characteristics ' Location SkeTch
Was Gnound Water, Encountered?
If Yes, At Wha~ Depth .
Reading DaTe Gross Time Net Time Depth To H20' Net Drop
Proposed Installation: Seepage Pit Drain Field
Depth Of Inlet . Dep%h T~ Bot'~om O'f"Pit Or Trench
Test Perfor~d B~.e ~ ~ ,, ,
BECEIYE~
AU6 24 1971 PI~
GREATER ANCHORAGE AREA BOROUGH
DEPT. O1: ENVIRONMENTAL QUALITY