HomeMy WebLinkAboutUS SURVEY 3045 LT 441)55 3045
Lot 44
#075-031-15
GREATEK ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPE ION REPORT ON-SITE SEWAGE DISPOSAL YSTEM
I �
MAILING ADDRESS � '� �- •' / `' �-r=� � PHONE
NAME
x 2
LOCATION
LEGAL DESCRIPTION
SEPTIC TANK:
DISTANCE
FROM WELL b C MANUFACTURER
INSIDE LENGTH
INSIDE WIDTH
MATERIAL
tit
U 6Lt
NUMBER OF
COMPARTMENTS
LIQUID DEPTH LIQUID CAPACITY0-60° GALLONS.
SEEPAGE PIT:
NUMBER OF PITS DIAMETER OR WIDTH_ LENGTH_ DEPTH
LINING MATERIAL CRIB SIZE: DIAMETER DEPTH DISTANCE FROM: WELL
TOTAL EFFECTIVE
BUILDING FOUNDATION NEAREST LOT LINE ABSORPTION AREA (WALL AREA) SQ FT
ADDITIONAL ABSORPTION
WELL:
TYPE CONSTRUCTION DEPTH DISTANCE FROM:
BUILDING NEAREST NEAREST SEPTIC SEEPAGE
FOUNDATION LOT LINE SEWER LINE TANK SYSTEM
CESSPOOL OTHER SOURCES
APPROVED DISAPPROVED
REMARKS
DISTANCES:
INSTALLED BY: 'T"`t0-m1'es'
PIPE MATERIAL-` \ 16
LOT SLOPE:
REMARKS'
DIAGRAM OF SYSTEM
DATE APPROVED
G.A.A.B.
NAME OF APPLICANT
GREATER ANCHORAGE AREA BOROUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C" STREET ANCHORAGE, ALASKA 99503
TELEPHONE 274-4561
SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT
Ci.Q«J c1
PERMIT NO
MAILING ADDRESS /` t4 -Q
-PHONE
LEGAL INSTALLATIONSR LOCATIONO4 `—
LEGAL DESCRIPTION C)-Lfl a ,••Ws �C^/lw'_i
INSTALLATION OF: SEPTIC TANKt" SEEPAGE nPIIT DRAIN FIELD ln/ . OTHER
TYPE AND SIZE OF FACILITY TO BE SERVED `ce Q LJ
iter- - 4'_� 1 tctvN fr-i'L"Pry-
FINANCED THROUGH
SOIL TEST RESULTS NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
COMPLETION DATE ANTICIPATED
TO BE INSTALLED BY
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.
SEPTIC TANK SIZE
TYPE
(J
4
ii.
Leis
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT DRAIN FIELD
SEPTIC TANK TO SEEPAGE PIT WALL
SEEPAGE AREA SIZE TYPE
SEPTIC TANK
r
SEEPAGE PIT DRAIN FIELD
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK la° SEEPAGE PIT
DRAIN FIELD ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK SEEPAGE PIT
DRAIN FIELD
SEPTIC TANK, the.. SEEPAGE PIT DRAIN FIELD
TO RIVER. LAKE, STREAM.
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 REGULATIONS RE NG INSTALLATION.
OR
LICENSED DESIGNER
DIAGRAM OF SYSTEM
1 CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO
DESCRIBED SYSTEM I5 IN ACCORDANCE WITH SAID CODE.
DATE
APPLICANT'S SIGNATURE
26-68 AND THAT THE ABOVE