HomeMy WebLinkAboutINDIAN VALLEY ALASKA LT 11NP(AN yALLE`(
ALASKA sir)
1-T is LK
11+tiaA I
LT ih PIA RCEe640•-031-10•odo
l,T 12,A: ppktiet.040 - 03 (-31- N 00
GRF?ER ANCHORAGE AREA BO ' UGH
Department of Environmental Quality
3330 C Street
~0 '-(~'~ f- /~ Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
MATERiAL~.2,//~/¢//~~ ///~_ NUMBER OF
COMPARTMENTS
.LIQUID DEPTH LIQUID CAPAC Ty,~C c:~r GALLONS.
SEPTIC TANK:
DISTANCE
FROM WELL /L~2{) MANUFACTURER
INSIDE LENGTH /i? / INSIDE WIDTH
SEEPAGE PIT:
NUMBER OF PITS / DIAMETER __ OR WIDTH
LINING MATERIAL -~/~%~ / CRIB SIZE: DIAMETER
BUILDING FOUNDATION,;~O )~ NEAREST LOT LINE
ADDITIONAL ABSORPTION
LENGTH /.~ DEPTH ("~
DEPTH DISTANCE FROM: WELL
TOTAL EFFECTIVE . ,,,;, ~
ABSORPTION AREA (WALL AREA) ~.T ~//~'z/~:"SQ FT.
WELL:
TyPE
BUILDING
FOUNDATION
CESSPOOl
APPROVED
CONSTRUCTION ~ ~-
NEAREST ~ NEAREST .~.
LOT LINE ~g-) '~ SEWER LINE
OTHER SOURCES
DISAPPROVED
DEPTH / //] DISTANCE FROM:
SEPTIC/~.<] z SEEPAGE -. /
TANK SYSTEM / ~ .S
REMARKS
DISTANCES:
INSTALLED BY:
PIPE MATERIAL:
LOT SLOPE:
REMARKS:
Form No. EQ~031
DIAGRAM OF SYSTEM
GREATER ANCHORAGE AREA BOROUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C"STREET ANCHORAGE, ALASKA 99503
TELEPHONE 274-4561
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
pERMIT NO. --
PHONE
LEGAL DESCRIPTION
INSTALLATION OF: SEPTIC TANK
TYPE AND SIZE OF FACILITY TO SE SERVED
SEEPAGE PIT ~., DRAIN FIELD OTHER .
TO SE INSTALLED SY
NOTE: THIS pERMIT iS l~OT VALID WITHOUT SOIL
FINANCED THROUGH
SOIL TEST RESULTS -- '
FINAL iNSPeCTION:
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION,
FOUNDATION TO SEPTIC TAN:< --
FOUNDATION TO SEEPAGE PIT J~
SEPTIC TANK TO SEEPAGE Pit WALL ~
SEPTIC TANK -- '~' / .--i SEEPAGE pit ~ --, DRAIN FIELD
DRAIN Field
WATER MAIN TO SEPTIC TANK --
DRAIN FIELD ~ --'
SEPTiC TANK._ / 20.:SEEPAGE PIT
TO RIVER, LAKE. STREAM.
DRAIN FIELD-
SEEPAGE pit
ALSO CONSIDER AREA WELLS.
SEEPAGE Pit
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBEO SOIL.
4 INCH DIAMETER CAST IRON SIPHON pIPES ON SEPTIC TANK AND SEEPAGE Pit
FITTED WITH AIRTIGHT REMOVABLE CAPS.
DIAGRAM OF SYSTEM
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHO~RAGE AREA BO;ZGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. /