HomeMy WebLinkAboutLot 01Ii,
GREi'- R, ANCHORAGE AREA BOR'- IGH:
Department of Environmental Quality
3330 C Street
Anchorage, Alask~ 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
(" PI~O~J E
SEPTIC TANK:
DISTANCEFROM WELL /0~ MANUFACTURER
NUMBER OF
MATERIAL ~ ~i-.~ ~ COMPARTMENTS
INSIDE LENGTH__ INSIDE WIDTH
LIQUID DEPTH
LIQUID CAPACITY ~{~0~ GALLONS.
SEEPAGE PIT:
NUMBER Of PITS / . DIAMETER ~ OR WIDTH
LINING MATERIAL bl~¢-~ CRIB SIZE: DIAMETER~'~2
BUILDING FOUNDATION *~6~I, NEAREST LOT LINE.~¢
ADDITIONAL ABSORPTION
/
LENGTH/f, DEPTH /~
!
.. DEPT~ /O DISTANCE FROM; WELL J//
TOTAL EFFECTIVE
ABSORPTION AREA (WALL AREA)
SQ. FT.
WELL:
TYPE --..~.~ b
BUILDING
FOUNDATION
CONSTRUCTION/
NEAREST NEAREST
LOT LINE SEWER LINE
DEPTH DISTANCE FROM:
SEPTIC SEEPAGE
TANK SYSTEM
CESSPOOL OTHER SOURCES
APPROVED ~'/ DISAPPROVED
REMARKS
DISTANCES,/~: /~2¢~
INSTALLED BY: ~2~44Z41/'Jzx~4b ~¢(',
PIPE MATERIAL,
,24
LOT SLOPE:
REMARKS,
Form No. EO-O31
DATE
G.A.A.B.
GrEATeR ANCHORAGF ARea BOROUgh
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
PERM JT NO,
!NSTALLAT[ON OF: SEPTIC TANK ~ SEEPAGE Pit ~
TYPE AND ~,ZE OF FACIL]TY TO BE SERVED~ ~
aDDRESS
FINANCED THROUGH
SOIL TEST RESULTS
TO BE INSTALLED BY
DRAIN FIELD ., OTHER.
NOTE~ THIS PERMIT IS NOT VALID WITHOUT BOIL TEST
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.
SEPT,C TANK S'ZE TYPE PAGE AREA S'ZE
~VIINIMUM DISTANCES, REQUIREMENTS:
FOUNDATION TO SEPTIC TANK ~'//
FOUNDATION TO SEEPAGE Pit K~
SEPTIC TANK To SEEPAGE Pit WALL
, DRA~N FIELD
TO NEAREST LOT LINE. .
WELL TO SEPTIC TANK /~-~/ , SEEPAGE PlY ' :~'~ 71'
DRAIN FIELD ~ ALSO CONSIDER AREA WELLS,
WATER MAIN TO sePtiC TANK ~ / , SEEP2~E P~T ~ ~ /
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.
GI~AVEL BACKFILL
OR
i CERTIFY THAT [ AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 2B-68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE.
lq SILVER SPRUCE
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