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HomeMy WebLinkAboutEKLUTNA EAST LT 2 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVlRONIViENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4~20 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL ~NSPECTION REFORT .jP I-.I O N E M NAME /} . / ~ , LOCATION I ] wdl ~ ~ Ab~mt[o~ ~r~a ~DISTANCE TO'._. ] Manufacturer /~ ~Liq. cai Inside length IF HOMEMADE: DISTANCE TO: Manufacturer IWell Xi DISTANCE TO: J__ (~4,~/~ t¢¢)~ No. of lines/ / Length %( each Ii, ne Top of tile ~ofin~sh grade ~Z~~_ ~idftl Length Type of crib Crib diameter Well Dwelling Foundation /~/ Total ler~zth of lines / Material beneath tile Depth Crib depth DISTANCE TO: Class Depth Drifter Building foundation Sewer line DISTANCE TO: Building foundation Dwelling. M at eria' 5~ ~¢.?..~- Wid th NO. OFBEDROOMS._~ ~UPGRADE ,:RM,T q 7 I TrencL~id~ Liquid depth Licluid capacity in gallons Total effectiN~ a[%orpt' area PERMIT NO. inches OTHER PIPE MATERIALS SOl L TEST RATIN?/:: INSTALLER REMARKS DATE LEGAL \ (;~ii:;;:Ot. jt'~D FIt",iD i"Ht~}; BOT TO!"I OI:;' "I'Hi~ I~;;:':;Ct:':I ¥ H t .t.I...tt'.;~ ,:..[ I',~I" M:::. I .:. "t'Hi:::i:;?i:;: i"::;; I",1~"~ ';:;t::"1' I41;I)TH i'1...$:1 I I'<I;:.t',IUHI:::.::~. '~ " 'I"i'11~,.." ........ ! ....... I t::.I'"'11"t ;I; S THE] I¥i ]; I",1 ;i; i"if..11"1 i';~ii::~;*~ 0t;:~ (ii~;?.Fi',/Et... BIETI,.tiEIi~:t",I TI'tIE .... rt:::'l:::ll. I. F' :( PiE ' ' ' Ri'ID t'!~1~; F: '; T"I"" t"i "q::: I!.. 1i Ii::;;~:: i~iI:::t~;:l{l::' ;i; L.I~ ;!; t'q(~i 0l:::' I:::11',1"~" ,'~; ."; '"'F:I'I , t"i ;!; N ii; I'ti..!H I);i :~F'i'I::IN(;:I ii 1::,1. I, t1:. .::, : ......... ................... ] .... I., i:::11",11;;; ;;: ....................... 1' I' i P ' I i 1'_~ I'.;, ~:t__': ..": :'. ;:t ' f::: ~ ::: :: :;: ;;] f Iq':::t, II:;}:E I::'I:;' '" Pt:i'l:;;:. i!i I;;:iiii/C!"ZiiI:::V "i"I-t!:::IT ::!.: ;t; i:;:~i"I I:::'t:::fI'qlI;L. X I:::Ii;;: b.lZli'i"H TI..lt;i!; I:;'.IiX;;!LI];I-;':ilii;t"iEi'..I'I":iil; t:::'(:)t';i; Ol',!..-.S;i;'l"lli; :iii;l!ii;l.,.iliii;l:;?.S 1::11'.,!I)14i!~;i...Llii; l;::l;i!i ::ii;ET F:OI:;i;'i"t-.i E:Z 't"!..lt~i] I"It..INZi;C;!;t::'FIt.;i."I"'~" (')I':: ;?.: ;i; i4 ;i'. L.i.. iii i',i:iii;TF~M... THE SV'.i?F!Ei"I ;[ N I'::IC:(XiiII:;:D!::~,i",ICt!i: 1,1 ;1; 'i"H THE ;.ii;; i; i..IN!:)ii!i;i:;;::iii;'l'FIi',ll) THFtT "i"Ht~X ()t'-:!.~-S:i: Fliil; '.i!i;lEl.,ll;!i:i:;?. S'.,."!ii;/"lEl"l t'"11;::1'.~.' !;?.IE(;'!UiI;!;;~:Ii!i' I:;?.iE:ii:;i;DENCIi: ;t;::!i; I:,;:!:::;i'1(;)I)I:!:X..ED "t'O ]Zt',IC;LUDiii; i"iOI;;?.E TI...tFIN 6 FIi::;'I::;'I I; CI::t?,!T t:::II ..lili~!!ii;l:;i:T (;(I ~; ii" ) z / ? NA:Vi, E~__2_ "' ''~ .... , .' -.~;/." MAILING ADDRESS . : - . ~--- ;--- r q: ~.': c-:,\ 3 i S T/',, N C }1 ' ' x>". //,-,- .v. ¢,¢' EROM WEL. L ; MANUFACTURER- ;ix. SiDX ',_.?_ik~:TH '-' INSIDE WIDTH IX~ UM£~,E it LIQUID DE°'rH -- ...LIQUID CA'~qC '-w ]PLLOiXS. NU~VISER O~ PiTS / LINING MATERIAL fl '>':; SUiLDING ixOUNDATiON DIAMETER ---' OR WIDTH , LENGTH · , DEPTH, ":' CRIS SIZE: DIAMETER; ..~1, Db.P H DIal-ANs.,- TOTAL EFFECTIVE NEAREST LOT LINE ,.O7/ ABSORPTION AREA (WALL AREA) ~%l~;;~= .SQ. FT. ADDiTiONAL mc,~u ....... ";-' CONS--RUCTION LOT LiNE C2SS!:'C,S. .... O-i-HER ~,OU RCcS DISAPPROVED DEPTH D',STANCE FROM NEAREST SEPTIC SEEPAGE SEWER LINE -rANK -- Sx,/STEiV~ REMARKS D1AGFiAM OF SVS-FEiV~ iNSTALLED '~' ' '9,,, ,'".~ ,¢'s.//;'.~ .,: ~',".j., FqPE LOT SLOP;Z: DATE 0 ¢. ?4 ~{/, / - APPROVED ~- ; Q.A.A'.L;. ALSO CONSIDER AREA WELLS. SEEPAGE PIT