HomeMy WebLinkAboutEKLUTNA HEIGHTS #1 BLK 3 LT 41=kiutna rlei h TImS
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GREATER ANCHORAGE AREA
DepaCment of Environmental Qualit ~TER ANCHORAGE AREA BORO~"'~H
3s00 rudo -- Pouch 6-6 8 6 5
INSPECTION REPORT ON-SITE SEWAGE ;AL SYSTEM
SEPTIC TANK:
DISTANCE FROM WELL.
LIQUID CAPACITY
GALLONS.
MAILING
ADDRESS ~',~-~--~'":~'~ "~,""~'"' PHONE.__
COMPARTMENTS ~)
MATERIAL
~ ..... LIQUID
INSIDE LENGTH INSIDE WIDTH. DEPTH
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS / OUTSIDE DIAMETER
LINING MATERIAl
NEAREST LOT LINE ' ~'~ / ~/¢' /J/J . TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)
OR WIDTH
DISTANCE FROM WELL /~/-;9/~'
TILE DRAIN FIELD:
DISTANCE FROM WELL ..~-~-~"~,~~ ~ , NEAREST LOT LINE
NUMBER OF LINES -/' DISTANCE BETWEEN LIN TRENCH WIDTH
ABSORPTION ARE~( SQ. FT. LENGTH OF EACH LINE
TOTAL LENGTH
, OF LINES
EFFECTIVE
DEPTH: TOP OF TILE TO FINISH GRADE
.DEPTH OF FILTER MATERIAL BENEATH TILE
IN. ABOVE TILE__
,,.:/,///?/:, DISTANCE FROM
WELL: TYPE , DEPTH ' , BUILDING FOUNDATION.
NEAREST SEPTIC SEEPAGE
LOT LINE ' ' , SEWER LINE ,TANK , SYSTEM
WATER
SAMPLE
, CESSPOOL
, NEAREST
OTHER-
, SOURCES
DISTANCES:
DATE
DIAGRAM OF SYSTEM
APPROVED