HomeMy WebLinkAboutALYESKA Block 2 Lot 1
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3500 Tudor Road, Anchorage, Alaska 99507 279-8686
Date Received
Time of Inspection
Date of Inspection
e
REQUEST FOR APPROVAL' OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR '; ' '
Aoproval Requested By: '~%N~-, ~ C~~ .
Prooerty Owner: ~ ~ ~ /_ Phone ~ .........
ยท
Legal Description: ~
Type of Facility to be Inspected:
Number of Bedrooms:
Well Data:
A. Type ~v~,~J~ B. 'Depth ..............
C. Construction D. Bacterial Analysis '
7. Sewage Disoosal System:
A. Installed t~. 8. Installer
C. Septic Tank: 1, Size 2. Manufacturer .....
D. Seepage Pit: 1.
E. Disposal Field:
Size 2. Material
Total Length of Lines
8. Distances:
A. Well. To: Septic Tank
, Absorption Area
Sewer
, Nearest Lot Line
, Other Contamination
Foundation to Septic Tank
",~ Ab'~orption Area
Absorption Area t'o Nearest Lot Line
Request for Approval c :dividual Sewer & Water Factli'
Page Two
Approved Disapproved Date
Approval Valid for One Year From Date Signed
Greater Anchorage Area Borough, Department of Environmental qua!i~y
DIAGRAM OF SYSTEE
I cert.(fy that, the information con~aine in t s request for appreval to be a true
and accurate representation of the subject sewer and water facf!ittes located ~t:
Signed Date
waker anproval for
'|ock ;! ~lveska Sub(iivistort
Sir:
l'he wa~ur is cot, re)unity ,~nd is approved by this department.
A.y qu~s~io.s, please feel free to call.
Sincerely,
Rob~r[ C. Pratt.,
ENVIROIIMEi'~TAL CONTROL OFFICER III
RCP/~,o
Eric 1 osu r~
cc: Nrs. Joa,a Crossma~'~
