HomeMy WebLinkAboutT12N R3W SEC 15 LT 860 IS -"OF "z.z.-
GRP~.I'ER ANCHORAGE AREA
HEAl. TH DEPARTMENT
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCATION_ ¢:'/~' .)~J~¢,71 /h~i>, (d~/~¢.,.k~ ~:~I.¢~..LEGAL
SEPTIC TANK:
DISTANCE FROM WELt
LIQUID CAPACITY_
GALLONS.
MATERIAL~_,~ ! Yt,.'.
INSIDE LENGTH
MAILING
ADDRESS_
DESCRIPTION
INSIDE WIDTH z',J DEPTHLIQUID
SEEPAGE SYSTEM:
NUMBER OF PITS
LINING MATERIAL__
NEAREST LOT LINE_
SEEPAGE PIT;
OUTSIDE DIAMETER.~
IOIAL EFFECTIVE ABSORPTION AREA (WALL AREA)
OR WIDTH
DISTANCE FROM WELl /C~_~'"
, LENGTH //~'-~ / DEPTH
, BUILDING FOUNDATION__
- z)- ()(' 5 SQ. FT.
TILE DRAIN FIELD:
DISTANCE FROM WELL__
NUMBER OF LINES__
ABSORPTION AREA _____
DEPTH: TOP OF TiLE TO FINISH GRADE___
· NEAREST LOT LINE__
TRENCH WIDTH__
· FOUNDATION_
DISTANCE BETWEEN LINES
SQ. FT. LENGTH OF EACH LINE
DEPTH OF FILTER MATERIAL BENEATH TILE
TOTAL LENGTH
, OF LINES
IN. TOTAL EFFECTIVE
IN. ABOVE TILE__
LOT LINE ~¢,~:)) t NEAREST ~ SEPTIC
_, SEWER LINE. (-/~1 / , TANK
DISTANCE FROM ~}/--,/ WATER
· BULDING FOUNDATION. (~L/ SAMPLE
--, . SEEPAGE ,~ /
C/'(..;.) , SYSTEM__ /~--) , CESSPOOl
NEAREST
OTHER
SOURCES
DIAGRAM OF SYSTEM
DISTANCES:
.~/~/,U'
Depth
Fee~ Soil Charu,.t~., ~L~t~.~
Was Ground Water Encountered?~___/~p.~_~
If Yes, At V,'.hat Depth
aotng ~a~e Net Time
Frop~sed Inst,'allat~ont Seepage Pit a~---
G~oc~s Time
Location Sketch
Depth To H20
Deain Field
Net Dpop
Dept. h Of Inlet. .h/ Depth 1o Bottom Of P~.t Op Tpenc] /?~
Test Perf6~med By:~~ ..... ',
Dora Certified