HomeMy WebLinkAboutT14N R2W SEC 12 Plate# T199 NW4 NW4
~'~TER ANCHORAGE AREA
~ ; HEALTH DEPARTMENT ' ?
EAGLE ST. ANCHORAGE, ALASKA 99501 '~79-2511
INSPECTION REPORT ON*SITE SEWAGE DISPOSAL SYSTEM
N.° 417
NAME~ ~ '~ ~F',/~/~I ~ ?~'
LOCAT,ON
SEPTIC TANK:
DISTANCE FROM WELl
L,OU,O CAPACITY
GALLONS.
L~ ~-~' NUMBER OF I
MATERIAL ~ (~ Y~/-\c~-/~'~ '-/'~' ~ COMPARTMENTS
INSIDE LENGTH /(~ l ~ I LIQUID
INSIDE WIDTH DEPTH__
SEEPAGE SYSTEM:
NUMBER OF PITS
LINING MATERIAl
NEAREST LOT LINE
SEEPAGE PIT:
OUTS,DE DIAMETER
TOTAL EFFECnVE A~SORPT~ON AREA (WALL AREAl
OR WIDTH , LENGTH , DEPTH
SQ. FT.
TILE DRAIN FIELD:
TOTAL LENGTH
DISTANCE FROM ,FOUNDATION ~ NEAREST LOT LINE , OF LINES
hiST TRENCH IN. TOTAL EFFECTIVE
ABSORPTION AREA SQ. FT. LENGTH OF EACH LINE
DEPTH: TOP OF TILE TO FINISH GRADE
DEPTH OF FILTER MATERIAL BENEATH TILE
IN. ABOVE TILE
WELL: TYPE 4~,'//~ DEPTH //~' DISTANCE FROM WATER ~/~
, , BUILDING FOUNDATION. SAMPLE_ , NEAREST
NEAREST SEPTIC /<~ SEEPAGE ,j<:~ ~ ~ OTHER ~
LOT LINE SEWER LINE ~ TANK . SYSTEM , CESSPOOl , SOURCES
DISTANCES:
DIAGRAM OF SYSTEM
DATE APPROVED