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HomeMy WebLinkAboutT13N R3W SEC 28 SW4 NW4 G/ee-q, TER ANCHORAGE AREA BORO~'-~H HEALTH. DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279'2511 N? 728 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM / MAILING . ~ ~ NAME /,~z~/'~-/f/ ~/vLr-~'T'/~r'~'--~'.~/ . w -- ADDRESS~' ~, ~/~. PHONE LOCATION ~i~C~ ~ - LEGAL DESCRIPTION ~bJ ~' ~/J~ F~, ~' ..../" TANK DISTANCE FROM WELL LIQUID CAPACITY NUMBER OF /;~'~/~ MATERIAJ .~',.~'~..~-~,~rT__ COMPARTMENTS ~ .~,~.~/_~ ~.r~.~. ~.~..~ f.~_./~ ~- /~'~/~ ~-;/~'~'~"~/ LIQUID GALLONS. INSIDE LENGTH INSIDE WIDTH DEPTH SEEPAGE SYSTEM: SEEPAGE PiT: NUMBER OF PITS LINING ~ NEAREST LOT LINE ~-~C~3'TD B D lAM ET~ OR WIDTH ,LENGTH ,DEPTH DIST~ ~'/'~,BUILDIN G~u NDATIO N TOTAL EFFECTIVB ABSORPTION AREA (WALL AREA) SQ. ET. TILE DRAIN FIELD: DISTANCE FROM WEL[~*'~/~' FOUNDATION~"~ TOnka' NEAREST LOT LINE NUMBER OF LINES ~. DISTANCE BETWEEN LINES ,~ ,~,~CH WIDTH ABSORPTIO~A SQ. FT. LENGTH OF EACH LINE / DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TiLE TOTAL LENGTH , OF LINES //~TA, FFFF~CTIVE IN. ABOVE TILE WELL: DISTANCE FROM TYPE-- ----"~.//~/'~//-~ , DEPTH ~ . BUILDING FOUNDATION NEAREST SEPTIC SEEPAGE LOT LINE ~- SEWER LINF ~"~TANK ~"~, SYSTEM WATER SAMPLE_ '~-- , NEAREST OTHER CESSPOOL ~ SOURCES DISTANCES: DIAGRAM OF SYSTEM DATE (:ollueted By. ~'~/F ~ JA/g'~ ,. ,Date 3/,~ /~ Hour /~ .- Legal 'Address of Property: Lot 6,,g M~/~ Block U.S. Survey ~/ ~ ~ ~ ~ ~ ~ h,~/3 ~ ~,,~* ~ ~,~ = ~,w~' ~ /n~x ~ ',~. w.,, ,~,~/z' 5~,~ 1, Well Type [~e e~ 2, Surface Water: 3. Number of }loines Served / 4. Treatment: ./_/ Yes PURPOSE /-7 l, Water Approval for BuildioB Permit, / / 2, Routiae /malysis, WATER SYSTEM Depth __ OF ANALYSIS Gallons per Minute .... Temporary /___~ Permanent (Column 1) (Columns 1 and 2) (Columns 1, 2 and 3) ~- 3. Special: Check Specific Items for Analysis. (1) Analysis Limits (2) Limits (3) Analysis Limits 0.3 [Ir---on (Fs} Fluoride {F) Chloride (C1) Phosphate (PO4] Total Hardness !,~te_rgents Specffic ]onduct ance '1~7 1,5 25O .05 goo( ~ 30_p~ !-~soft 1300 hard 6,5 -- Magnesium ~(M~) Calcium Ca) Turbidity Color B Lcarbon- Uarbonate ~lkali~it~ 'otal Dis- ,lved ~olids ~alysis 125 3O0 5 ].5 25 gooc 500 pom, 350 350 500 Sodium (Na) Potassium (K) Sulfate Su] f ! t e _*_(S93) , ~.l~l{!Z!t e (NO3~ Suapentled So I I ds Arst,nl c (Aa) Cyan.ids (Cn~ Phenols Zinc (Zn)- 200 ~5__0 5.0 0,0l 0.01 0.001 5.0 Barium (Be) !.0 Ca__dmi um (Cd) 0.01 0.05 Lead (Pb) Silver (Ag) Mercury~(Hg) O, 05 0,05 0.05 DTI002411