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T14N R1W SEC 17 Parcel 2
:I QGREA/ t:R ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: DISTANCE FROM WELL F~-' INSIDE LENGTH MANUFACTURER d,/~'~ '("&.MATERIAI '~"7~2-(' ¢' /COMPARTMENTsNUMBER OF c.~) INSIDE WIDTH LIQUID DEPTH_ LIQUID CAPACITY /~/%¢-'g';' GALLONS. SEEPAGE Pit: NUMBER OF PITS / DIAMETER -- OR WIDTH -~ , LINING MATERIAL~"~'¢/~/¢//'~' /CRIB SIZE: DIAMETER BU,LD,NGFOUNDAT'ON /. ¢ NEAREST LOT L,NE¢' ADDITIONAL ABSORPTION LENGTH ~ DEPTH /~ / .-/ DEPTH 5 D~STANCE FROM: WELL /~ 'C-- TOTAL EFFECTIVE ,.~'0 ABSORPTION AREA (WALL AREA). SQ. FT. WELL: TYPE BUILDING FOUNDATION -- CESSPOOt APPROVED CONSTRUCTION NEAREST LOT LINE QTHER SOURCES DISAPPROVED NEAREST SEWER LINE REMARKS DEPTH DISTANCE FROM: SEPTIC SEEPAGE TANK SYSTEM DISTANCES: INSTALLED BY: PIPE MATERIAL:' REMARKS: DIAGRAM OF SYSTEM APPROVE~/ F:IF:'F'L ]: C:I::It",tT H Z I..FOF~:I::' ..]'OHNSCJJ",t [iillZt::.:: ~]>Z.;::' E:. LEi3:ii:;;IL. I~ I . :l '~!: Z!~C :l.?:' "l'~L41q F][sLI-,J LOT ._ J.~..[... 'i"r'F::'JiE I[:~F[ ::BJ:iZL. JE._UF..E I ~[Oi",t ..... ~L. IJ ]:S: 'I"F;:Et",ICI~I t"Ji:::J::'::]il'"Jl H t",ILIi"IE::EEt:;~: OF:' F.:F:DFOZfOH'.~ =: [~: Tl.-li: LE:h,IE~i'TH I)]:P'IEEI",tS:[O]'-,I :[':'~; THE: LEENGTH (Zh,l F'I~:Z'T:) CIF: THE: 'TRESF,ICFf 01:;~: I::,f;]:F:I:[I",!F:ZIE:L.[::,. Iii[: B,[EI::'~t'H OF' F! 'TF?EENCH 0[~'. F'Z'T' Z S: THE: [':,Z:STF:tNCE: EIEVi"FJEE~N "I"HI%: SUf~tF'F:IC:E~ OF' 'I"t-IE~ J/~i[.~:(/iL.ti'..t[:) [~I-,!E:, TILE. E[OTTC~H OF' TF'IE~ [EXC:!:~YF:I-!':[EII'.,I ,:::[BI I::'E:E:'T'::,. "I'I'tE[~:i~: :IS i",tO SE:T [,.I ;[ f::,"l'l'"l F'OF?. TF?.EI"~C:Hi~EZ. 'fi!E: GfRF:i'v'i::I.. t:)E:F"TII :!;~; TI'IF:; I'"t:[NZHLJH PE::F'TH OF: GI;?.F~',,,'E:L F:~;fK'i"I.q[F:ZN THE: OI...tTF:F:II...I... FINE) THF{ I:~JCFF-FOH OF' THE: E:XCI::I'v'RT:[OP~ ,::]:h,I i'l :[ N :I: I"iiJH l) :[ Z;l"fqi",lC:E:: E:ETI-,.II:[/N F:I I.,IZL.L_ l::llqD F:II',IY ()l'-,t-'-'S :[ 'FEi: ZE.UFtGE: [:) :[ ':E;F'OSFIL S"r'!:;'FFi:H ]Z :Fi; ::lOCi l:::[i:[:~:l' F'Cd,?. F't F:'I':?.):YFIT[~i: I.'.i[EI..L 0i:;~: ;:i:O0 Eli:[CT I::'-Cl[;~: FI F:'U[~&. :[ C: IdE:LL. :E;F'F{C::ZF:Z[C:faT:i:[')i"~S F:fi",ff::, I::::I:)NSi;TF~:UCT:[OI'~] f:)ZF:IG[~:F:IPI:!~.; FIF'~:IF: F:I',,,'Fi.]JLFtE:L[E 't-0 :[I'-,IZLtI::i:I!i: ]: i",i::'~'I'F:II .!...1:~'1" ): :'I.: I:::'(:)Fi:ttl t::?-d T'H[i: hlI..tt:',I]:C]:F'Ft[.:[T'~" 2: :[ IqZL.t. :[NS"I'FII..L "I"t"tE:~ S"r'ZT[::H ]:i",t F:tCCOF::DI::INC:}::. F.IZ-I"H THE: COD[:::::;. ::ii:: Z ItF,![:)IiS~:':"~;TF:fl",ID THFFT' THE: Ot",!'"":E;]:TE: l:;i:F::!:;Z[':,!:.i:lqCli~ :iS F;:IEt"I(:)DE:LIi:~:D 'r'o [.IqC:l.l. jl:::,[~ ......................................... F'~I:'[._. :[ C:i::I~',[T J'"l ]: j~,.[::l ,.)'OHJ".J~:i;OJ".t ./ Z !:::' 'I"HE: ') ~ "One ~es~ is worth a lhousand opinlon~" 2204 Cleveland Anchorage~ ~laska 99503 Performed For ~. ~o~ ~,t~ Performed _~/7 Le,al ~escrintion: Lot Block Subdivision ~/~'~/~ This ~orm Re~orts Soils Loq ~ ~ Percolation Test Denth Feet Soil Characteristics 6-- 10-- 12-- 14-- . 16 18-- 20-- Was Ground Water Encountered? I~ Yes. At what Denth? L~L..I i i i ; , I Readinq Date Gross Time Net Time Depth to H20 Net Dron Percolation Rate ~linute Proposed Installation: Seenaoe Pit Drain Field Deoth of Inlet Deoth To Bottom Of Pi~ Or Trench Test Performed BV ,~. ~*S~ Data Certified Date: