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QGP'"* R ANCHORAGE AREA Br- F' GH
Department ~.E0n;irs~er~;ntal Quality
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCATION
MAILING ADDRESS ~' ~ gO//rf~, ~-~-cE/.~/~ /ifil' PHONE
LEGAL DESCRIPTION/~r Z? ~'E¢t- ~-'~' ~-/~TV'
SEPTIC TANK:
DISTANCE
FROM WELL
INSIDE LENGTH
MANUFACTURER
INSIDE WIDTH
MATERIAL
LIQUID DEPTH ~__
NUMBER OF
COMPARTMENTS
.LIQUID CAPACITY
GALLONS,
SEEPAGE PIT:
NUMBER OF PITS ! . DIAMETER
OR WIDTH //'/' LENGTH '/~//, DEPTH
DIAMETER__DEPTH ~ ~ DISTANCE FROM: WELL
TOTAL EFFECTIVE
NEAREST LOT LINE __ ABSORPTION AREA (WALL AREA)
LINING MATERIAL ~/~J~'~-~ CRIB SIZE:
BUILDING FOUNDATION__
.SQ. FT,
ADDITIONAL ABSORPTION
WELL:
TYPE ~l ~g~""~
BUILDING
FOUNDATION __
CESSPOOL
APPROVED
CONSTRUCTION
NEAREST
LOT LINE
OTHER SOURCES
DISAPPROVED
NEAREST
SEWER LINE
REMARKS
DEPTH_ DISTANCE FROM:
SEPTIC SEEPAGE
TANK __ SYSTEM
DISTANCES:
INSTALLED BY:
PIPE MATERIAL'
LOT SLOPE:
REMARKS:
Form No. LQ-031
DIAGRAM OF SYSTEM
DATE ~/*f77'
APP ROV ED ~.A,~'~,B. [~' ~
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C'~ Street, Anchorage, Alaska 99503 274-4561
Date Received Feb 19, 1974
Time of Inspection 2:00 pm
Feb 19, 1974
Date of Inspection
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
CMRO
1. Approval requested by:
Mailing Address:
2. Property Owner:
Mailing Address:
CMRO Office
1530 Gambell St. Anchorage AK 99501 Phone:
Harold Haeg Phone:
St. Rt. Box 196 Eagle River AK 99577
277-7311
694-2401
Legal Description: Lot 24, Sec 25, T15N, R1W, S.M.
Location: Hilcrest Drive Apartments
5. Type of facility to be inspected
6. Well Data:
A. Type Drilled
Apartments
B. Depth
No. of bedrooms
130'
C. Construction Standard
Sewage Disposal System:
A. Installed 1964
C. Septic Tank: 1.
D. Seepage Pit: I.
D. Bacterial Analysis Satisfactory
B. Installer
Size 2000 gals 2. Manufacturer
Absorption Area 2. Material
E. Disposal Field:
Distances:
A. Well to: Septic tank
Nearest lot line 27'
B. Foundation to septic tank 10'
C. Absorption area to nearest lot line __
Total length of lines
85' , Absorption area
, Other contamination
, Absorption area
20' plus
160'
, Sewer Lines 80' ..,
85'
EQ-034 (1/74) Page 1 of two pages
Page ~ of two pages - Req.._gt for Approval of Individual & Wa~er Facilities
L~gal Description
Comments
Appro -v; . Disapproved Date
/ / Approval Valid for one year from date signed
~./ Greater Anchorage Ar6a Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
certify that the information contained in this request for approval to be a true and
ccurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED
Date
EQ-034 (1/74)