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HomeMy WebLinkAboutMEADOW BROOK BLK 2 LT 6 oGRr fER ANCHORAGE AREA BC Department of Environmental Quality 2330 C Street Anchorage, Alaska 99503 )UGH INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: DISTANCE FROM WELL INSIDE LENGTH MANUFACTURER MATERIAL NUMBER OF COMPARTMENTS INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY I~D~) GALLONS. SEEPAGE PIT: NUMBER OF PITS LINING MATERIAL BUILDING FOUNDATION___ DIAMETER L'I~"~ OR WIDTPII ~''~ , LENGTH I')'''' I DEPTH CRIB SIZE; DIAMETER '~Zt DEPTH DISTANCE FROM: WELL TOTAL EFFECTIVE ., NEAREST LOT LINE__ ABSORPTION AREA (WALL AREA) SQ. FT, ADDITIONAL ABSORPTION WELL: BUILDING FOUNDATION __ CONSTRUCTION NEAREST LOT LINE CESSPOOL OTHER SOURCES APPROVED DISAPPROVED DEPTH DISTANCE FROM: NEAREST SEPTIC SEEPAGE SEWER LINE TANK __ SYSTEM REMARKS. DISTANCES: DIAGRAM OF SYSTEM INSTALLED BY: PIPE MATERIAL: LOT SLOPE: Form No. EQ-031 EATER ANCHORAGE AREA BOROUGH ntal Quality GR . _ f Environme. na~n 274-4561 Department ~ .... ~ Alaska ~v3 3330 "C" street, ancnu'°~' · Date Received August 5, 1976 lime of InspectiOn 2:30 8-6-76 Friday Date of inspection iqeale REQUEST FOR AppROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR ~ka pacific Bank Approval requested by: A ~-~--~ ~=------ ~ Mailing Address: ~~~BOX 420 ~alp~ property Owner: ~ Mailing Address: % pat jones 276-3110 Phone: 694-2755 Phone: . _~. ~ubdivision 6 BlOCk 2 3. Legal Description: LO_~t~ see 4. Location: -------~---- be inspected 5. Iype of facility to 6. ~ell Data: ~ ............. ~ B. Depth A. Iype O. Bacterial Analysis C. ConstructiOn C. Septic 'lank: 1. D. Seepage Pit: 1. E. Disposal ~ield: Sewage Disposal System: on-site system A. Installed J-~~ B. installer -- 2. Manufacturer size ~----- Absorption Area _~ %otal length of lines / Distances: No. of bedrooms _-~ Absorption area A. ~lell to: Septic tank other contamination Nearest lot line __------~ , Absorption area B. Foundation to septic tank C. Absorption area to nearest lot 'line Sewer Lines __---~ page 1 of two page Page 2 of two pages - Re~ st for Approval of~Individual ~ er & Water Facilities Legal Description Lot 6 Block 2 Meadowbrook Subdivision Comments Approval Valid for one year from date signed Date Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECi',)~N 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: CMRO VA x/~ 2. Property Owner: ~,~, ,ot~, 'kJkJKc ~.',,,~ \/v vvx, MailingAddress'.~ (~ '~,>~ 3. Name of Buyer: '~'- ~ } ~ t ~ (~W'~ Mailing Address:__ ~, 4. Name of Lending Institution: Mailing Address'._~,(r~), Name of Realtor or Agent:_ Legal Description: Location: FHA CONV Day Phone: Day Phone:. Phone: .~, ( (I '-~-~ lc'~ 7. Type of Facility to be Inspected: 8. Water Supply Type of Supply: Public Utilitv ~>< No. Bdrms. ~ Individual If Individual, number of dwellings presently served If Individual, depth of well Sewage Disposal System Type of System: Public Utility If Individual, date of installation Individual (on-site) 72-003(3/76)