HomeMy WebLinkAboutHILLCREST BLK 3 LT 9H i I lC reS,t::
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71 2.2
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'TER ANCHORAGE AREA B,
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
)UGH
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
N A M E ,////¢/'~ ,,Y
MAILING ADDRESS~r?:~/4/-4Z-' ,~-. /(2. /~.
PHONE J~,L~/~~.Rz~IZ .~-.~_
TANK:
LEGAL DESCRIPTION .~
DISTANCE ,
FROM WELL /~2'¢2 MANUFACTURER
MATERIAL
NUMBER OF
COMPARTMENTS
INSIDE LENGTH
INSIDE WIDTH
LIQUID DEPTH__
LIQUID CAPACITY ,¢~/-20<~ GALLONS.
SEEPAGE P I T ..'7'~ ~.~//-~----
NUMBER OF P TS __.~ OR WIDTH ~,-~L~&'~G~H DEPTH
LINING MATERIAL __ CRIB SIZ~--R-~ DEPTH DISTANCE FROM: WELL
BUILDING FOUND~L~~--~- , NEAREST LOT LINE ABSORPTIOf;T'A-R~W. ALL AREA)
SQ. FT.
ADDITIONAL ABSORPTION
WELL.:
("~E)/,~//I42/V/'~' _CONSTRUCTION DEPTH
TYPE
BUILDING NEAREST NEAREST SEPTIC
FOUNDATION LOT LINE SEWER LINE TANK_
CESSPOOL OTHER SOURCES
APPROVED DISAPPROVED REMARKS
DISTANCE FROM:
SEEPAGE
SYSTEM
DISTANCES:
INSTALLED BY: /[]'¢'~ /¥ ~-d X (-
PIPE MATERIAL:
REMARKS:
Form No. EQ~O31