HomeMy WebLinkAboutT15N R1W SEC 8 LT 41 LESS W 100'GRE/
R ANCHORAGE AREA
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME 2~7~// ~ ~
/
MAILING ADDRESS ~-~O~/~_~ (¢0
LEGAL DESCRIPTION
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 ti~/ .OR WIDTH I~'', LENGTH 17-/, DEPTH ~/
LINING MATERIAl_ ('ot4C~-~ CRIB SIZE: DIAMETER ~__DEPTFI_ ~/ DISTANCE FROM:
TOTAL EFFECTIVE
BUILDING FOUNDATION____ NEAREST LO*I' LIN[:
WELL
ABSORPTION AREA (WALL AREA) ~3~
SQ. FT.
ADDITIONAL ABSORPTION
WELL:
TYPE
BUILDING
FOUNDATION
CESSPOOL _
APPROVED
CONSTRUCTION
NEAREST
LOT LINE ....
OTHER SOURCES
DISAPPROVED
NEAREST
SEWER LINE
REMARKS
DEPTH DISTANCE FROM:
SEPTIC SEEPAGE
TANK _ --, SYSTEM
DISTANCES:
INSTALl_ED BY:
PIPE MATERIAL:
LOT SLC)PE: /¢; ~CI
REIVlARKS;
Form No. EO~031
DATE