HomeMy WebLinkAboutT15N R1W SEC 5 Lot 11, 12 & 13LoT'
GRm~TER
ANCHORAGE AREA BORO[,"~H
' HEALTH DEPARTMENT
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-~511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
MAILING '
LEGAL DESCRIPTION
SEPTIC TANK:
DISTANCE FROM WELL
LIQUID CAPACITY
NUMBER OF j
MATERIAL ~ ~'.1,¢ ~,/~Z ~'",~ COMPARTMENTS
~1~;~' ;~ LIQUID
GALLONS. INSIDE LENGTH INSIDE WIDTH DEPTH
SEEPAGE SYSTEM:
NUMBER OF PITS
LINING MATERIAL
NEAREST LOT LINE
SEEPAGE PIT:
OUTSIDE DIAMETER
OR WIDTH /~- , LENGTH / ~'- , DEPTH ~
. DISTANCE FROM WELL //~ BUILDING FOUNDATION ~/~,
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ~-' SQ. FT.
TILE DRAIN FIELD:
TOTAL LENGTH
DISTANCE FROM WELl , FO~ NEAREST LOT LINE OF LINES~
NUMBER OF LINES ET IN. TOTAL EFFECTIVE
A B SORPTIO N '"~'/// I
DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE__
WELL: TYPE J~/I/~E~ DEPTH ~' DISTANCE FROM WATER
· BU LDING FOUNDATION. SAMPLE_ NEARESt
OTHER
'dEAREST SEPTIC(J~-~'~! SEEPAGE //~ e
LOT LINE · SEWER LINE , TANK , SYSTEM . CESSPOOl
SOURCES
DISTANCES:
/:/-&
DATE
DIAGRAM OF SYSTEM
APPROVED
HEALTH AUTHORITY