HomeMy WebLinkAboutUPPER EAGLE RIVER ESTATES BLK 2 LT 3A1VPPERIO, 6A&LG
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1. Approval requested by:
Mailing Address:
2. Property Owner:
Mailing Address:
3. Legal Description:
4. Location:
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
Street, Anchorage, Alaska 99503 274-4561
Date Received
Time of Inspection
Date of Inspection
REQUEST FOR APPROVAL OF
iNDIVIDUAL SEWER & WATER FACILITIES
FOR
Phone:
Phone:
5. Type of facility to be inspected $t~91e
6. Well Data:
A. Type ~i1~
o
A. Installed
C. Septic Tank:
D. Seepage Pit:
C. Construction Standetrd
Sewage Disposal System:
1.
E. Disposal Field:
Distances:
A. Well to: Septic ~ank
Nearest lot line
No. of bedrooms
B. Depth ~ ~e6,
D. Bacterial Analysis
B. Install er
Size 1~ ~1~ 2. Manufacturer
1. Absorption Area 2 p~t~ caen 2.
Total length of lines
6~ Absorption area
, Other contamination
Material
B. Foundation to septic tank , Absorption area
C. Absorption area to nearest lot line
Sewer Lines ,
EQ-034 (1/74) Page 1 of two pages
~ -Pege 2 of~wo pages - R st for Approval of Individual ._..l~r & Water Facilities
Legal Description Lot 3-A~ 81ock ~, U~ne~ Ea_~l~ R~u~. _~_~*~-_*_e_'
Comments
. ,
Approv/~ ~'~. Disapproved Date .
Approval Valid for one year from date signed
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)