HomeMy WebLinkAboutWYNTER PARK #1 BLK 3 LT 13
GRF'
ANCHORAGE AREA BO"' JGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCATION
MAILING ADDRESS PHONE
LEGAL DESCRIPTION ~' [~ /~/q(~ ~ J~//~'lt~
SEPTIC TANK:
DISTANCE
FROM WELL.
INSIDE LENGTH
. M AN U FACT U R E R _ (~ f/~/<'~'r/'--~LC ~' MATERIAL
INSIDE WIDTH LIQUID DEPTH
NUMBER OF
COMPARTMENTS
LIQUID CAPACITY / ~?12C; GALLONS.
SEEPAGE PIT:
NUMBER OF PITS I
LINING MATERIAL
BUILDING FOUNDATION____
ADDITIONAL ABSORPTION
DIAMETER ~i OR WIDTH I'~',
CRIB SIZE: DIAMETER__
NEAREST LOT LINE __
LENGTH l(~, DEPTH '~'
DEPTH DISTANCE FROM: WELL
TOTAL EFFECTIVE
ABSORPTION AREA (WALL AREA)
SQ. FT.
WELL:
TYPE CONSTRUCTION
BUILDING NEAREST NEAREST
FOUNDATION LOT LINE SEWER LINE
CESSPOOL _ OTHER SOURCES
APPROVED _ DISAPPROVED REMARKS
DEPTH DISTANCE FROM:
SEPTIC SEEPAGE
TANK SYSTEM
DISTANCES:
DIAGRAM OF SYSTEM
INSTALLED BY:
PIPE MATERIAL:
LOT SLOPE:
REMARKS:
Form No. EQ-031
_ APPROVED
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