HomeMy WebLinkAboutWYNTER PARK #1 BLK 3 LT 17
QGRE,
t!R ANCHORAGE AREA BOt JGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME fj'r 'L'-I(L~T~.tA '~P. Oe[o~,. MAILING ADDRESS PHONE
LOCATION P~t~b-~, ~t=~ LEGAL DESCRIPTION ~,-ol-Iq ~C.c-K ,~, ~L~,~,
SEPTIC TANK:
DISTANCE
FROM WELL _
INSIDE LENGTH
INSIDE WIDTH
MATERIAL
NUMBER OF
COMPARTMENTS
LIQUID DEPTH
LIQUID CAPACITY /t¢~1~ GALLONS.
SEEPAGE PIT:
NUMBER OF PITS
LINING MATERIAL
BUILDING FOUNDATION__
DIAMETER__OR WIDTH I~'~ LENGTH /TF, DEPTH f!
CRIB SIZE: DIAMETER f~' DEPTH ~:~1 DISTANCE FROM: WELL
NEAREST LOT LINE ~-~''¢ TOTAL EFFECTIVE
ABSORPTION AREA (WALL AREA)
_sQ. FT.
ADDITIONAL ABSORPTION
TYPE CONSTRUCTION
BUILDING NEAREST
FOUNDATION LOT LINE
CESSPOOL , OTHER SOURCES
APPROVED ____ DISAPPROVED __
DEPTH DISTANCE FROM:
NEAREST SEPTIC SEEPAGE
SEWER LINE TANK SYSTEM
REMARKS
DISTANCES:
INSTALLED BY:
PIPE MATERIAL:
LOT SLOPE:
REMARKS:
Form NO, EQ-031
ATE
DIAGRAM OF SYSTEM
APPROVE~fA¢ J~. ~ .// G,A,A,B,