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GREA'I£R ANCHORAGE AREA BORG,.$H
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISP~O~SAL SYSTEM
LOC^T,ON LEGALOESCR,PT,ON
SEPTIC TANK:
FROM WELL ~,~d, MANUFACTURER MATErnAL
INSIDE LENGTH. ~ INSIDE WIDTH LIQUID DEPTH ~ IQUID CAPACITY ~ GALLONS·
SEEPAGE PIT.' / /
NUMBER OF PITS / , DIAI~ETER OR WIDTH / ,e~" LENGTH/~, DEPTH ,,//,,~.~ , ,
_, _ ~ ..,~-~~C~-.~'~
LINING MATERIAL /~'~ '~ CRIB SIZE: DIAMETER .~l DEPTH ~ DISTANCE FROM: WE~L ~-~-~"~'W~)
- / TOTAL EFFECT,YE ~ ~ ~o ~
/ LOT L,.E ~ .~BSO~,T~O. ~R~A (W~LL A.~) ~S~. ~.
BUILDING FOUNDATION ~, NEAREST
WELL:
TYPE O,-~.~ CONSTRUCTION DEPTH OISTANCEFROM:
BUILDING NEAREST NEAREST SEPTIC SEEPAGE
FOUNDATION LOT LINE SEWER LINE TANK.__ SYSTEM .
CESSPOOL
OTHER SOURCES
APPROVED
DISTANCES:
INSTALLED
DISAPPROVED REMARKS
..'~.~
~.~ '...., ~-~'~
PIPE MATERIAL:
LOT SLOPE:
/K
APPROVED LX~
G./A.A.B.
Form No. EQ-O31
Grel~r ANCHORAGE Area BOF~'JGH .~~
DEpARTMENT OF ENVIRONMENTAL QUALITY ',..i,;.. j 1.0 : ~O
TELEPHO Z74456l ~ :-f .-~ ~ ~ ~ , ~
S~AGE DISPOSAL SYSTEM APPLICATION AND PERMIT
/ / /
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
FOUNDATION TO SEPTIC TANK
.~/ ------
i~) jr~..j-'~ DIAGRAM OF
CONFORM TO BOROUGH BEGULATIONS REGARDING INSTALLATION.
GR£AT£R Ai;ClIOI~GE'AR[A UOROUGII
Department of [nvironmenLal Quality
3330 "C" Street
Anchorage, Alaska 99b03
SOlhS.I.O(i - I'EROI,A'I'ION 'I'EST
Legal Uescrip~Co-n~ ./.~_Z-_~JL Z~LOC,~,~? ~ ~,~'ZG--..~~'/'~.~7F'K ~J'
This rom reports. Soils log ~
Depth
F.eet
l-
t
10 - 'rlo, oo
ll-
12-
14-
Percolation test
I/ ,
· ! I
~as ground water encountered? _~ t~Jq If yes, at what depth?
Da te
Reading
Gross Tim~
Net Ti"me~'" Depth to ~,ater
et iJrop ..
pe rcol a't'i'on~ rate ~ --m'~'~'e~'
-Proposed installat-'T~'n'{"-~'J'ge Pit . Drain Field
'., ..... ~ '-'et . Depth to~m ~l)i~c~_<~.<~F~ .....
']~ ~ Certified By: ~g' ~ ~f16 Date,~i