HomeMy WebLinkAboutABBOTT LOOP TERRACE BLK 1 LT 2
~GRE.~_~. ' ANCHORAGE AREA BOR_
Department of Environment Quality
3500 Tudor Road
Anchorage, Alaska 99507
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
MAILING ADDRESS 3"~OF ~, C~'~)~/~t~(' - PHONE~I~L~' 0951
LEGAL DESCR,PT,O. Lot ~. ~l ~ I Aga~'~ ~)')¢~'~,n~
SEPTIC TANK:
FROM WELl t,J M~UFACTURER
MATERIAL.
NUMBER OF
.COMPARTMENTS
INSIDE LENGTH
INSIDE WIDTH
LIQUID DEPTH
LIQUID CAPACITY GALLONS.
TILE DRAIN FIELD:
DISTANCE FROM WELL
NUMBER OF LINES ~
ABSORPTION AREA LI s~ SQ. FT. LENGTH OF EACH LINE ~'~
~/ DEPTH OF FILTER
DEPTH: TOP OF TILE TO FINISH GRADE MATERIAL BENEATH TILE
FOUNDATION ~,{,~l NEAREST LOT LINE J~'! TOTAL LENGTH~"~tloF LINES -I /
D,S~ANCE ~ETWEEN L,NES td J ~ TRENC. W OTH~'q ,N. TOTAL EFFECT,VE
IN. ABOVE TILE ~tt IN.
WELL:
TYPE ~'~5 II~ CONSTRUCTION
BUILDING NEAREST
FOUNDATION.__ LOT LINE
CESSPOOL OTHER SOURCES
APPROVED DISAPPROVED
NEAREST SEPTIC SEEPAGE
SEWER LINE.~0 TANK SYSTEM
REMARKS
DISTANCE FROM:
DISTANCES:
SEWER LINE DEPTH:
LOT SLOPE:
DIAGRAM OF SYSTEM
DATE
&)/GREATER ANCHORAGE AREA BOROUGH
SEWAGE DISPOSAL SYSTE~ -- APPLICATIOH AHD PER~IT
CO~,,''ON DATE ANT,~,,A, EO
PFRHTT VAI Tr) ~Nr YrAI~
FINAL IN~PE~I'IONi I& HOUN NOTICI: NEGUIRED. BAC:KFILLING OF ANY sY~r~M WITHOL~T FINAL INSPECTION BY THE
HEALTH DEPARTMENT AUTHORrT'Y WILL Ble BURJleCT TO PROSECUTION.
~ /~'/c//~/ ~/~/~ ~,/~,/~.~-~/~,~/
SE~IC TANK TO SEEPAGE PIT WALL 15
WATER MAIN TO legit TANK 10 f~.
/ PIT
25 ft. srr,io~ 1~ fi, ~o.A,. ~0 ft._
GRAVEIr BACKFIII
LICENSED DESIGNER
TYPE
DIAGRAM OF
q
GREATER ANCI.~DRAGB AR~A BOROUG~
Department of 8nvtronmental Quality
Date ~eceived
Time of Inspection
Date of In~pection
FOR.. APPROVAL OF
SE~ER & WATER FAClq-ITI~S
FO~
F// A"
A. Type, B. Depth
C. ConstructS~ D. Bacterial Analysis
7. Sewage Dia,~oeal System'.
A. Installed ./~/~ / B. Inet,liar
C. Septic Tank: 1. Size ~?~- 2. ~facturer
D. Seep,ge Pi~, 1.~--~z~~ 2.
E. Disposal F~eld: Tole] tam,th of LAnes
Distances:
A. Well To=
Septic Tank
· Nearest Lot Line
B. .~aundatton to ~ptic Tank
, Absorption Area
· Other Contamination
"~ Absorption Ar~a
Absorption Area to Nearest Lot Line ....
, Sewer Lines
:.. R~q~est for Approval of . tdual Sewer & Water Fecilitt
~ Page Two ' ~ >~ ' ~ ' -"
Approve! Valid for One Yeer Pre~ Date $1gned
~reate~ A~chora~e Area ~o~ough, De~art~e~t of ~nuiro~menta! ~ualit~'
DIAGRAM OF SYSTE~',
I certify, that the information contained in this request for approval to be a true
and accurate representation of the_~bject sewer and water facilities located at.'