HomeMy WebLinkAboutSCHROEDER LT 70SGh�oecler 5►p
GRAB -1111 GVATER ANCHORAGE AREA sOR01"'I'H
HEALTH DEPARTMENT
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
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MAILING PHONF/�/ =d�(
NAME''J��J))_ Utt? AJe g--� ADDRESS //j o�
LOCATION del Lj L LEGAL DESCRIPTION Z o - 76 -�c clvA�n
SEPTIC TANK:
! c _ NUMBER OF
DISTANCE FROM WELL—�� MATERIAL J COMPARTMENTS
LIQUID CAPACITY /j4200GALLONS. INSIDE LENGTH_ INSIDE WIDTH
SEEPAGE SYSTEM: SEEPAGE PIT:
LIQUID
DEPTH.
NUMBER OF PITS—OUTSIDE DIAMETER _OR WIDTH // _, LENGTH, DEPTH - _–,
LINING MATERIAL-'°"'"�� . DISTANCE FROM WELL V 5 / BUILDING FOUNDATION -6'z ,
! 6! a
NEAREST LOT LINE a�� `� TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)_— SQ. FT.
TILE DRAIN FIELD:
DISTANCE FROM WELL
NUMBER OF LINES
ABSORPTION AREA
DEPTH: TOP OF TILE TO FINISH GRADE
FOUNDATIO
STANCE BETWEEN LINES
FT. LENGTH OF EACH LINE
NEAREST LOT LIN
TRENCH WIDTH
TOTAL LENGTH
OF LINES—
IN.
INES ,
IN. TOTAL EFFECTIVE
OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE
o�/Ips DISTANCE FROM '� ! WATER
WELL: TYPE S -� DEPTH , BUILDING FOUNDATION. ' ' -' SAMPLE. NEAREST
/ OTHER
NEAREST ,��"� /C SEEPAGE`5 / SYS EM�5 , CESSPOOL SOURCES
—
LOT LINE /� SEWER LINE _SG
TANKnler;RAM nF SYSTEM LL -
DISTANCES:
FHA form 2873Form Afprond
U. S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT et Bureau No. 6a-R796.B
Rove July 1958 FEDERAL HOUSING ADMINISTRATION budget
HEALTH AUTHORITY APPROVAL
INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM
PART I.—TO BE COMPLETED BY FHA
INSURING OFFICE
MORTGAGEE
Amlaonge#
MORTGAGOR OR SPONSOR
ESS
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TOYAL NUMBIRt Can attic or other area be made Into
LIVING t1=NIT5110R00M1 BASEMENT additional bedrooms?
• ■ e e eSAGE DISP03AL
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REPORT OF INSPECTION -INDIVIDUAL SEWAGE -DISPOSAL. SYSTEM
PRIMARY TREATMENT consists of ❑ Septic tank. ❑ Cesspool.
Septic Tank:
Distance from well, feet. Material, Number of compartments
Total liquid capacity, gallons. Capacity inlet compartment,__
Inside length,_ feet. Inside width, feet. Liquid depth, feet.
Cesspool:
Distance from: Well, feet; foundation,
Inside diameter, feet. Depth,
SECONDARY TREATMENT consists of ❑ Tile disposal field.
__feet; nearest lot line at ❑ front, ❑ side, ❑ rear
feet. Liquid capacity, gallons. Lining material
❑ Seepage pits. Other .
gallons.
feet.