HomeMy WebLinkAboutAIRPORT ARCTIC LT 2
ANCHORAG. E AREA B0r UGH,
Department of Env,ronmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME /~'~'~ ~-' .~ .~:~../Y/~:; MAILING ADDRESS -~/~- ~ ~'' "~'~'¥~:~ %~PHONE
LOCATION
DISTANCE ~'~ A J
FROM WEL~MANUFACTURE~,.~,~,'~ MATERIAL
INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH
NUMBER OF
COMPARTMENTS ,/
lIQUID CAPACITY'¢:~ GALLONS.
SEEPAGE PiT:
N U M E,F_JT,..OF-P~ b
LINING MATERIAL
BUILDING FOUNDATION
ADDITIONAL ABSORPTION
~__ ~ ~, M F"T £ ~
CRIB SIZE: DIAMETER
, NEAREST LOT LINE
OR WIDTH--, LENGTH DEPTH
D Ep~'"~'~T H O ISTAN C E FROM: WELL
TOTAL EF FECTI~'~E~
ABSORPTION AREA ~AREA)
WELL:
TYPe
BUILDING
FOUNDATION
CESSPOOL
APPROVED--
CONSTRUCTION DEPTH DISTANCE FROM:
NEAREST NEAREST ~ SEPTIC SEEPAGE
LOT LINE SEWER LINE \.,~,~TANK , SYSTEM ·
OTHER SOURCES '
DISAPPROVED -- REMARKS_ ~
DISTANCES: '~ ' ~ .
INSTALLED BY:
PIPE MATERIAL.' ~~
LOT SLOPE~
REMARKS:
DIAGRAM OF SYSTEM
DATE ?-
G.A.A.B. ~
Form NO. EQ-031
GREATER ANCHORAGE AREA BoROUGI'~
SEWAGE DISPOSAL SYSTEM -- APPLICATION Al,ID PERMIT
I bISTALt,.~T I ON LOCATION. ~.~
~/f , SE[PAGE PIT- , DRAIN Fa[ED '"