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Home My WebLink AboutDEBORA BLK B LT 12i 40,50oss 13 APPIs':ANT FILLS OUT UPPER W'S ONLY Time I lo7 Property Owner 3ohN c . `�' '�� YyQG1q F. UvCl h (j Phone 69 L'_ ^_ '1 (� Mailing Address O� IgG mor r 21p Code q Buyer Ck-, A MQ!:S '- Address 243 3 YMte ldObA '6Q a R'(�(N` . Zip Code q q SO EDa ^ Lending Institution , 1 1�� Sa0L 4 , Phone �0. �-�Q/�IC?i OOM1.O'H'O C� 1� g zip Code Q 'S) C) •� (J/� Address Inspector Realty Co. & Agent i G'�"en,.n QQU ) p1 Phone Address {�, %\1 zlp Code -lg6'2 In ((�� Legal Description [- ,12' SIOA— P>, �2.�yLG✓ � �nJ � 1? Street Location r _ MAY 161983 Type of Residence Municipality Of Anchora?c-- 5C Single Family "Dept. of fiea%h & ❑ Multiple Family No. of Bedrooms EnVII'DIlMentat Protection" ❑ Other 'CONDITIONS OF APPROVAL Water Supply Individual -" ATTACH WELL LOG. A well lop Is required for all wells drilled since June 1975. Community - For wells drilled prior to that date, give well depth (attach lop If available). ❑ Public Utility - J e Sewer Disposal Individual` A Year Individual Installed: Public M114---rp �'\M(pw\ N� 6kl1TC' S✓&W� h°n C nnected to Public Utility: —4q��'�'3 Holding Tank, NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Well Lop Received Time Time / / Time EDa Date Date Date Inspector Inspector Inspector In Field Notes: � �nJ � 1? D _ MAY 161983 Municipality Of Anchora?c-- "Dept. of fiea%h & EnVII'DIlMentat Protection" (x) APPROVED BEDROOMS �G... 'CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL' DATE r _r(��7/� BY: _�1J e Soils Rating Oate Sewer Installed Well To Absorption Area Well Lop Received Septic Tank Size Well to Tank t2M uen GREATER ANCHORAGE AREA BOROUGH9 Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503,1 - 561 sW F�eceived ,Tule 30. 1976 ime of Inspection 11) ,,An aA f' Date of Inspection c _ 9G VEQUEST FOR APPROVAL OF /Cez-o INDIVIDUAL SEWER & WATER FACILITIES FOR 1. Approval requested by: Mailing Address: Phone: 2. Property Owner: John Briebv Phone: 694-9888 Mailing Address: Box 186 Mercy Drive 3. Legal Description: Lot 12 Block B Debora Subdivision al 5. Type of facility to be inspected Single Family No. of bedrooms 2 6. Well Data: A. Type Individual C. Construction B. Depth 601 D. Bacterial Analysis 7. Sewage Disposal System: On-site system A. Installed Unknown B. Installer C. Septic Tank: 1. Size j Manufacturer D. Seepage Pit: 1. Absorption Area 2. Material E. Disposal Field: Total length of lines B. Distances: ? �� A. Well to: Septic tank Absorption area G Sewer Lines Nearest lot line Other contamination B. Foundation to septic tank Absorption area C. Absorption area to nearest lot line EQ -034 (1/74) Page 1 of two pages Page 2 of two pages - Rer^,st for Approval of Individual F"br & Water Facilities Legal Description Lot 12 Block B Debora subdivision #1 A�oved `� Eisapprovid rA //�•f�t"'��' Ap y CL sig Jy r t r or Area Borough, Depar ent of Environ DIAGRAM OF SYSTEM �I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED EQ -034 (1/74) Date /'� P•,uN:ur-n_sr C F - A �: Cj 1CFAG= DEPT. c:.;:.;u:. Z, en�i^G�.zE:vi:.E Pac;:cnori *GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" St., Anchorage, Alaska 99503 - 27414561-��/0 RECEIVED REQUEST FOR APPROVAL'OF INDIVIDUAL SEWER & WATER FACILITIES 1. Type of Inspection: Gi•K VA F+hA CO*V-- 2. Property Owner: Mailing Addres 3. Name of Buyer: Mailing Addres 4. Nane of Lending Institution: 11W,412 Mailing Address: Phone 5. Name of Realtor or Agent: Cy r&4 Q 10 el rj GtgM Mailing Address: Ia'o,`ak Phone 6.. Legal Description: bQ'lcv Location: LLeIklf" _`�'w . 49/& //U .'P[ r/l)(EECF 7jt�L/1y U/1! 4L-cf'-/ - VVST ✓ toy -t L t'! J war—/, 7. Type of Facility to be inspected:. No. Bdrms. S. Plater Supply Type of Supply: `•Public Utility Individual If Individual,'humber of dneili•ngs. preseotly.served �. If Individual, depth ,of well 9. Sewage Disposal -System Type.of System: . Public Utility Individual (on-site) t� _...I-f.Individual, date of installation „(,�d"Ou)?1 06.12201.:) Rev. 1977 AW'DEPARTMENT OF HEALTH AND SOCIAL SE"':ES 55,12 DIVISION OF PUBLIC HEALTH Lab No. lor 61A76 DATE 1)ACTERIOILOGICALNDIVIDUAL �WATER ICANA YSIS OFFICE Analysis shows this Water SAMPLE to be: FADDRESS -PUBLIC ❑ CHLORINE RESIDUAL PPM Satisfactory REPORT RESULTS TO ❑ Unsatisfactory 0 Questionable Somplo too long in transit; sample should not be over 48 /C;? - hours old at e.aminotion to indicate reliable results. Pleose send new sample. ZIP CODE ❑ Bottle broken in transit, please send new sample. SANITARIAN'S REMARKS COMPLETE THIS SECTION ONLY IF WATER IS AN INDIVIDUAL SUPPLY SAMPLE COLLECTED BY — CO"` — �� TIME COLLECTED T g /O •7" DATE COLLECTED Sample Collected From KDchen Tap ❑ Bathroom Toa ❑ Basement Top O Other (list) ❑ Well — ❑ Dao. 8 C iv . 8 D,;IlOthd O Bared SOURCE, ❑ 5'. a ^ DYa We1I w CI.IN. Co^\Irurtlom Wolfs—❑a Woad 8 Mnol 8 Tile Brick or Top — 1.J Wood B Concrete Metal Open ToP O CorlC.,.,.control. LOCATION: O in Basement O Basement Offset O Under House Oln Yard O Olhw Building Sewn w Other Droina • Pi NI. g M F S.PIIC fork - TitsTO: Tits SNpag. Co... Field FNI. Pre Fen. Pool Fort. Privy F—t- Other P ... Ibl. Source. of Conleminalion MATERIAL: BuBding Sown• O Ca.t iron O Wood O The []Fib,* O Asbestos Content O P10 -tic Joint Mnoial • Type GENERAL: Does Water Become Muddy or Diuofored? O Yes 0 No Who.? Diame,sr of Well Depth FNt. Well C.d.g Mo,nial Diam.ter D.Pth Length of Water Depth Feel. fl"Bolt. Drop Pipe Offset {n In UliliF PUMP LOCATION: O I. Well O Bo»mon, O in Bomment O Room On Top O Of Well O Other PURPOSE OF EXAMINATION: Illness Suspected? ❑ Yes ❑ No Nsw Source of Supply? O Yes O No Revoir. te Sptmn? O Yes ❑ No Signature �s 06,122(�a) Rev. 1973 ' DATE 100MMAL E] NAME ADDRESS 6 CITY SG ADDRESS OF SOURCE ALAS )EPARTMENT OF HEALTH AND SOCIAL SEES DIVISION OF PUBLIC HEALTH INDIVIDUAL AND SEMI-PUBLIC BACTERIOLOGICAL' WATER ANALYSIS 21P CODE COMPLETE THIS SECTION ONLY IF WATER IS AN INDIVIDUAL SUPPLY SAMPLE COLLECTED BY DATE COLLECTED TIME COLLECTED Sample Collected From ❑ Kitchen Top ❑ Bathroom Top ❑ Boremanl Tap ❑ Other (Lt.,) Wel—p Doa Driven Drilled ❑ Bored "SOURCE: ❑ SPn e CW.,. B Other_ Dog Well er Cistern Coraauction: Wolfs—❑ wood B Concrete ❑ Metol 8 0, Bails er Top ❑ Wood Conmb ❑ MNaI OPen Top Concrete LOCATION: ❑ In Baument O Basement offset '❑ Under House Qln Yard ❑ Other Building Sew., Septic DISTANCE TO: w Other Dralwge Pipe Feet. Tont Fwt, Tb S«pose C...• fiNd Feet. Pit Feet. Poral FM. Privy F.I. Otho Pes.We Sources of Contamination MATERIAL Builth., Saw., • 0 Cast bon ❑ Wood ❑ Tile ❑ fibre El Asbestos Cement ❑ Plastic Joint Material • Type GENERAL: Does Water Became Muddy or Discolored? ❑ Yes ❑ No When? Diameter of Well Depth Feet. Well Casing Mabriol Diameter Depth length of Wafer Depth Drop Pipefrom Bottom feet. Offset In In Utility PUMP LOCATION: ❑ In Well ❑ Baumenr ❑ In Ba»mens ❑ Room On Top ❑ Of Well ❑ Other PURPOSE OF EXAMINATION: Illness Suspected? ❑ Yes O No New Soune of Supply? ❑ Yo ONO Repain to System? ❑ Yes ❑ No Signature Lab No. OFFICE Analysis shows this Water SAMPLE to be: Satisfactory ❑ Unsatisfactory Questionable Sample to, long in transit; sample should not be ever 48 hours old at esominotion to Indicate reliable results. Please sand new sample. - ❑ Bottle broken in transit, please send new ample. SANITARIAN'S REMARKS 06.1220 (b) BACTERIOLOGICAL WATER ANALYSIS RECORD Rev. 1973are t READ INSTRUCTIONS Dat. aes.ited /41 / Time Receive pm lab. No. Lactose Moth IOce 10. IN, IDcc Nice 1.Occ l.Occ ON 24 Hour AS Hoo, Brilliant Green REVERSE SIDE 24 Haws 48 Noun EMR AGAR BEFORE Leclar Brolh, 24 hn As hn. Gram's stain Coliform Density (Most probable No. per 100cc) Mf Rs..Its COLLECTING SAMPLE Reported by .Dote. Th' I ' Id' I Coliform Or ani.m, to be, Absent SEMI-PUBLIC ❑ CHLORINE RESIDUAL PPM REPORT RESULTS TO Th; arca ysn uo es 9 •_Present-