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HomeMy WebLinkAboutHANSON ACRES #1 BLK 2 LT 9 ~ D AI~I~ RECEIVED TIME ; ~ t DATE DATE~~ DATE INSPECTOR ~ INSPECTOR INSPECT?~ MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPT. OF  DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIOE/~xlViP, ONMENTAL F FO [ECTION 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL SANITATION DIVISION FEE I981 Telephone 264-4720 .o. o. DIRECTIONS: Complete all parts oll page 1. Incomplete requests will not be processed, Please allow ten (10} days for processing. I PHONE I. PROPERTY OWNER MAILING ADDRESS .~916 Denali Street Anchorage, Alaska PROPERTY RESIDENT (If different from above) PHONE Same as above 2, BUYER PHONE Richard A. & Diane L. Millar 279-9397 MAI LING ADDRESS 122 E. ~4th Anchorage, Alaska 99~02 3~ =LENDING INSTITUTION ] PHONE Alaska USA Federal Credit Un,ionI 276-~100 MAILING ADDRESS 777 Juneau Street Pouch 661~ Anchorage, Alaska 99~02 4. REALTOR/AGENT I PHONE N/A I MAILING ADDRESS 5. LEGAL DESCRIPTION Lot 9, Block 2 Hanson Acres Subdivision STREET LO~c~I~N Denali Stree~ 6. TYPE OF RESIDENCE NUMBER OF~BEDROOMS [] One [] Four [] Other ~ SINGLE FAMILY [] Two [] Five [] MULTIPLE FAMILY ~] Three [] Six 7. WATER SUPPLY INDIVIDUAL* [] COMMUNITY [] PUBLIC UTI LITY * ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM ~'~ INDIVIDUAL/0N-SITE** ~'~ ,~,,~' PUBLIC UTI LIT-~Y~ YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATI:R SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] IN DIVI DUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER []Septic Tank or []Holding Tank Size:__ If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line I WELL TO: Absorption Area to nearest Lot Line 5. COMMENTS ~ ~ APPROVED FOR --,' BEDROOMS [] CONDITIONAL APPROVAL (letter must accompan~Lcertificate) E~ DISAPPROVED .~ ,~~p./~ DATE ~.~ ~. ~..._ ~1.. BY )~ 72-010 (Rev. 6/79) CHEMICAL & Gk, OLOGICAL LABORATORIES ~,,F ALASKA, INC~ TELEPHONE (907)-279-4014 ANCHORAGE INDUSTRIAL CENTER /~_~ 274-3364 5633 B St re et ~"J~' ~;-;;,"-'~ Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER WATER SYSTEM: Water System Name I.D. NO. Phone No. Mailing Address City SAMPLE DATE: MO. State Day Year SAMPLE TYPE: [] Routine [] Check Sample (for routine sample with.lab ref. no. [] Special Purpose SAMPLE NO. 1 2 3 4 5 LOCATION Zip Code [] Treated Water [] Untreated Water Time Collected Collected By TO BE COMPLETED BY LABORATORY Analys~s shows this Water SAMPLE to be: [] Satisfactory [] Unsatisfactory [] Sample too long in transit; sample should qot be over 48 hours old at examination to indicate reliable resLIts Please send new samole. Date Received Time Received Analytical Method: [] Fermentation Tube [] Membrane Filter Lab Ref. No. Result* Analyst J I-]-I I I *NO~ of colonies/t00 mi. or No of Positive portions READ INSTRUCTIONS BEFORE COLLECTING SAMPLE 06-1220 (b) Rev. 1978 BACTERIOLOGICAL WATER ANALYSIS RECORD Date Collected Sourca 48 HOURS 24 Hours EMB Multiple Tube Report: Membrane FIItar~ Direct Count Verification: LTB Final Membrane Filter Results Broth 24 hours: Broth 48 hours,' 10mi Tubes Positive/Total 10mi portions , Collform/100ml BGB :~ Collform/100ml . ~' : F. .: Date ;,i ' !i: .i' de.als with materials present iii very mim~te quantities, Carelessness iu collecting wi!! iiave to ~'e~ch the laboFatow as quickly as possible withi~ 4.8 ho,r~; aiter collection. sure that it is tight, b~.~,t iici so tight as to split the cap. f) thc pot'/iol~ of the lab form ~¢Aiich is indicated "TO BE C,.CMt,~ ~l.,:l k[' ....... }tlY fi!.lPPlJEl:i." fi) Pack horde carefully ia maili~19 tube wi'ih lab form. The FequiFemmtt,q for analysis of public wate~ systems for total colifomt bacteria are de,tiled iii tile E~Finkili.q Watet' re.qutations administered by the Department of Environmental Gonsel'vatio~l. '* ;" MUNICIPALITY OF ANCHORAGE MUNICIPA TY ©F ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION D~PT.  825 L Street- Anchorage, Alaska 99501 ENVIRONMENTAL ENGINEERING DIVISION oE,~ 2 0 1 Tg Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEW~ DIRECTIONS: Complete all par(s on page 1. Incomplete reques~ will not be proce~ed. Please allow t~n (10) days for processing, 1. PRoPER~YOWN~ J PHONE MAILING AD~SS. ¢ ~(~ ~ PROPERTY RESIDENT (If different from above) PHONE PHONE 2. BUYER MAILING ADDRESS 4. REALTOR/AGENT 2 ~ J PHONE MAILING ADDRESS/ 5. LEGA L,D ESC, RI PT,L~N STR E ET LOCATI ON TYPE OFRESIDEN ~ NUMBER OF BEDROOMS [2~].~S~N G L E FAMILY E~wo [] Five [] MULTI~AMILY [] Three [] Six [] Other 7. WATER SUPPL~~''~ E~'~DIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY * ATTACH WELL LOG. A well log is required for all wells drilled ~ince June 1975. For Wells drilled prior to that date, give well depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM c DUAL/ON-SITE~ UTI LITY **If individual/on-site, give installation date If system is over two (2} years old an adequacy test is required by this Department, NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010{3/78) THIS SIDE FOR OFFICIAL USE ONLY , ,. DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX 2. WATER SUPPLY PERMIT NUMBER [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER []Septic Tank or F-1 Holding Tank Size: If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4, DISTANCES Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line WELL TO: I Absorption Area to nearest Lot Line I]~""~APPROVED FOR '~ BEDROOMS ~NDITIONAL APPROVAL (Petter mu~mpany certificate) DATE )O~r)~ BY(Title) LEGAL 72-010 (Rev. 3/78) REQUEST FOR APPROVAL OF INDIVIDUAL SEWAGE AND W[TER FACILITIES (Fill out in Triplicate) ~ ~lame .of person requesting approval , 2. ~Jan,,a of property, owner 3. L~yal. descriptior~ ~ 4. Number of b~d~ooms in house Water, Analysis: a, Bactemial b. Detergent Well data: a. Type .... Depth c. Casing Size d. Distance from well to closest existing or proposed: 1. Sewer line .. 2~ Septic tank Seepage Area Oesspool 5. Property Line 6. Other sources of possible contamination, i.e., creeks, lakes, houses, barn, drainage ditch, etc. 7. Sewage disposal system. a. Age of system b. Septic tank capacity in gallons. c. Name of septic tank manufactu~e/r 1. If "home made" show diagram on reverse side of this form. d,' Disposal field or seepage pit size and type ~,~ ~ ~ 1. Distance to property line~ to house foundation e, Percolation, Test ~esults f. Percolation Test performed by Use the reverse side of this form to show diagram, Diagram should include the f0ilowing information: ~operty lines~.well location, house location, ~ptic tank location, disposal area location, location of percolation test, and direction of ground slope. The h~foz~tlon on this form is true and correct to the best of my knowledge. Signature of Applicant Date Signed TO BE FILLED OUT BY HEALTH DEPART~.~ENT PERSONNEL above described sanitary facilities are hereby approved, subject to the ~6'ltowing conditions: The above described sanitary facilities are disapproved for the following reasons: Approval is valid for one year following the date of approval. CPJ:cw I~DIV~DUAL SEWAGE AND WATER FACILITIES (Fill Out in Triplicate) (F~i out in Tr: ..... ~~~2soJ~e qUe s~ ing approval: ~~, a. b. Detergent Well data: a, b. ¢o d. Type Casing Size Distance from well to closest existing or proposed: 1. Sewer line 2. Septic tank 3. Seepage Area 4. 5. Property Line 6. Other sources of possible contamination, i.e., creeks, lakes, houses, barn, drainage ditch:% etc. Sewage disposal system, a, Age of system b, Septic tank capacity in gallons c, Name of septic tank manufactu~.r 1, If "home made" show diagram on reverse side of this form, Disposal field or seepage pit size and type 1, Distance to property line to house foundation ~ ~ PercolationxT~st '~r~sults f. Percolation Test performed by Use t~ reverse.side of this form to show diagram. '-~he fo~].~,~ing infommation: p~operty llnes~.well location, house location, ~'K~.~c tank location, disposal area location~ location of percolation test, ~ d~motion of ground slope. Diagram should include 9. Tko ~'~,-~'~-,~t~on on this form is true and correct to the best of my knowledge. k S,ignature of Applicant' '~'ate Signed FILLED OUT BY HEALTH DEPART~.~ENT PERSONNEL 'The above described sanitary facilities are hereby approved, subject to the Conditions: The above described sanitary facilities are disapproved for the following measons: .ii Signature of ~ff~i'¢:i;&Ag ut ........ ;, ' -, " '""-:' ~'t'e .-"? App,'oval is valid for one year following the date of approval. CPJ:cw (wi)ted to FORM SA-lB MEMORANDUM TO: C Clifford P. Judkins Environmental Health Ilirector FROM: Richard H. Britt Sanitary Engineer State of Alaska DATE SUBJECT, August 22, 1969 Hollowbreok Lateral I~prove~nt District No. 8, Schedule A, 1969. Hanson Acres Lateral Improvement District No. 7, Schedule B, 1969. 1. This involves t~o sets of plans for sanitary sewer extensions in each of the subject subdivisions. The plans, Applications for Approval of Plans, and the Dickinson-Oswald (consulting engineers) letter of August 12, 1969 to you, were forwarded by your memorandum of August 12, 1969. 2. Noting that 100% testing of sewer lines is required (stated in the August 12, 1969 Dickinson-Oswald letter), these plans and specifications are approved for those features with which this Department is concerned. RHB :plb cc: Dickinson-Oswald AUG 26 196,o GREATER ANCHORAGE AREA I~DROUGI~--HEALTE January 29, 1969 Mr. Dan Rapalee Veterans Administration P. O. Box 1399 Anchoraze~ Alaska 99501 SUBJECTs Lots 11 and 9, Block Hanson Acres Subd. ~i, Charley Height Property Dear Mr. Rapalee: While the sewage disposal systems serving the subject property are not in complete compliance with local codes, it does appear, considering the location and lot size involved, that the systems are not creating or will not create a hazard to health or fall to operate within the next 18 months. Consequently, this office would approve an arrangement whereby funds would be escrowed to insure connection to public sewers which w~ll be installed in the spring and summer of 1970. Presmnt calculations indicate that a sum of $750 per lot would at least cover the ma~oP portion of lateral assessment and connection fees. Sincerely, DAVID R. L. DUNCAN, M. D. Medical Director BY: ~l~ffo~d ~. Judkfns, ~. S.' ' Environmental Health Director CPJ/srr