HomeMy WebLinkAboutLot 01, 14
· APPLI~/NT FILLS OUT UPPER HA[_~ONLY
Phone
Property Owner ~/~
Buyer
Address Zip Code
Phone
Lending Institution
Zip Code
Address
Phone
Realty Co. & Agent
Address Zip Code
Street Location .:'~ )), 0
Type of Residence
[] Single Family
[] Multiple Family No. o! Bedrooms_
~ther
Water Supply
,J~--tndividual A'~rACH WELL LOG. A well log is required for all wells drilled since June 1975.
~] Community For wells drilled prior to that date, give well depth (attach log if available).
[] Public Utility
Sewer Disposal
[] Individual Year Individual Installed:
,~ '--I~"l~"l~lic Utility When Connected to Public Utility:
[] Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REC~IEST BEFORE PROCESSING CAN BE INITIATED.
Time Time Time Time
Date Date Date Date
Inspector Inspector Inspector Inspector
~IINICiPAI [TY ~F ANCH(~RA~F
DEPT O~- ['C~l_T!! ~.
Field(totes:
OCT ~ 9 1982
RECEIVED
i , APPROVEDBE ROO 'S 'COND,'.O.S OF APPROVA'
DATE~. ~ //:~'7'~'t--"/
BY: v--~ _~_~.~! . _ _
Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received
Well to Tank Septic T~nk Size
72.023 (3182)
ALASKA eF1UIROFImelqTAL COF1TROL Si RUICeS, IiqC.
~n§ineerinq $ ~'nuJponmentaJ $1udies
November 1, 1982
Municipality of Anchorage
Department of Health & Environmsntal Protection
825 L. Street
Anchorage, Ak. 99501
Re: Health Authority
One October 28,1982 our co~oany collected a water sample from
the structure located on Internation Airport Subdivision,
Block 18, Lot 14. The water contained no coliform bacteria.
The well casing stands 1 foot above the ground.
A copy of the report is attached.
Sincerely,
Dan Roth
Engineer
Approved
Leroy C. Reid Jr., PhD, PE
President
1220 LU~s125th Auenue · J~nchoroqe, f~laska 99503 · [907) 276-1361
CHEMICAL & Gi~I~z, OGICAL LABORATORIES ~...~/ ALASKA, INC.
TELEPHONE (g07)-27g-4014 ANCHORAGE INDUSTRIAL CENTER
274-3364 5633 B Street
Drinking Water Analysis Report for Total Coliform Bacteria
TO BE COMPLETED BY WATER SUPPLIER
I.D. NO. ~
WATER SYSTEM:
Phone No.
Water System Name A~/.~T/1
Mailing AddresS '
State Zip Code
c~
Mo. Day Year
SAMPLE TYPE:
~ Routine
[] Check Sample (for routine sample
with lab ref. no.
[] Special Purpose
I-I Treated Water
[] Untreated Water
SAMPLE
NO, LOCATION
I
, I
4 l
Time Collected
Collected By
o~ - L,L , ~ ,
TO ~ ~OMPL~EO BY ~BO~O~Y
~n'~lVs~s s~ows ~s ~er SA~PL~ ~o be:
n~ be over 48 ~ours old ~ examination
to~md~ca~e reliable res~l~s. Please sen~
Da~ Receiv~ lO ~ ~ --~ ~
Ti ReceTv~ ~.~ o ~ ~
An~lytical Meth~:
D Fermentation Tu~
~Membmne Filter
~b Ref. No. Result* Analyat
I~ I ~
READ INSTRUCTIONS
BEFORE
COLLECTING SAMPLE
0~-1220 £~)) BACTERIOLOGICAL WATER ANALYSIS RECORD
Rev. 1978
Date C oltecte~l 5~urc~ /
~**~Jmpt lye Z0ml 10ml 10mi 10mi 10mi S,0ml 0.1mi .
24 Hours
48 Hours
Verlfk'.~tlonz LTB ~_~ ~ age
Final k~¢nbra~4~ FIIt er R e~ult I (~ ,~'"~ ~O
Time'
CMIfolm/lO~ml