HomeMy WebLinkAboutALDERWOOD BLK 2 LT 12
PERMIT NO.
fdLIf-I I I~ I F'F:tLIT'~' CIF I:If-IC:H~D~:I:IGE
DEPRRTMENT OF--HERLTH AND ENVIRONMENTAL P-~.~TECTION
825 'L STREET, ANCHORAGE, AK. 99L ~
2~4-4720
L4ELL PERM IT
( 821172 )
APPLICANT 'GRINDLE & KOON COMPANY
LOCATION AIR GUARD ROAD
LEGAL L 12 B 2 ALDERWOOD S/D
2900 ILIAMNA DRIVE ANCH 9950~ 24~-6559
LOT SIZE ~ SQUARE FEET
MINIMUM DISTANCE BETWEEN 8 WELL AND 8NY ON-SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL.
MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND
TO A COMMUNITY SEWER LINE IS 75 FEET.
NELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN ~0 DAYS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AYAILABLE TO INSURE PROPER INSTALLATION.
PEP. M I T EXP I RES DISCEFdBER '~;i. i982
I CERTIFY THAT
t: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
SIGNED:
ISSUED
V4. 0
(907) 261 411~
Z 0/,,/ ,~,,
~Permit ~: 821172
· January 31, 1983
TO: Permit Applicant
Subject: Lot 12 Block 2 Alderwood Subdivision
A permit issued by this department for an individual well
and/or on-site sewer system has expired as of December 31,
1982.
Permits are issued On a calendar year basis, as stated on
the permit, by authority of Municipal Ordinance.
If you have drilled the 'well, a well log needs to be sent
to this department for documentation of the installation
date and to close the permit.
If a private engineer inspected the installation of the
on-site sewer system, please have them send us the as-builts
for our files and documentation.
If there are any further questions, please call this office
at 264-4720.
S incerel~
Robert C. Pratt, R.S.
Acting Program Manager
Sewer and Water Program
RCP/ljw
enc: Copy of Permit
SWP/057
APPLIC~ NT FILLS OUT UPPER HAl-' ONLY
Pr'°pertYOwn_er~_.~,~,}-ld(~.~. ~ K~O~ ~' Phone
Zip Code
Address
Lending Institution ~ ~, ~d d~',~ //~S~ Phone
Zip
Code
Address
Realty Co. & A~nt Phone
Address Zip Code
Legal Description /0~ /~ ~/ot~ ~ ~/~~W~ ~,
Street Locati~ ~ ~ ~ ~ ~. /~
Type
of
Resi~nce
Single Family
~ Multiple Family No. of Bedroo~ ~
~ Other
Water Supply
Individual A~ACH WELL LOG. A w~l log is required for all wells drilled since June 1975.
~Communit, ¢~ ~ For wells drilleO prior to th, date. give welldepth (attach log if available).
~ Public Utility
Sewer Disposal
~ Individual Year Indiv~ual Installed:
Public Utility When Connected to Public Utility:
Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED.
Time Time Time Time , __
Inspector Inspector Inspector Inspector
Field Notes: ,] MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH
ENWRO,'~MZNTAL PROrECnON
MAY
.RECEIVED
( ~ ) APPROVED BEDROOMS *CONDITIONS OF APPROVAL
( ) DISAP~OVED
< ) oo.~,.,o~.~..~.ow~'
Soils Rating Date ~wer Installed Well To ~sorption Area Well Log Received
Well to Tank Septic T~k Size
72-023 (3182)
CHEMICAL & GE-LOGICAL LABORATORIES ~'-" ALASKA,
.'* TELEPHONE (907) 562-2343 ANCHORAGE INDUSTRIAL C,.~NTER
5633 B Street
Drinking Water Analysis Report for Total ColifOrm Bacteria
TO BE COMPLETED BY WATER SUPPLIER
WATER SYSTEM:
Water System Name
Mailing Address
City
SAMPLE DATE: I 161 ~
Mo. Day
SAMPLE TYPE:
[] Routine
r-I Check Sample (for routine ~ple
with lab ref. no. ,
[] Special Purpose
State
Ye&r
Zip Code
SAMPLE
NO.
I
I
4 I
I
LOCATION
Time
Collected
t
! ,
I
1
06-~220
Rev. 1978
TO ~E COMPLETED BY LABORATORY
A0alys,s shows this Water SAMPLE to be:
Satisfactory
[] Unsatisfactory
[] Sample too long in transit; sample should
not be over 48 hours old at examination
[o ,ndicate reliable results. Please send
new sample.
Date Received
:
Time Received
~lytical Method:
:;;O Fermentation Tube
~ Membrane Filter
Analyst
;~ *No. Of colonies/100 mi o¢ NO; of Posit,ve portions
s^CT~mOLOmC^LWA )~"A~'S'CO"O:
READ INSTRUCTIONS
BEFORE
COLLECTING SAMPLE
Data Cotl~ct ~1 Source
a.m.
No.
Pr~uml~t lye ]Omi 1Omi ~,0ml 1Omi 10mi 1.0mi 0.1mi
24 Hours
48 Houri
Confirmatory
24 Houri
4~ Hours
EMB Broth 24 I~ours:
MultlDle Tube Report:
Membrane F#ter: Direct Count
Verification: LTB
Final Membrane Filter Results
Report. By ~__~_~LL~
Broth 48 hours:.
1Omi Tubes poMtlwfrotal 10mi Portions
Collform/100ml
BGB ~
Collfoml/100ml
Dat. ~--.
p.m.