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Home My WebLink AboutALDERWOOD ADDITION #1 BLK 3 LT 11 APPLIC iT FILLS OUT UPPER HAL'-ONLY Phone Property Owner '-.,4 C~,~ ~1 Address ~ ~'/~F. ~ ~ ~;c~ Zip ~e ~ ~ ~) ~ ~ ~ ~ ~ ~ / ' ~ :' /~/ Phone Realty Co. & A~nt Street Locat,, Type of Resi~nce ~ Single Family ~ Multiple Family No. of Bedroo~ ~ Other Water Supply ~ Individual A~ACH WELL LOG. A w~l log is requir~ for all wells drilled since June 1975. ~ Community For wells ~illed prior to th~ date, give well depth (attach log if available). ~ Public Utility Sewer Disposal ~ Individual Year Indiv~ual Installed: ~ Public ~ility 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 ~3_ ~_.~L~.'~--t Date Date Date Date Inspector Inspector Inspector Inspector Field Notes: ( -2_LAPPROVED BEDROOMS *CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL' DATE BY: Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received Well to Tank Septic Tank Size 72-023 (3/82) !-.CONSTRUCTION AND OPERATION CERTJJJ:uL TT I~ ~'i:~%L~OS~N[ ,! ALASKA DEPARTMI:.T OF ENVIRONMI::NTAL CO"$1:RVd~'~ APPROVAL TO CONSTRUCT Plans for the construction of /~17£~. 14.)O(/P in by RECEI_V_ED public water system located /~'~'1C, ~t8 ~¢.~L~ ~, ., Alaska, submitted in accordance with 18 AAC 80.100 ~L,4~'_ .1~.~ .r) _~l/_~£~3 P~.h"/L~I~/'r~ ~Oi3/~LT~'.IVT-~--~,~ve been reviewed and are [] approved. conditionally approved Ieee attached conditions). -- TITLE If construction has not started within two years of the approval date, this certificate is void and new plans and specifications must be submitted for review and approval before construction. APPROVED CHANGE ORDERS Change (contract order no. Approved by Date The "APPROVAL TO OPERATE" section must be completed before any water is made available to. the public. APPROVAL TO OPERATE The construction of the ~f'/ ]~)~' ~ J~ ~.)0_.) /'~ ~ ~ ~. ~T~ ~gT~ public water system was c~mpleted on /~ ~~'ff ~ j ~ ~ (date). The system is hereby granted interim approval to operate ~o'r 90 days following the cpmpletion date. BY TITLE DATE As-built plans submitted during the interim appr~)val period, or an inspection by the Department has confirmed the system was constructed according to the approved plans. The system is hereby granted fi n~,~roval to2~ CONSTRUCTION AND OPERATION CERTIfY]I_[ OF ANCHORAGE Pr::T Cc !:~""'-~ ~. ALASKA DEPARTMENT OF ENVIRONMENTAL CONSERV,~r~TI~t~N~:..i.~,. ::o ~ - 1 PUBLIC WATER SYSTEM ,.,EP ~. z. Iv,~.2 APPROVAL TO CONSTRUCT Plans for the construction of public water system located in J~l C. L ~ Y o. ~ -f~ , Alaska, submitted in accordance with :18 AAC 80.100 by 17}"' !~ b~'tJC"/O~P¢~4~'~f do ~ , ~t [~tl, lf~ have been reviewed and are El' approved. v_condition_.aJIly app. r~oved (see attached conditions). TiTL, E[,/I _ ~1. _ DATE If construction has not started within two years of the approval date, this certificate is void and new plans and specifications must be submitted for review 'and approval before construction. APPROVED CHANGE ORDERS Change (contract order no. Approved by Date Zoo-S+ ~ll(~ s~ ~.<~;~,~ 17o~. _ _ %'--2_I- ~ The "APPROVAL TO OPERATE" section must be completed before any water is made available to the public. APPROVAL TO OPERATE The const ruction of the ~/4 ~' 1~ '/,(Sd)C)t°J CID /~J4 '"~f public water system was completed on /~ ~L~-("~r' ~ ~' /,~ ~;r.~. (date). The system is hereby granted interim approval to operate for 90 days following the cpmpletion date. BY TITLE DATE As-built plans submitted during the interim appr~)val period, or an inspection by the Department has confirmed the system was constructed according to the approved plans. The system is hereby granted f'mal~'pproval to operate. CHEMICAL & GE'-',OGICAL LABORATORIES '-; ALASKA, INC. TELEPHONE (907)-279-4014 ANCHORAGE INDUSTRIAL CENTER 274-3364 5633 B Street Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED B~ WATER SUPPLIER WATER SYSTEM: Water System Name lz20 W Maili~ng Address .~/ /' Phone No. State Zip Code Mo. Day Year SAMPLE TYPE: ~m Routine [] Check Sample (for routine sample with lab ref. no. [3 Special Purpose C..],l,,r,~e ?" .~ Treated Water .[~ Untreated Water SAMPLE NO. I I I , I , I LOCATION Time Collected Collected By /0 '~ v TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: .~tisfactory [] Unsatisfactory [] Sample too long in transit; sample should not be over 48 hours old at examination to indicate reliable results. Please send · new sample. Date Received Time Received Analytical Method: E] Fermentation Tube .l~Membrane Filter Lab Ref. No. Result* I l-Yl I l-Ill I ~-~ I ~ Analyst eNo of colome$/lO0 mi or No Of Positive READ INSTRUCTIONS BEFORE COLLECTING SAMPLE 06-1220 (b) Rev. 1971 BACTERIOI'OGICAL. WATER ANALYSIS RECORD C)ate Collected Source 0.m. Date Received Time Recelve(I p.m.L.ab. No. Pre~4Jml 24 41 Confl. 24 EMB Multlp ) Tube ReDort: Membl ~ne Filter: Dl~t C~nt v~lf~ tlon: LTB ~flll I ~briM FNt~ R~I, f ~ ~ ,.L '~ ~',~ 0.1mi 11)~1 Tubss PoMtl~'Total 10mi Pcxtlof~ CollformllO0ml BQB ~ ¢olltomtll00ml ,i- /, -,.'! MUNICIPALITY OF ANCHORAGE ENVh, '~,~ I..A.' ;0 [: ;-.~ LETTER OF TRAN$¥1TTAL RECEIVED ALASI A ]]EVELflPMENT CONSULTANTS, INc. Engineers Surveyors Planners 6100 "A" STREET, SUITE 2 ANCHORAGE, ALASKA 99502 Office: (907) 276-2437 ATTENTION: 'DATE COPIES GENTLEMEN: WE ARE SENDING [] Attached [] Under separate cover via the following items: [] Shop dwgs OPrints [] Plans []Samples [] Cha~ge'Order[]Copy of Ltr D Specifications O Other. NO. DESCRIPTION THESE ARE TRANSMITTED as checked below: O For approval E! Approved as submt'd~ Resubmit for approval ~F'or your use O Approved as noted ~ Submit copies - distr []As requested O Returned ~' -~$Rtn corrected prints ~ For review/comment~-" ~ ~'~' re []FOR BIDS DUE !9__ []PRINTS RTN'D after loan to us REMARKS: COPY TO: SIGNED: ~~ If enclosures are not as noted, please notify us at once.