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Home My WebLink AboutBELLA VISTA #1 LT 34 Sheet Date: WATERWELL - TEST PUMP REPORT / ..~ Owner /~/~ ~ ~~ - Address ~ ~ ~ T Well Information: Ttl. Depth ~/~"~' ~epth of Casing /~'~ Screen From Casing Size ~ /r Screen Dlam ~ Screen Slot Remarks ~Z ~~/~- /~ ~ ~~/~ Pump Information: Intake Depth~P~m~ Size ~ ~ ~:~ Air Line Depth Static Water Level ~/- ~" Av. Discharge 7 ' ~ GPM, Max. Drawdown Pump On: Time /~ ~ ~ Date ~~ Pump Off: ,Time /'~C'~ Date WATER ~ FLOW TIME LEVEL ~ GPM REMARKS ~ ~ ~ ~ REMARKS 1 ~e '7~, ~ 1~.~ ,~::X~ ~,c-~o~ , ~/~' ~2~~ - < ~ ..... .' ~~ (907) 243-2282 KEN JOHNSON KEN'S COMPANY WATER WELL DRILLING PUMP SALES & SERVICE 35 YEARS ALASKA DR/LLING 3163 LINDEN DRIVE ANCHORAGE, ALASKA 99502 JULY 12, 1986 RICH L. HUFF 64 East 79 th ANCHORAGE, ALASKA 99518 ( 344-3915 ) RE, LOT 34 BELLAVISTA # ONE WATER ~LL UPGRADE TO MOA CODES Remove old well seal from one ft. above pitless adapter. Weld on existing stand pipe to grade. Pull pump out of pitless and tag bottom for well depth. 83 ft, below old pump setting. 153 ft 5 in. ( T0C ) Flow test well with old pump setting. ( See test pump data ) Remove old pump and install new FN 3D5008 to 116 ft. 5 in. TOC. New inline check valve one ft. below pitless. Installl new well seal & conduit. Install New 30-50# press, switch & precharge press, tank to match. Install new control box & press, gauges. Change filters and cycle system for service. One Fairbanks Norse mod, 3D5008 ½ HP Submersible pump & control box 230V .... ~ 439.00 46 ft. one in. galv drop pipe .... 60.26 120 ft. 12/3 submersible pump cable .,... 62.40 I brass inline check valve .... 16.00 2 100# 2" gauges & fittings .... 12.00 i 30-50# Press, switch ..,. 18.00 I Sanitary well seal & conduit .... 40.00 8 hrs. Pump truck, welder, two men ,... 52o.oo BALANCE .... $ 1167.66 WATERWELL · TEST PUMP REvORT Owner /~/~t/'/ '/~/U~"~''' ' ~dr;ss~--'~.q~ Well Intonation: Ttl, Depth J~ Depth of Casing ~Sereen From Pump Information: Pump On: Casing Size ~ // Screen Dlam "-' Screen Slot Intake Depth ~.~_.~_~Pump Size /,//,-?' ///~/r-/'~'?'~,~'_A~,5' A~r Line Depth Static Water Level -:;J'/'"~ *': - Ay. Olscharge ~' "~ . GPM, Max. Orawdown Time /~' ~-~ - Oa~ ~/~ Pump Off: .Time ~ Date l__ I I TIME LEVEL ~ GPM REMARKS ~ ~ ~ ~ L--I I ......... I -I I GENERAL INFORMATION (a) Legal Descr.,~ption (include lot, block, subdivision, sect~, township, range) Locat;on. (address or dir.ect~o~s) ":Application Date , . (b) Applicant .... . Telephone: Home 3 Business ;A'l~pli(~anf Address ~ $F ~- 7'$ ~ /~/'~-/ ,~'~". ~/~ (c) ApPlicant i~ (check one): ~end~ng Institution ~; Owner/builder~; Buyer ~ · Other ~ (explain); (d) Lending Institution .Telephone Address ~f/~ (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: 2/ TYPE OF RESIDENCE ,' Single-Family~ Multi-Family Number of Bedrooms ~ Other WATER SUPPLY , ~ .,,. Individual Well Community [] Public [] .'!';~"';'., ~" "" Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page I of 2 SEWAGE DISPOSAL ~ Onsite [] Public'S[' Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. ,.. 72-025 [11/84) 5. ENGINEERING FIRM PROVIDIN... ,NSPECTIONS, TESTS, FILE SEARCH, DA . AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. / Name of Firm ' Telephone Date 7 ,.!..: .,,::.,L. . DHEP APPROVAL ""/'- ^..row ,or Cg room Approved . :: Disapproved Terms of Cor~ditional A ppr~val Conditional Date CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued.~The Municipality of Anchorage is not responsible for errors or omissions in the MUNICIPALITY OF ANCHORAGE (MO~j HEALTH AUTHORITY APPROVAL (HAA) A4UNh~dPALITY OF ANCHORAGE DEI~'. OF HEALTH & ~NVIRONMENTAL PROTECTION; CHECKLIST- FEBRUARY 1984 264-4720 Legal Description: JUL t 5 luo, WELLDATA REcEIV .D_ Well Classification . "~;t/'/~"~-~' If A, B, C, D.E.C. Approved (Y/N) Well Log Present) . ~ Date Completpd ~'/~ Yield Total Depth /~A 5 Cased t~ /~ -~ Depth of Grouting ~/~ / Static Water Level ~/, ~ - Pump Set At //~ /, ~ ~ Sanitary Seal on CasingS) Depression Around Wellhead (Y~ Casing Height Above Ground Electrical Wiring in Conduit(~l) Separation Distances from Well: To Septic/Holding Tank on Lot · On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot ~)' ~ 'Date To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line / Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments (~ B. SEPTIC/HOLDING TANK DATA Da~ Size No. of Compartments Standpipes ~ Air-tight Caps (Y/N) ___ Foundation Cleanout (Y/N) Depression over Tan~ .... Date Last Pumped ____ Pumping/Maintenance Contra~ (Y/N) ____ ; for ____ Holding Tank High-Water Alarm (Y/N)~ Temporary Holding Tank Permit (Y/N) Se~~olding Tan~ To Water-Supply Well ~ilding Foundation To To Water Main/Service Line ~m, Pond, Lake, or Major Drainage ~ Course 'i i~- Comments , :":. *~ '~~ -- Page' 1- of 2 72-026t11/84) Co ABSORPTION FIELD DATA / z/j// ils Rating in Absorption Strata /i'2~' Type of System Design en ,h o, __ __ Width ~ Fi~ Depth of Field ____ . ..... ~ Gravel Bed Thickness ~ ~t ~ Ab~rpti~ ~ __ Standpipes Present (Y/N) . ~mn ~er Find (Y/N) ~ Date of Last Adequacy Test. _ ~eparatio~ Distance from Absorption Field: ~ :o ~at..e:-st~ly we'' ~ ToPropedy Line__ ~ B~ild~o~d~i~ ~ To Existing or Abandone~ Syste~n To Driveway, Parking Area, or Vehicle Storage Area Comments / LIFT STATION i/ ....... ~ ~/'~' Dimensions Size in Gallons ~ Manhole/Access (Y/N) "Pump On" Level at ~ "Pump Off" Level at High Water Alarm Level at ~nt (Y/N) Tested for ____ Pum~uring Adequacy Test. Meets MOA Ecl~Cmt rimCeal t~odes (Y/N) ~ ** Check Permitted Bedroom Rating Against HAA Request ** ' ............... I certify that I~~ed, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed~--~-(/~ ~'~/~'/'"'"'~ Date Company /~'$ MOA No. Receipt No. Date of Payment Amount: $ Page 2 of 2 72-026 (11/84) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) t [ I ! Location (,~ddress or direction,s)~ (b) Applicant Name ApPlicant Address (C) AppliCant i~ (check o0~): Lending Institution '. ,~. ~ ,~ , ',, (d) .L~nding Institution"'~- ~¢~/ ~¢'~ Telephone Address. ,': . (e) Real Estate Company and Agent Address Telephone (f) Mail,t~e J~A/~ to?the fol~wipg address: TYPE OF RESIDENCE Single-Family~' Multi-Family [] Number of Bedrooms ~ Other WATER SUPPLY Individual Well,~ Community I-I Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL , Onsite [] Public,~ Community [] Holding Tank [] Note: If community well system, must haVe written confirmation' from the State Department of Environmental Conservation attesting to the legality and status. Page I of 2 72-025 (11/84) ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DA*I A AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm /~[~"'~--~'~ ~'~z~' Telephone ~:::~' Address I~~L (~:2 ~. ~.~w~ A//t ¢ ~o c/~o.y..~ / / Date 6. DHEP APPROVAL Approved for Ap .~ved Terms of Conditional Approval bedrooms by Disapp~'ed v Conditional CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements, Employees of DHEP do not conduct inspections or analyze data before a certificate is issued, The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 7p-~95 (11/84} MUNIGIPAI-ITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE (MOA) DEPT. OF HEAl,TH & ENVIRONMENTAL PROTECTION HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST-FEBRUARY 1984 MAR 1. 4:1986 264-4720 Legal Description: /- ~ ~ /~/, ~/~" ~t~J1~_~ (' WELL DATA Well Classification . - If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) ..,/~f,/~ Date Complet~[~ ~,~.ou., ~ Yield Total Depth (.CH ~. ~<,~ Cased to /.~4~--~x~,~,~_ Depth of Grouting ----- Static Water Level /'.4 (.,t ~'~ ~,z~ ?.~ (~ Pump Set At t~ ~,,'¢~' Casing Height Above Ground ! Sanitary Seal on Casing ~IN) Electrical Wiring in Conduit (~ Depress,on Around Wellhead (Y/{~) Separation Distances from Well: To Septic/Holding Tank on Lot f~ On Adjoining Lots To Nearest Edge of Absorption Field on Lot ~b/~[ · On Adjoining Lots To. Nearest Public Sewer Line /~)0 (~ To Nearest Public Sewer Cleanout/Manhole Ice ~'¢ To Nearest Sewer Service Line on Lot Water Sample Collected by ~- ~z~'t~ , Date Water Sample Test Results .~.~ '~ ¢¢ ¢~'/ Comments ~ ~'~-~&~-~¢? ~',k"~-~/--~{~ /"~//~ I B, SEPTIC/HOLDING TANK DATA Date Installed Standpipes (Y/N) Air-tight Caps (Y/N) Depression over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well To Property Line To Water Main/Service Line __ Course Comments Size No. of Compartments Cleanout (Y/N) Pumped ; for emporar ,.Holding Tank Permit (Y/N) Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot To Water Main/Service Line To Stream/Pond/Lake/or To Driveway, Parkin! Comments or Drainage Course or Vehicle Storage Area Type of System Design __ Length of Field Depth of Field __ Gravel Bed Thickness Standpipes (Y/N) Date of :y Test To Property Line To Existing or Abandoned System On ; On Adjoining Lots To Cutbank (if present) D. LIFT STATION Date Installed _ Di Size in Gallons . ManhH21'6/Access (Y/N) "Pump On" Level at j~ i/j~,/~ump Off" Level at High Water Alarm Level at ~ ) ~.~,.,-' Vent (Y/N) Tested for ~ Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments ** Check Permitted B lng Against HAA Request ** I certify that I have e~hecked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed ._ ° Date B- / Compnny /4~-'~ ~r'~'~-- MOA NO. _~-'-O~ Receipt No. Date of Payment Amount: $ Page ~?~¢' M~;~ .~, 72-026 (11/84) ALASKA ellUIRO[lI11EI1TAL COI1TROL SERUIC S, I[1C. March 13, 1986 Municipality of Anchorage Department of Health & Human Services 825 L Street Anchorage, Alaska 99502-0650 MUNICIPALITy OF ANCH ~... DEPT, OF HEA,~, ORAO~. ~WRONMEN~.. L~ & t,~L PROTECTION RECEIVED Attn: Mr. Steve Morris S bject: Health Authority Approval Lot 34, Block 1, Bella Vista #1 Dear Steve: This letter will reiterate our phone conversation on March 12, 1986 about the subject lot. The owner, Mr. Richard Huff is trying to obtain Health Authority Approval in conjunction with re-financing his home. The house is served by a private well and city sewer. The residence was built in 1954. Municipality Health Department records have information on a driven well for this lot. It was 20 feet deep, cement casing, and water 3 feet from bottom (data from Alaska Department of Health, 1959, attached). The well was supposed to be upgraded in the mid-1970's. A site inspection March 10, 1986 found 6 inch casing 1 foot above ground and a sanitary seal. However, ~ plug had been installed in the casing approximately 7 feet below the surface. Verification of casing depth, static water level, and flow information cannot be determined as the well casing will have to be dug up to remove the plug. There is a good possibility the well casing will need to be extended, or a new one drilled. Because of inclement construction weather, and the depth of frost, we are requesting that a Health Authority Approval be granted with the condition that the well be upgraded to meet Municipal Codes within 90 days. Recommend funds be escrowed 1200 LUesl 33~'~I Aucnu~, $ui1¢ [~ · Anchoro§¢, Alosko 99503'(907] 561-5040 s-fficient for well replacement. A water sample was taken March 10, 1986 and found to be free of bacteria contamination. If you have any questions, please call. Sincerely, Dennis Roe Field Engineer Approved By: ~ Attachments 1-3 P.E. o OF ANCHORAGe: OF HEALTH & PROTECTION MAR 1 ~ 1981~ ECEIVED i~ APPLICANT FILLS OUT UPPER HA' - ONLY Pi'~)pert,'v Owner '~ ~;'c~ ~-,~ ~._~.L~ L.~ [~L~ ~'~ Phone Buyer ~.~ lv~ ~2 ~; h~ O d ~ Address Zip Code Lending Institution ~ L.f~ ~k~ CV"~AT~ ~ [~ Cj ~ Phone Address ~2.~k~ ~ ~t ~fJ ~O~ ~ Zip Code Realty Co. & ACnt ~) C)N ~ Phone Address Zip Code LegalDesc?pt~n l~ ~:~[ ~'~LL~. O~ ~ Street Locati~ ..... ~q ~-~ ~ . '-(~, ~.~ Type of Resi~nce ~ Single Family ~ Multiple Family No. of Bedroo~ ~ ~ Other Water SuPply ~ Individual A~ACH WELL LOG. A w~l Icg is required for all wells drilled since June 1975. ~ Community For wells drilled prior to that date, give well depth (attach Icg if available). ~ Public Utility Sewer Disposal, ~ Individual ' Year Indiv~ual Installed: ~ Publlc~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 Date Date Date Date Inspector Inspector Inspector Inspector ( Field Notes:I'~J'/..,.~ MUNICIPALITY OF ANCHORAGE [;~,6 2 0 1982: ¢[C£1V.ED ( ~ APPROVED BEDROOMS *CONDITIONS OF APPROVAL ( )DISAPPROVED DATE BY: Soils Rating Date ~wer Installed Well To Absorplion Area Well Log Received Well to Tank Septic T~k Size 72.023 (3182) t~tt,'~HH/~)~) , L) GREATER ANCHORAGE AREA BOROUGH \g'l I~,1~/ ~,~,'~' D~e~mm~q~ent of Environmental Quality ~ ~}r' 3330~tr~ Anchorage, Alaska 99503 274-4561 .... ~ ' '~~ Date of Inspection FOR 2. Property Owner: ~~ Phone: Mailing Address: 3. Legal Description: ,-~~.~, 6. Well Data: . /. / Type~~~~ '- A. Installed ~ B. Installer C. Septic Tank: 1. Size 2. Manufacturer D. Seepage Pit: 1. Absorption Area 2. Material E. Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank , Absorption area , 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 - Reques ~or Approval of Individual Sewe Water Facilities Legal Description Comments Approved 7~ ~. ~~ Disapproved Date / Approval Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM 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 Date EQ,034 (1/74) GREAI'ER ANCHORAGE AREA BOROUGH.. Department of Environmental Quality 3330 "C" St., Anchorage, Alaska 99503 - 274-4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES Type of Inspection: CMRO Property Owner: Mailling Address: .~.,-/'c/ ~. _7~'~/ ...... Name of Buyer: _./~>i~//~A~ Mailing Address: Name of Lending Institution: Mailing Address: Name of Realtor or.Agent: . Mailing Address: Da_s_ Phone Phone Phone Legal Description: Location: _ ,..:/a,. l 7. Type of Facility to be inspected: 8. Water Supply No. Bdrms. Type of Supply: Public Utility _ ~ Individual If Individual, number of d~ellings presently served If Individual, depth of well Sewage Disposal System Type of System: Public Utility __~ If Individual, date of installation I vidual -~ (on-site) EQ-037 (]/74) ~ Time of Inspection ._ Date of lns~,ection REQUEST ?R APPROVAL OF - .INDIVIDUAL SEWER & WATER FACILITIES FOR Mailing Address' ~ l~ ''-~ Phone. · ..... Property Owner' ~ ~ Phone Mailing Address: __~~ Legal Description: ~ _~.~ ~~ ~~ ~~~,] Lo~tion: ~~ ~, ~ ~ ~, ~ Type of facility to be inspected~~~ No. of bedrooms Well Data: ~ ~ A. Type B.'Dep~h C. Construction Sewage Disposal System: Bacterial Analysis A. installed B. Installer C. Septic Tank' i. Size 2. ManuFacturer D. See?age Pit' ?, !,~aterial Disposal, Field: Total length of lines 8, Distances- Well to' Septic tank Nearest lot line Absorption area Otme? contamination , Sewer Lines B' Fo., ......ion to septic tank ,.Ab"orption. ~ area C, Absorption area to nearest lot line E.~-u.'.,,; (I/7,!, Page i o'i:' t",o pages ~' w?~t?r Facilities Comments Approved Disapproved Date Approval Valid for one year from date .signed Greater Anchorage Area £,orough, Department of Enviro;~mental Quality DIAGRAM OF Da ue J · t September 24,. 1974 ¢11fford 644 E~st Y~A~ SUBJECT: Se~r and ~tor facilities sef~tng Lot 34. 84119 Jtste S~bdtvl$ton Your request for ,~er and water apprffal on your ~. cannot be a~proved et thts ttm. In order_ for you to get approval you wi11 md te do tho following: 1) Extend the wll casing 12" above ground leu1 and f111 tn the ptt that tt t$ tn utth t,lae~lous ~4t1. up to tr. Thts ts a State La. and. tht$ ts & requ ~hich ~tll have to be mt by Novonbor 1. 1074. If .you have ~TY questions, please fonl free to contact m et, 274,4661. Sincerely, RoberC C. Pratt, En~tromental Control Offtcor ADH~HSE-6-1Vl 2s /~o,m Must Be Out ComPletely. Filled INDIVIDUAL W'ATER SUPPLY ALASKA DEPARTMENT OF HEALTH Section of Sanitation and F. ngineering Please Look on Reverse of Sheet for Sample Collection Instructions. Request for Bacteriological Analysis / Lab.. No ............. Water sample collected by ....................... ..-~..:'.J:...~..~/..,. .......................................... ~...L,) V/q~ (Name of person collecting sample) ..... Z ...... ~'~i" .... ~ ........... ih;i~/j3.............. Water sample collec~d from ~ Kl~hen tap; ~ Bathr~m tap; ~ B~emen~tap; ~ Other (l~t),~,...~. ............... ~....3..~ ....... ~.~ / ......... . ....... ' ...... Address pre~lse where source ~....~.... .~..~_..~~'..-~~~~S (~me) ff ~ ~ '~ox No. or street address) Please ~l~ee an "X" tn ~he ~ox ~e~or~ l~m~ which ~ d~serl~ your wa~v su~ly: ~OU~g: Well ~ ~ Dug, ~ D~tven, ~ Drilled, ~ Bored [~ ~rlng, ~ ~l~e~, ~ O~he~ (llsg) .............................................................................................................. ~ ~ree~, ~ ~tve~, ~ La~e, : Pond ................................................................................................................... O~ ~I~Tg~ CO~T~CTIO~: Walls~ ~ Wood, ~oneFe~, ~ ~al, ~le, ~ BFte~ or Conere~ Bloe~ · o~ ~ ~ Wood, ~onere~e, ~ Me~al, ~ ~en To~ LO~ATIO~; ~ In ~asemeng, ~ B~semen$ offseL ~ ~ndor Ao~e,~ In yard Other ~eeg, Seepage pt~ ~eeg, Cesspool feel, Privy ..............fee~. Ogher p~sIble sou. tees of contamination (1~) ......................................................................................................................... Joint material ~l~pe ........ ~.~.~ OENER~ IN'FORe. ON: Does water become muddy or discolored? ~_] yes,~no ~en? ................... ~ ............................................................. Diameter of well .............. ~ ............... ~ .............. depth .......................................................... feet Well casing material ...... ~:'~~.. diameter...~..:~. ..... depth .....~.~ ......... ~ ...... Length of drop pipe ................ ~.~ ....................................... ,:~. ........ : .................... ~ ...... .~ ................... Water depth from bot~m ~ ~ ' ~'~' - feet ....................... z ............... ............. ..... ...... Pump location: ~ In well, :~ Offset in basement, ~ In base~ent/] ~ ~ utility r~m, ~ On top of well ~ Other (l~t) .......................................................................................................... Oo you suspect illne~ from this supply? ~ yes, ~ no :~emarks: .......................................................................................................................................................................................................... .?5EAoE DRAW A SKETCH ~ ~ SPACE BELOW. THIS SK~CH SHOULD SHOW ~CATION OF HOUSE, WA~ SUPPLY SOURCE, SEPTIC TANK, SE~R, DRAIN LI~S OR O~R SOURCES OF POLLU~ON ~D DIST~CES :.'~E~N WAT~ SUPPLY SO.CE ~D ~ OF ~OVE FAC~q. SAMPLES MUST BE SUBMITTED IN CONTAINERS ]PROVIDED BY THE'AL'ASKA DEPARTMENT OF HF~~ Voterana iaateual Off~ce Tover Build,ns 7th Aven~e ami Olive DL 123671-AAA GenC%enan: ~he oubeurfaee seuase d~l eyoCen for Chis property Mots the uAnf~ma requirem~o of tim A~aaka Depart of Health, Phlllip a. bits e/o U. ~. ~Oistriet P, O. ~x 7~ ~mk ~u for your Jsr~at~ 31 letter infor~t~ us that the ~ We ~lll ~ o~er a~ i~p~ttoa of t~ ~rk ~til ~ r~t~ a reply you ~ our Fe~ ~ le~ red. tug ~he app~vaI (7) or r~J~c~ion ('~) of ~he water supply by ~ ~al~h aut~riCtes. ~ do ~t wish ~ incur u~ecessa~ e~o~e for you. ~ a~ ti the tnspeotion is ~, PaYm~nt ~ ~ ~de diraetly ~o t~ tns~tor. Foll~t~ iS t~ p~raph f~ ~ letter ires t~ ~lth aut~rities that ,~ wa~er suppl~ syst~ is a dug well wl~h a ~od~ pl~. Alaska ~P~r~n~ of ~lth ~es ~t ~p~ve p~ or ~ll pits, It ts r~~~ t~t t~ ~ ~ put in es~ e%~ to~ dr%!l~ veil," Furt~r proCe~ing oi ~ur loan ~11 ~ sump~ded until ~ ~ f~m you, Ve~ t~l~ ~urs, Officer tn Ch~r8o, A~horMe ~-'SKA DEPARTMENT OF HEAL''~'' ' ' .~*--=..----._ ¢-- SANITARY INSPECTION Name of Manager ~aeion Sir: An inspection of your plant has this day been made, and you are notified of e de ecs mar ed be ow wi ~ cross ~/,?,~X) in column marked with (U). The defects not~ should be corrected. "' S U COMMENTS ON CONDITIONS 1, Site' [~ ~-~ 2. ' ilding 3. Ventilation 4. Heating 5. Lighting 7. Rodent Control 8. Insect Control 9. Water Supply ~1. ~efuse Disposal 12. Toilet Facilities 13. Hand-washing ~acilities 14. Equipment 15. Construction 16. Cleansing 17. Sterilization 18. Storage 20. Refrigeration 21. Wholesomeness of food and drink 22. Storage, Display 23. Personnel, Cleanliness 24. communicable disease control 26. Adulteration 27. Misbranding 28. Premises Clean REMARKS: ..... '- /. ~.4' ,/ _ .~/, '~/ ~--' a[tl/.~. /5 d/,,~ ~¢ reviewed this with ins~tion .,' L, '~v. ~~"f ..... me .5' ? ,,( *,SKA DEPARTMENT OF HEAL'r~ SANITARY INSPECTION ~ S U COMMENTS ON, CONDITIO'NS 1. Site ~J L '~:' .~luilding L[i L] _ 3. Ventilation LJ L 4. H ting L L 7. Z~ent Control ~ ~ 8. lns~t Control ~ ~ 11. Refu~ Dis~s~ ~ ~ -- ~ ~ -- ' ~ -- ~ 12. Toilet Facilitie~ 13. Hand-washing facilitie~ 17. Sterili~tion 19. mn~ling 20. Refrigeration 2 I. Whol~meneu of f~ and ~ 22. Stooge, Display 23. Personnel, Cl~ineu. 24. ~m~unicable dis~e control 25. ~beling 26. Adulteration 27. Misbranding 28. Premises Clean REMARKS: reviewed this inspection with me ~ ..... '~ Name of Establishment ~P'h~'4~' ,~0%~P &ddres, ~it~ ~.._~. DI ~ ~~- Name of Manager . ~ation Z~/~ ~~ Sir: An inspection of your plant h~ this day been made, and you are notifi~ of the defects marked below with ~ross ~X) in column marked with (U). The defects not~ should be corr~t~. Henry P L~ng Lot 3~ Bella Vista Drive Bella Vista Subdivision Alaska Alaska Department of Health Anchorage, Alaska February ~959 Dear Mr Walker: In regard to improving~r water facilities, I propose to do the following work this spring as soon as the ground thaws out: ~. Relocate the present water pump from the well to the basement of the house. 2. Line the walls of the well with circular cement blocks up to a level equal to the entry of the buried water line; cover with a concrete sl~b and backfill with earth. Respectfully; AXB, I4AXT,,, fo O. ~ox 7002 DL 123 67t ,AAA 30~6/2St vorkable. Ver~ t:t'dly /ours, GBAYCE MOEGEi O~C, AneboraSe Alaoka h~ 6~ ~959 7th ANtoine mod OLiw Uly Sub~iou GtutLmm~ prim,Loll mmm~; vLth ~ ltSVmm! o! ~ld.m dm~mm, mmut. Jooeph L. #mXImr Sanf. Carf~n VA, DL X23 67X ~ ~tly ~t~ t~ m ~ptt~ er t~ t~ p~t ~Xt ~td di~Xt~ thin t~ttou ~e We are ~ ~ ~u ~ ~i~ ~to diffteuZ~, ~~, ~ ~uld ~tate ~ i~o~t~ ~ ~ ~ H ~8tblm ~t~ or ~t ~ h~lth ~t~flttmm m ~pmi~ t~ ~t~ ~ply. ~ M, ~ viii tbir mt~ W~/ ~uruty ~ Ousrmty Dtvtsion ~__~,,~I~I-H SE-8 ,F 1 (f) 10-55 - 5M Lab. No. INDIVIDUAL WATER SUPPLY ALASKA DEPARTMENT OF HEALTH office. Section of Sanitation and Engineering ACTION ON REQUEST FOR BAC,TER!...Q,LOGICAL WATER ANALYSIS Your recent request for an analysis of a sample from the Individual Private Water Supply serving ?° was received ~ and ex~ation has been completed. Records in this office indicate this Individual Private Water Supply to be of sanitary status. ~ Analysts shows this SAMPLE to be Satisfactory ~ Satisfactory (~uestionable , (~uestionable Unsatisfactory Unsatisfactory. If an "Unsatisfactory" or "(~uestionable" status is indicated above, you should take immediate actton as recommended below. 1. Boil or chemically treat your water supply to protect your family from water-borne diseases as outlined in en- closed leaflet, "Drink It Pure." 9.. Improve your spring- See bulletin HSE-6-fl 3. Improve your ctstem -- See bulletin HSE-$-3 4. Improve your dug well- See bulletin HSE.6.4 5. Improve your driven well -- See bulletin HSE-6-$ 6. Improve your drilled well--See bulletin HSE-6-6 7. Relocate your well to a sate location in relationship to your sewage disposal system -- See bulletin HSE-15 8. Bottle broken in .transit, please send new sample. 9. Sample too long in transitl sample should not be over 48 hours old at examination to indicate reliable results. Please send new sample, 10. Contact your nearest [] Local Health Department or [~ Alaska Health Department, Sanitation office for bulletins, consultation, and assistance. I 1. This is a surface water source and subject to pollution by man and animals. An approved water supply source should be developed. SANITARIAN'S REMARKS A~'H-HSE-e*FI (f) · ~0-ss. ~( Lab. lqo. ~ INDIVIDUAL WATER SUPPLY ,/' ALASKA DEPARTMENT OF HEALTH DATE Section of Sanitation and Engineering OFFICE ACTION ON REQUEST FOR BACT. ERIO.LOGICAL WATER ANALYSIS Your recent request for an analysis of a sample from the Individual Private Water Supply received. 2/~ and examination has boon completed. s. mst. Records In this office indicate this Individual Private Water Supply to bo of sanitary status. Analysis shows this SAMPLE to bo ~ Satisfactory, Satisfactory ,, Questionable ,, Questionable Unsatisfactory Unsatisfactory, If an "Unsatisfactory" or."Questionable' statue is indicated above, you should take immediate action as recommended below. 1. Boil or chemically treat your water supply to protect your family from water-borne diseases as outlined in en- closed leaflet, "Drink It Pure." 2. Improve your spring m See bulletin HSE-6-2 3. Improve your cistern m Soo bulletin HSE-8-$ 4. Improve your dug well- Soo bulletin HSE-8-4 $. Improve your driven well m Soo bulletin HSE-6-$ 6. Improve' your drilled well ~ See bulletin HBE,8-8 7. Relocate your well to a safe location in relationship to your sewage disposal system m See bulletin HSE-IS 8. Bottle broken in transit, please send new sample. 9. Sample too long in transib sample should not be over 48 hours old at examination to indicate reliable results. Please send new sample. 10. Contact your nearest ~'~ Local Health Department or [] Alaska Health Department, Sanitation office for bulletins, consultation, and assistance. 11. This is a surface water source and subject to pollution by man and animals. An approved water supply source should bo developed. SANITARIAN'S REMARKS Source ALASKA DI~ARTM]m~ OF HEALTH Division of Publto Health Laboratories BACTERIOLOGICAL WATER ANALYSIS Lab, No. Lot 3l+, Ibl~a V:Leta BubaJ.v"J. aion Mail Report to ]~F'o HOl3~ LLvI~ Address Dates: Collected 2/S/~q! Date Lactose Broth 10cc 10cc 10cc 10cc 10cc 1.0cc 0.1cc 24 hours 48 hours ~s~.iAT~'I ~ EMB , , , B O B, Lactose Broth, 24 hre. 48 hfs. Greta's stain , Coliform Density (Most probable No. per 100cc.) Reported by A~i Date 2/7/69 Absent X~ This analysis indicates Coliform Organisms to be: Present 3 Februaxy 1.959 Veterans Administration ~e$ional Office 7th Avenue and Olive ~ay Seattle 1, Washinltm~ Loan Ouarauty Oivtsion Copy o£ your letter dated February 2, 19~9 to, ~dr. Henry F. DL 12367i*AAA 3046-261 Lot 34, gmlla '.'isis ~u. bdivtalon Gent leman: The subsur[ace sewage disposal system [or this property the ~dmia~m require~entt oi the Alaska Department of ~ealth. The water supply syst~:m is a dug well w£th a ~ooden we~t pit and la not approved by the Alaska Department of Health. The I)epar~n~nt o£ ttealth does hoc ~pprov¢ p~ or ~ell pits, It is recoemended that the money be put in escro~ either £o~ i~rovemeuts on the present ~ell or for the installation of a drilled well. Siucerely, Phtllip B. Krettz PBK:pb