The URL can be used to link to this page

Home My WebLink AboutHOLLOWBROOK BLK 1 LT 14Iqo I brOOk L__lq 041 ot DA,. RECEIVED . INSPECTION APPOINTMENTS (~~_.' ~-/~-/~ ~'~..~' '~T' TIME ~_~ (,~. ,~ TIME INSPECTOR INSPECTOR I NSPECTOR~ MUNICIPALITY OF ANCHORAOE MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTEC~ONMENTAL t ROTECTION 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL SANITATION DIVISION JUL 3 1981 Telephone 264-4720 REOUEST FOR APPROVAL OF INDIVIDUAL WATER AND SE DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow t~n (10) days for processing. 1, PRO~TY OWNER PHONE MAILING A~R ESS PROPERTY RESIDENT (If different from above) ~E PHONE 2 BUYER 'MAILING ~--Z~t ~C~. ~, 3. LENDING INSTITUTION ~ PHONE MAILING ADDRESS ~ 4. REALTOR/AGENT ~ PHONE 5. LEGAL DESCRIPTION /.o/- IL/, 6. TYPE OF RESIDENCE [] SINGLE FAMILY ~ MULTIPLE FAMILY NUMBER OF BEDROOMS [] One [] Four [] Two [] Five [] Three ~ Six [] Other~ 7. WATER SUPPLY INDIVIDUAL* COMMUNITY [] PUBLIC UTILITY *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/ON-SITE** [-~ PUBLIC UTILITY YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED, 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. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL - [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER []INDiVIDUAL/ON 'S I T E ~.~'~-~,~.~ DATE INSTALLED [~cud~-IC UTILITY f ..~/ ~'/.-f'/,~l 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 WELL TO: Absorption Area to nearest Lot Line 5, COMMENTS [] APPROVED FOR /~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED · TELEPHONE (907)-279-4014 ANCHORAGE INDUSTRIAL CENTER 274-3364 5633 B Street Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER~i I.D. NO. Mailing Address City State Mo, Day Year Z~p C e~ SAMPLE TYPE: [] 'Routine [] Check Sample (for routine sample with lab ref. no. [] Special Purpose ~ Treated Water Untreated Water SAMPLE NO. LOCATION TO BE COMPLETED BY LABORATO RY Analysis shows this Water SAMPLE to be: ~l~S~atisfactory [] Unsatisfactory [] Sample too long ntrans~t; sample should qo[ De over 48 hours old at examination to indicate rehaPle results. Please send new sample Date Received Time Received ,, ,, Analytical Method: [] Fermentation Tube '~ Membrane Filter Analyst Lab Ref. No, Result* I F--r'q I F-i-I I F-Fi *NO O! COlOflles/100 mi. or Noel Positive 3ortlons. READ INSTRUCTIONS BEFORE COLLECTING SAMPLE 06-1220 (b) Rev. 1978 BACTERIOLOGICAL WATER ANALYSIS RECORD Date Collect e~ Source PresumPt lye = 10mi 10mi 10mi 10mi 10mi 1.0mi 0.1mi 24 Hours 48 Hours 24 Hours 48 Hours EMB Broth 24 Ilour$= Broth 48 hours: Multll~le Tube Rebort: 1Omi TUOeS Positive/Total 1Omi Portlonl Membrane Filter: Direct Count Collform/100ml Final Meml)rane Filter Res~lt~ ', ,. ; ~- Collform/].00ml CHEMICAL & GE~ _,OGICAL LABORATORIES c_ ALASKA, INC. TELEPHONE {907)-279-4014 ANCHO ;{AGE INDUSTRIAL C ENTER 274-3364 5633 B Street Drinking Water Analysis Report for Total Coliform Bacteria WATER SYSTEM: Water Svsten~ Name TO BE COMPLETED BY WATER SUPPLIER I.D. NO. Phone No. Mailing Address City StarVe< ~' Zip Code Mo. Day Year SAMPLE TYPE: ~3 Routine [] Check Sample (for routine sample with lab ref. no. [] Special Purpose [] Treated Water [] Untreated Water SAMPLE NO. I 3 I 4 I I LOCATION J I TO BE COMPLETED BY LABO RATORY Analys~s shows This Water SAMPLE to De: [] Satisfactory :. ~%.U.nsatisfactory ~' [] Samale too long in transit; sample should no! De over 48 hours old at examination to indma~e reliable results. Please send new sam Date Received Time Received Analytical Method: [] Fermentation Tube ,~ Membrane Filter Lab Ref, No. Result* Analyst [ ,';:; ? /)" ~ I I I i r-I-] i I F--[-I I I F-I-I '*'NO of COlOnies/100 rnl or No of Positive portions. READ INSTRUCTIONS BEFORE COLLECTING SAMPLE 06-1220 (b) Rev. 1978 BACTERIOLOGICAl' WATER ANALYSIS RECORD Date Collected Source Presumptive 10mi 10mi Z0ml 10mi 30mi 1.0mi 0.1mi 24 Hours 48 HOurs Confirmatory 24 Hours 48 Hours EMB Broth 24 hours: Broth 48 houri: Multlole Tube Report: t0ml Tubes Positive/Total 10mi Portlolta Membrane Filter: Direct Count / Collform/lO0ml Verification: LTB ' ' ..~ Collform/lOOml Final Membrane Filter Results Reported By Date ; ,~¢'T ,, ( ',N unicipalit3 nchora e 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 264-4111 GEORGE M, SULLIVAN, MAYOR DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION August 5, 1981 Dorian Cox Post Office Box 10-1845 Anchorage, Alaska 99511 Subject: Lot 14 Block 1 Hollowbrook Subdivision Approval for the individual sewer and water facilities cannot be granted until the following items have been completed: The water analysis report needs 'to be submitted to this office ~rom the Chem Lab, 5633 B Street, fo? our review. (2) The seal on the well head needs to be tightened so that it is water tight. (3) The on-site sewer system needs to be located on the property across the street, 644 East 76th Avenue, so that measurements can be taken between the community water supply and the sewer ~ystemo This is to insure proper protective radii for the community well system. Please notify this department for another inspection when the noted descrepancies have been cbrrected. If there are any further questions, please call this office at 264-4720. Sincerely, James S. Roberts Associate Environmental Specialist JSR/ljw CC: First National Bank of Anchorage % Una Bennett Post Office Box 4-2090 99509 Don Gay % Northland Realty 2932 C Street 99503. Printer's Inc. DBA PRINT SHOP Service 349-7602 Quality