HomeMy WebLinkAboutLAKE SPENARD PARK Block 4 Lot 2 of resubd. of E2 of lot 26 & 27 and N2 of E2 of Lot 28c nd
D,~, E RECEIVED
' ' " INSPECTION APPOINTMENTS
TIME TIME TIME
DATE DATE DATE
INSPECTOR INSPECTOR INSPECTOR
MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH &
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECT~Rt~IRONMENTAL PROTECTION
825 L Street - Anchorage, Alaska 99501
) ENVIRONMENTALSANITATIOND~WS~ON OCT 3 1980
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS: Complete all parts on page 1, I~complete requests will not be proce~ed. Please allow ten (10) devs for processing.
1. PROPERTY OWN~~ PHONE,
PROPERTY RESIDENT (if different from above) PHONE
PHONE
MAILI~RESS ~
3. LENDING INSTITUTION . - ' ~ / PHONE
4. REALTOR/~GENT ~, ~ ~ ~__ , ~ ~ // ., PHONE
§. LEGAL DESCRIPTION ,-~ /] // / ~ .
6. TYPE OF RE~IDENCE ~ NUMBER OF~BEDROOM8
~ne ~ Four ~ Other__
-- -'~'-[&:~ SINGLE FAMILY [] Two [] Five
[] MULTIPLE FAMILY [] Three [] Six
,7 WATE~UP~DiVlDUAL, /.~ ,-~. ~-.--"* ATTACH WELL LOG. A well log is required for all wells drilled
E~COMMUNiTY ,.~c~,~r~ ~ ¢~ce June 1975. For wells drilled prior to]hat date, give we I
~ PUB LIC UTI LITY ~'~th (attach log if available.)~ ~ ~ ~ ~ .~
8, SEWAGE DISPOSAL SYSTEM ~~ ~ ~ ~'
~ INDIVIDUAL/ON-SITE** YEAR ON-SITE SYSTE~WAS INSTALLED.
PUBLIC UTILITY
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED,
t,- , . CHEMICAL & GL~.£OGICAL LABORATORIES ~._.' ALASKA, INC.~.
,/~ . TELEPHONE (g07)-279-4014 ANCHORAGE INDUSTRIAL CENTER
/~~ 274-3364 §633 B St re et
~,- ..... ~,.~'-,~ Drinking Water Analysis Report for Total Coliform Bacteria
TO BE COMPLETED BY WATER SUPPLIER
WATER SYSTEM:
I.D. NO.
, - ? ~ ) ",.~
I I~ Phone No
Water System Name
Mailing Address
City State
Mo. Day Year
Zip Code
SAMPLE TYPE:
[] Routine
[] Check Sample (for routine sample
with lab ref. no.
[] Special Purpose
[] Treated Water
[] Untreated Water
SAMPLE
NO.
LOCATION
Time Collected
Collected By
TO BE COMPLETED BY LABORATORY
Analysis shows this Water SAMPLE to be:
[] Satisfactory
[] Unsatisfactory
[] Sample too long ~ transit; sample should
not 3e over 48 hours om at examination
to indicate reliable results. Please send
nev~ sample
Date Received
Time Received
Analytical Method:
[] Fermentation Tube
[] Membrane Filter
Lab Ref. No. Result* Analyst
I FTq
I
· No of colomes/lO0 mi. or NO. of Positive oorbons.
READINSTRUCTIONS
BEFORE
COLLECTING SAMPLE
06-1220 (b)
Rev. 1978
BACTERIOLOGICAL WATER ANALYSIS RECORD
Date Collectsd_ Source
a.m.
Presumptive /Omi 10mi 10mi 10mi 10mi 1.0mi 0,1mi
24 Hours
48 HOurs
Confirmatory
24 Hours
48 Hours
EMB Broth 24 hours:
Multiple Tube Report:
Membrane Filter: Direct Count
Verification: LTB
Final Membrane Filter Results
Rsport~ By ':" .' % ' "i .
Broth 48 hours:
10mi Tubes Positive/Total 10mi Portions
Coliform/100ml
BGB
Coliform/100ml
Date
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
Environmental Sanitation Division
825 L Slreet - Anchorage, Alaska 99501 Telephone 264-4720
SEWER AND WATER FACILITIES
1. PROPERTY OWNER
· Kathy Kiilsgaard
MAILING ADDRESS
2. LEGAL DESCRIPTION
Lot 2 resub E~ Lots 26 and 27; N½ E½ Lot 28 Block 4
Lake Spenard Park Subdivision
3. TYPE DWELLING
',,. ~ ".';' ~3~,. SINGLE AMILYRESIDEN E ':.-- ':
.. 12]~:.. O~.HE~,D~e~c, ri~e).,,.- .~:~'ii :'. {~...:~;.~. ~.:~-.:
-..: '~ ~.:_ MULTIPLE FAMILY RESIDENCE: "
,. ,~, .... ~:-~ :', .::~: ..:.' , ,. :.:'.. ::
...... .. '~:',',.~.~,,~:.~ .~:~ ... . :,. ,.. ..
4. WATER SUPPLY
INDIVIDUAL
~ COMMUNITY/PUBLIC
5. SEWAGE DISPOSAL ,
- --~ ' ~ .-':: :'- ~']RI ICII~Ii lTV~,: ' :' "" ' '." '~ '~ '
-.' ' ~' n~MH~u'/~l~ ~al~tsns~ce ~eqylrsd~ ': ' ~-~'.~ ,..,;....~ '. .... ;-"? '
' q~f.~ ?/~'" ' ,:,~" ~'~4 ' · ~ ..... ~ ...... ~ ~':~--'.,'.":-v' -..,.~ :':'w,~.-'- ', '.~:~ :~1, ,~.~ ,:~J ~-~ ~.~ !~,.:,~:.'.:.:"~/'z~ "" '~"'~
":: .... ':'.-:.: :' ' ~~L'-'~ ~'J~'] ;? ~?,,.' ~":"': ~~
· . · . :'...~'; :COND T ONALAPPROVAL(~A~ch~a~:~;'~,,~J~IJ [j ,, '"':....'~
· , . -'.. ~ · , -, .. ~ · ,.
-.L.......,: .-.r: . , .... ..- -
. .~-.-.c,' ~:,~% · .... ~.. ; · :,-,,,; ,. ~,.,, ;.' ' ' ~-~ .'%*I~k ;'~,.~;t.