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Home My WebLink AboutLINGO LT 24 APPLI'C=NT FILLS OUT UPPER HA!'r~ .ONLY Phone Lending Institution Address Zip Code Phone Realty Co. & A~nt Address Zip Code Type of Resi~nce ~ingle Family ~h ~ Multiple Family Np. of Bedroo~ ..-~'- ~ Other Water Supply ~ Individual A~ACH WELL LOG. A w~l log is required for all wells drilled since June 1975. ~ Community For wells drilled prior to that date, give well depth (attach log if available). ~ Public Utility Sewer Disposal ~~ ~ Individual Yoar Individual ~ns~alle~: ~ When Connected to Public Utility: '7-- ~ ~'~ g 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 ' n s P ect o r ~.~ (~ (~_0~ ,r~_~) A~T,f,~O F~,~ MUN,CJP ,CHO~C~ RECEIVED ( ~) APPROVED BEDROOMS *CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL* DATE '7 ~'"'//~'~ ~'~ "] Soils Rating Date ~ewer Installed Well To Absorption Area Well Log Received Well to Tank Septic Tank Size ..CHEMICAL & Gl. LOGICAL LABORATORIES ,~,,? ALASKA, INC.~ TELEPHONE (907) 562-2343 ANCHORAGE56331NDUSTRIALB Street CENTER Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER WATER SYSTEM: '-.,) /: /)/?"×y Water System Name I.D. NO. Phone No. City State Mo. Day Year Zip Code SAMPLE TYPE: r-I-R~utlne <'i-t Check Sample (for routine sam pie with lab ref. no. ) [] Special Purpose [] Treated Water [] Untreated Water SAMPLE NO. 1 2 , 5 LOCATION Time Collected Collected By TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: ,?~Satisfactory --I Unsatisfactory. [] Sam~ e too long in transit; sample should not De over 48 hours old a~ examination to indicate reliable results. , Pleas.e se~.d .. new samole. Date Received Time Received £~' ' Analytical Method: [] Fermentation Tube ~ Membrane Filter Lab Ref. No, I Result* Analyst *No. of colonies/t00 mi or NO of Positive READ INSTRUCTIONS BEFORE COLLECTING SAMPLE O6-]220 (b) Rev. 3.978 BACTERIOLOGICAL WATER ANALYSIS RECORD Data Collected Source Lab. NO. P~esumptlve 10mi 10mi /0mi 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 ~-:) Broth 48 hours: 1Omi Tubes Positive/Total 1Omi Portions Cotlform/100ml BGB Collform/lOOml Date Tiff,.;3 bate nspect~ Comments Time Date Inspector Date · Inspector Conditional Approval Date Sewer Installed Permit No. Septic Tank Size Holding Tank Size~ Soils Rating Well To Absorption Area Well Log Received Well to Tank Property Owner C~,'~ ¢ [~"~ iMailing Address ~L~ APPLICANT FILLS OUT LOWER HALF ONLY ~, ~ .,\.o~z., ~ ~, ~.~ 7- r~:y~ [Phone Buyer ~,~ Address Lending Institution Address ~,. '.D~,~. Realty Co. & Agent Address Phone Phone Legal Description Street Location Type of Residence ',~3Single Family [] Multiple Family [] Other No. of Bedrooms Wate~ Supply ' !El 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.) Sewage Disposal [] Individual '~ Public Utility [] Holding Tank Year IndK, idual installed: When Connected to Public Utility: NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. -. .. · CHEMICAL & G. ~,OGICAL LABORATORIES · ALASKA, INC.~ '~ · TELEPHONE (907)-279,4014 ANCHORAGE INDUSTRIAL CENTER /~,~ 274-3364 §§33 B St re et ~-'~-~';;;';;'"["~Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER WATER SYSTEM: I.D, NO. Water System Name ~- ~ / Phone No. Mailing Address '. ? ,., ,'~'1.,'~ Zip City SAMPLE DATE: MO, State Day Year SAMPLE TYPE: [] Routine [] Check Sample (for routine sample with lab ref. no. [] Special Purpose [] Treated Water [] Untreated Water SAMPLE NO. I 2 I 3 I LOCATION Time Collected Collected By J ,',,,) -'~, !i~ r ., ,..'.) (.; , , TO BE COMPLETED BY LABORATORY Analysis snows this Water SAMPLE to be: []. ,Satisfactory [] Unsatisfactory '-J Sample too long in transit; sample should not De over 48 hours old at examination [o indicate reliable results. Please send new sample· Date Received ·' ..... Time Received Analytical Method: [] Fermentation Tube [~:~Membrane F~lter Lab Ref. No. Result* Analyst I J-T-] rTl ~No of colomes/t00 mi. or NO. of Positive ~ornons. READ INSTRUCTIONS BEFORE COLLECTING SAM PLE 06-1220 (b) Rev. ].978 BACTERIOLOGICAL WATER ANALYSIS RECORD Date Collected Source - Date Received Time Received e.m. [.ab. No, Presumptive 10mi 10mi 10mi 10mi 10mi 3.,0mi 0,1mi 24 Hours 48 Hours Confirmatory , 24 Hours 48 Hours EMB. Broth 24 hours= Broth 48 hours,, Multiple Tube Report= 1Omi Tubes Positive/Total [Omi PortlOrla Membrane FIIter= Direct Count Collform/t00ml Verification= LTB BGB Final Membrane Filter Results Collform/lOOml Reported By '~ ~ Date December 17, 1981 Charles Edwards 1948 Wildwood Lane Anchorage, AK 99503 Subject: Lot 24, Lingo S/D Dear Mr. Edwards: This letter is in reference to our conversation on 12-17-81. As stated to you, there are two options to you for the upgrade of your well. 1o Raise the existing well casing to just below ground level and pour a 4" cement floor and wall. The walls should be flush with the existing driveway. 2. To raise the well casing flush with the driveway and fill the pit with impervious type soil. The top 4" should be cement to accomodate the existing cement driveway. A metal plate should be placed over the well to protect i% from vehicle traffic. Enclosed you will find the state regulation that I have made reference to. If there are any questions, please call this o~xice at 264-4720 Sincerely, Robert C. Pratt Associate Environmental Specialist Enclosure