Loading...
HomeMy WebLinkAboutSPENARD ACRES BLK E LT 3A OF LT 3 0 Sp~nar el, Alasl~a~ W'e':-~dv[se:you t~'record, this certificate with your' Warranty deed APPLIC..NT FILLS OUT UPPER HAL. ONLY Type of Residence ~ Single Family Water Supply '~lndividusI ATTAOH WELL LOG. A ~eli log is required for ~il wells drilled since ~une 1975. . Community (/',)~ $ [ l-¢ ~t L C For wells drilled prior to lhat date, give well depth (attach log if available). ~ Public Utility Sewer Disposal ~ Individual Year Individual Installed:  Public Utility 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 Insp~tor Insp~tor Insp~ Field Notes: DEPT, OF HEALTH /~[~. ~ ~ ENVIRONMENTAl. PROTECTION ..~.~.., .... ~ MAR RECEIVED ~) ~APP~OVED BEDflOOM8 *GONDITION8 OF APPROVAL ( ( ) DISAPPflOVED ( ) CONDITIONAL APP~QV~~ ~') C ILL . ~ / Soils Rating Date ~wer Installed Well To Absorption Area Well Log Received Well to Tank Septic T~k Size 72.023 (3182) · CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. ~.  --~" TELEPHONE (907)-279,4014 R ~,~,,~t,~ Drinking W~ilf3,~nalysis Report forS~itilSt~itliform Bacteria TO BE COMPLETED BY WATER SUPPLIER I,D. NO, Water System Name Phone No. Mailing Address City State Zip Code MO, Day Year SAMPLE TYPE: [] Routine [] Check Sample (for routine sample with lab ref. no, [] Special Purpose [] Treated Water [] Untreated Water SAMPLE NO. 1 2 3 4 5 LOCATION I Time Collected Collectea By I TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: [] Satisfactory [] Unsatisfactory [] Sample too long in transit; sample should not be over 48 hours old at examination [o ~na~ca[e reliable results. Please send new sam Die, Date Received Time RecelveC Anal ytical Method: [] Fermentation Tube [] Membrane Filter Lab Ref. No. I I Result* Analyst *No. oi colomes/100 mi. o~ No. of POSlhVe portions READ INSTRUCTIONS BEFORE COLLECTING SAMPLE 06-1220 (b) Rev. 1978 BACTERIOLOGICAL WATER ANALYSIS RECORD Date Received Time Received Lab. No. ~resumptlve 10mi 10mi ].Omi ].0mi 10mi 1,0mi 24 Hours 48 Hours :onflrmatory 24 Hours 48 Hours EMB Broth 24 hours~ Broth 48 houri.. Multiple Tube ReDorb Z0ml Tubes Positive/Total Z0ml Portlonl Membrane Filter= Dlre~t Count Collform/Z00ml Verification= LTB . .;r BGB Final Membrane Filter Results .': ,' Collform/100ml Reported By :' '~ ' , t Date A}l;p}:ova~ foF f:he individual sewer and water J:aci].ities cannot top f).~ %he </oli casiRg ¢~Jloi_tid ]){: s()a_].ed so {:hat i't :i.s O~J~iC() ~:UOifi '[:1}i(.: (JhOl[L il,al), 5(}33 }3 S'hr:~eJ_~ J:.or ot~r ;fovJ0w. r~o/: ',d ~l:Lsc~fep;iltcids have been cor~fooLed, ii'!: t:]~ere are ;.lily ful:hhol: qUc:stio~s, please call k}!is oJ{l:J, ce <th 264~.,!720, Sincerely,