HomeMy WebLinkAboutSUNNY ACRES BLK 2 LT 10 & 11 S2
PERMIT ~'.t ':
RF'F'L I C:RN !'
LOCRT I ON
L. EGRL
IRLEI',I [:,. H~,.LL
~.::L::Ld; _,'T~ IE =,I,..EE7
l l-IT ::LEI E,_I-.. ':; NN~'
........... Tr,.E[: f d:2:.'
LOT:,I--"E' .........
............ · , R NELL RN[:, RNV ON-.tSZTE :5;ENRGE DIrSF'OSRL S'?'STEM !'5
:Le~e~ FEET F3R R F'RZVRTE NELL 0~: ~.50 TO 2~3~ FEET F'ROM R F'IIEff ]'F: HELL .... F, ~I,,L
THE -,r'~: ' :' ''-' ','F" ' - -- '- "~:' '~" .... ~ '='
TO F! COMMLJNtT'¢ ~E!.IER LINE 'r,j 7~=~ FEET.
NELL L:3'5 RRE REQLJIF:E[) RN[?, MU:BT E,m RET tRNED TO THE [:,EF'RFITHENT I.,.~Z I HII,I 2E~ B, RVS
OF THE NELL COMF'LETION.
OTHEr: REQLI:EREMENT2; f"lFl~.' RF'F'L'¢. ~SF'EC:IFiC:RTIENS F!HE:, CONS'TRUCTICP.~ E:,IRGF:RM5 FIRE
RVRZLRBLE -FO IN_ URL F'F:OF'ER ZN%TRLLRTION.
! CEF. tTIF'¢ T'HRT
FL, rE, ET
FOF:'I"R B'T' THE MI...INIC:IP?L]:T"r' OF' RNC:HORRL:iE.
2: ! NILL~'TFILL T'R~= 5V-qTEM tN//RC:CF!RC, RNC:E I.'.IITH THE
RF'F'L'[ :R~'.I"F RF..'LEi"~ [:,. RILL
125 _c.; U E [: .......... D R T
DRrLL~NC & ENTEI~I~SEB
SI'lA Box 1560
Anchorage, AK 9950?
Phone 345.-4417
~.~/WATER WELL RECORD
STATE OF ALASKA
DEPARTMENT OF NATURAL RESOURES
Division of Geological 8~ Geophysical Surveys
Drilling Permit No.
LOCATION OF WELL (Please complele either lo, lb or lc.) A.D.L. No.
I~. Borough Subdivision Lot 8lock I~.I I/4qtrs. Section NO. Range Meridian
Township N [~
DtSTANCE ANO DIRECTION FROM ROAD ~NTERSECTIONS 3. OWNER OF WELL:
Address: 1 1 16 State St.
Street Address ..d Are. of WeH Loootion Anchorage,
Feel Below 4. WELL DEPTH; {flnol) 5. DATE OF COMPLETION
silty gravel ~eavy w/HZO 35 45 ~ Irrisetlon ~ Recherg.
gravel sandy w/H20 103 ~08 ,.~m,s. o~
I0. STATIC WATER LEVEL: ff.
~ Above or ~ eelo~ mend surfoce Dote
pump setting 70'
draw down 21' 8gpm
c
x~epartment of Environmental Quality
3330 "~.~Street, Anchorage, Alaska 99503 274-4561
.~/J ' %~y Date Received A~ril
of Inspection
27, 1976
Time
Date of Inspection
2:30 p.m.
4-28-76 Wednesday
Les
Approval requested by: Security Pacific Title
Mailing Address: 700 H Street
% Fay Kay
Phone: 277=2631
2. Property Owner: Toni Luz Brown Phone:
Mailing' Address:
3. Legal Description: Lot 10 & S½ of Lot 11 Block 2 Sunny Acres
4. Location: 1116 State Street
5. Type of facility to be inspected Fivelplex
No. of bedrooms 4 - lbedroom
6. Well Data:' Indiv~ual
A. Type
C. Construction
7. Sewage Disposal System: Public Utility
B. Depth
D. Bacterial Analysis
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
fPage 2 of two p~ges . Re ~.~t for Approval of Individual 5~.? & Water Facilities
Legal Description 'T,ot 10 & $½ Of ]Sot 11 Block
Comments
ApProved ~~_~/.~ Disapproved Date c~-f/'.7, --/~
Appr .q~.,.Valid for one year from date signed
Greater Anchorage Ar6a Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
certify that the information contained in this request for approval to be e true and
~ccurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED Date
EQ-034 (1/74)
~t~ilI J;i,~/' : '. -' .' .'Depa~craeni~ bt-,Envi~ohmen'~al Qual
· . ~.<.:.]-:"J;[J~:]~!~// "33.30 !*C" 'St, ~ Anchorage, A' a~ka 99503
REQUEST FOR
INDIVI:DUAL SEWER
APPROVAL OF
& WATER FACILITIES
Type' Of :(nspe. ction: CMRO ____ VA
FHA CONV
Hai'l i~]:t hthtress: ................................................ ~/_ Phone_ .........
Nam(~ of Buyer; ',4~L~-A,/ ~, ~-~A~ ,~,, ~z~
,, ~' ~/~I ~' ~'~ P ho~e~-~ ~__
Hailing Add~ess: ~ // ~ Phone -27~:.~,/
'4ailing Address: ~/6 ~_,. ~ <~ Phone
o
t,Ja/:n r Supply
'fy]e of Si pply~ ~ubli.c Ui;il~ity ..... Individual
If Individual~ number of dwellings presently served
Ii: Individual, depth of well
Sewage Disposal',Sysl;em
Type ,of Sysi;em: Public
Ut i 1 i ty
Individual (on-site)
If Individu~tl., date oi" installation
ADHW- LAB - 2w
~ .~ 4'
DATE COLLECTED /F ':Zp'- 2~ [I~E COLLECTED
D(" \RTMENT OF HEALTH AND-WELl' '~E
~ D V S ON OFiPUBLIC HEALTH
BACTERIOLOGICAL; WATER ANALYSIS
Well- ~ Dug E] Driven [] Drilled
SOURCE: [] Spring D Cistern D Other
Dug Well or Cislern Construction:
Walls - O Wood [] Concrem [~ Melal
Lob, No.
Yes E Nc,
When?
OFFICE
Records in this otfice [ndlca~e this WATER SUPPLY lo be of:
Analysis shows this Waler SAMPLE to be:
Sol~sfac~ory [] Questionable [] Unsalisfaclory
you Should take immediate action as recommended below.
/~,12/~/7~,~ .~ ,.- - 1. Noilly ........... ter is polluled. Boll or chemically
SANITARIAN'S REMARKS
D Of Well ~ Other
PURPOSE OF EXAMINATION: Illness SusDecled9 [] Yes [] No
$1gnature ....
READ INSTRUCTIONS
ON
REVERSE SIDE
BEFORE
COLLECTING SAMPLE
BACTERIOLOGICAL WATER ANALYSIS RECORD
Date Received I~ ~-"~ ~ ") ~ Time Received ..pm Lab No
Lactose Broth IOcc J 10cc lOcc 10cc 10cc I.Occ 0.1cc
I
24 hours
Brilliant Green
24 hours 'r
48 hours
AGAR
This analysis indicates Coliform Organisms to be:
'" 06-1'220[a) Rev. 1973
· ~, DATE
/
'ALAk.~ DEPARTMENT OF HEALTH'AND SOCIAL SEk~ES
DIVISION OF PUBL C HEALTH
INDIVIDUAL AND SEMI.PUBLIC
BACTERIOLOGICAL WATER ANALYSIS
INDIVIDUAL 'r~l SEMI-PUBLIC-{~ CHLORINE RESiDUAl. PPM
REPORT RESULTS TO
/ j ..... ~ C] , ?v t , ~'~,[~-'~., ZIP CODE
CITY r -
COMPLETE THIS SECTION
ONLY IF ,WATER IS AN INDIVIDUAL SUPPLY
Diameter of Well Depth Feet:
Lab No. ~
OFFICE
d Analysis snows this Water SAMPLE to be:
[] Satisfactory
[] UnsaHsfacfory
[] Questionable
[] Sample too long in transit; sample should not be over 48
h~>urs old at examinallon to indicate reliable results. Please
send new sample.
[] Bottle broken [n lranslt, please sene n~w sample.
SANITARIAN'S REMARKS
READ INSTRUCTIONS
ON
REVERSE SIDE
BEFORE
· .. ~- - COLLECTING SAMPLE
New' Source of Supply? [] Yes [] No Repairs to System? [] Yes [] No Signature
o61e2o ~bl BACTERIOLOGICAL WATER ANALYSIS RECORD
Lactose Broth 10ce 10ce 10cc 10cc 10cc 1.0cc 1.0c¢
EMB AGAR
Laclose Broth, 24 hrs. 48 ~rs Gram's stain
Col[fo~m Density (Most probable No. ~er i00cc)