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Home My WebLink AboutSUNNY ACRES #1 BLK 2 LT 1 P. O. ~ox 5-26a ~t, V~e~ Alaska have ~e~etvad Se~e~aL co~plalnta oi the dumpla~ o[ garbage on the lot at Zhe ~e~by deela~d a nulamiea, RECEIPT FOR CERTIFIED MAIL--20¢ SENT TO 14r. Tom Sun P. O. Box 5-283 Mt. View~ Alaska dehv~red del~eredl [~ 50~ fee (Fill out in T~iplicate) NaMe .of person requesting approval ~a~.' of property: owner ~= Q REQUEBT FOR APPROVAL OF I~D~VIDUAL SEWAGE AND WATER FAC!LI~f~S 3. [.~ya]. description 5. Watez<. ~.nalysis: a. Bacte~q.s 1 b. Deter~ent 6~ We] ] data: a# Casing Size Distance from well to closest existinf or proposed: t. Sewer line 2. Septic tank / ~/~ ~ Cesspool~., , 5. Property Line 6. Other sources of possible contamination, i.e., creeks, lakes, houses, barn, drainage ditch, etc. Sewage disposal system. b. Septic tank capacity zn gallons 8 j fY ~ Name of septic tank manufactu~9~ 1. If "home made" show diagram on reverse ~side of this form. Disposal field or seepage pit size and type 1, Distance to prope~y. ~ne to house fo~dation e. Percokatlor~ Test 'resuLts .. f. Percolation Test performed by ........ "~. Use the reverse .side of this form to show diafram. Diagra~ should include -~.~he following information: ~operty lines ~ .well location, house location, v~ptie tank location, disposal area location, location of percolation test, ~{~ direction of ground slope. 9. The h~fo~.~t~on Dn this form is true and correct to the best of my knowledge. 'Signature of Applicant Date Signed TO B, E FILLED OUT BY HEALTH DEPART~,~ENT PEP, SONNEL ~--]'~e above escrxbed sanitarY facil~tzes are hereby approved, subject to the _~ol!ow~n~ cond~0ns: Conditions: The above described sanitary facilities are disapproved for the following Date '-,' . ~, .'~ ¢.j. "-Approval is valid for one year following the date of approval. . - CPJ: cw AOHW - LAB - 2W ['--'~ARTMENT OF HEALTH AND WE' \RE Lob, ~ DIVISION OF PUBLIC HEALTH ~ DATE BACTERIOLOGICAL WATER ANALYSIS OFFICE REPORT RESULTS TO' SAMPLE COLLECTED BY ' ~r'r' Well [] Dug ~ Driven [] Drilled 0 Bored SOURCE: [] Spring [] C,slern 00lher Walls - [] WoocJ 0 Concrete ~ Metal [~ Tile D Concrete ~ In Yard 0 Other When? Diameter o~ Well Depth Fe Well Casing Records in Ibis office indicate this WATER SUPPLY to be of: 'Safislaclory [] Questionable ~1 Unsatisfactory Sanitary Status. Analysis shows this Water SAMPLE to be: SaBdaclory 0 Questionable [] Unsatisfaclory, READ INSTRUCTIONS ON REVERSE SIDE BEFORE COLLECTING SAMPLE If an "Unsatislaclory" or "Questionable" stalus is indicated above you should to~e 1mmediale acBon as recommended below I. Notify consumers water is polluted. Ball or chemically ~reat this waler o~ outlined in the enclosed leaflel "Drink II Pure." 2. Increase chlorinallon sufficiently tc meet recommended residual standards. Determine source of conlaminaBon and fake action necessary Io maintain a sale water supply at all limes 3. Check chlori~afinn and other mechanical equipmenl. Make certain i~ is funcBoning arooerly. 4..f abel checking equmment a disinfecting residual is not oblalned, alease wire Ibis office for emergency assistance or advisory services, 5. This is o surlace water source and subjecl to pollulion by man and animals. An approved waler supply source should be developed. 6. Improve your [] spring [] dug well [] driven well 0 drilled well [] cistern. 7. Relacale your well ~oa safe location n relationship to your sewage disposal syslem. [] see enclosure 8. Sample leo long in lranslt; samole should nm ae over 48 hours old'at examJnaBon to indicate reliable results, n~ease send new sample. [] Bottle Broken ia transit, zdease send new sample. 9. Conlac~ your nearesl [] Local Heallh Deoarlment or ~ Alaska Division of Public Health, sanitation offlce for bulletins, consultaflon and assistance. SANITARIAN'S REMARKS Signalure BACTERIOLOGICAL WATER ANALYSIS RECORD Laclose Brolh 10cc 10cc 10cc 10cc. '~ 10cc t 0cc 0,1cc · 24 hours ·I 48 hours ...... Brilliant Green 24 hours · ' 48 hours EMff AGAR Lactose Broth, 24 hrs. · dB hrs.- Gram's slain Coliform Density· {Most probable No aer 100cc MF results am Dm Repelled by Date Yhis analysis indicates Colilorm Organisms Io be Absent _ Presenl DIRECTIONS FOR COLLECTING SAMPLES OF WATER FOR BACTERIOLOGICAL EXAMINATIOiX! Read Carefully and Follow Instructions Exactly Bear in iT~ind that water analysis deals wilh materials presenl in very minute quantities. The least carelessness in collecting and handling may give rise to resulls which ore misleading. Arrangemenls should be mode 1o have waler samples reach the laboralory os quickly as possible. After 48 hours Ih~ significance of the bacleriologlcal analysis is impaired. For obvious reasons lhe laboralory prefers 1o receive samples ir, the early peri of lhe week bul is willing Io accept samples al any lime. In collecling samples from TAPS or PUMPS proceed as follows: (a) Thorougfdy flush lap or pump by allowing water to run freely for five minutes. (b) Shut off water and flame the oullet with larch or burning paper. The flame should not be melely pc~ssed over tile outlel but should be applied until fixture shows indicalion et being hal. Flame should be direcled againsl inside edge. (c) Open fixture so Ihat a small stream flaws. (d) Remove bollle from mailing tube. tlold baltic by Ibe lower half in one hand and with lhe other remove Ihe screw cap wilh lhe fingers, leaving paper prolecling cover in place. Fill the bollle 1o the shoulder. Replace cap wilh paper cover, screwing firmly into place bul do not apply pressure which will split cap. (e) Pack bottle carefully in mailing lube enclosing fi]is completed inlormalion sheel. In collecling samples from STREAMS and RESERVOIRS proceed as follows: (a) Remove cap and hold baltic as described under (d) above. (b) Collecl sample by holding baltic in a slanting posilion and sweeping it below the surface in such a manner that waler lhal has been h~ contacl with lhe band Js hal introduced into the bollle. Avoid collecting surface scum and bollom sediment. DO NOT COLLECT SAMPLES FROM FIRE HYDRANTS, YARD HYDRANTS, DRINKING FOUNTAINS OR SIMI- LAR OUTLETS WHICH ARE DIFFICULT TO DISINFECT PROPERLY. STERILE WATER SAMPLE BOTTLES ARE AVAILABLE UPON REQUEST FROM: Dept. of Healfl~ & Welfare Dept. of Health & Welfare 5OUYHCENTRAL REGIONAL LABORATORY 527 EAS? 4lb AVENUE ANCHORAGE, ALASKA 99501 Dept. of Health & Welfare "i~ ~9° 57 ~ I ZO.O0 EAf~"F ~4~-h COU~T : o,4oo EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT, ARE NOT SHOWN HEREON. '50'. PROPOSED CONSTRUCTION PLAN I hereby certify that I have su~eyed the folloWing des~bed property:_ L01~ 1, EbLOCE ~U.~,,d V AC~E5 :NO, Anchorage Recording Precinct, A~aska, and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on. prop- erty lying adjacent thereto encroach on the prermses Ln ques[ion and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska HEWI'i~ V. LOUNS~URY & ASSOCIATES Engineers, Surveyors & Planners FIELD BOOK No....~..~-:~O~- 7-- L 0 T Z I ~. 84/b ~Ob',qT & uaES ~o ~ NO~ OV~RCAP OR LYING ADdACENT THERETO, ~T