HomeMy WebLinkAboutUPPER EAGLE RIVER ESTATES BLK 2 LT 1
TO=: ~'"' ~ R
' Florence M
Fif. t~h Floor Fourth Floor
ESsAGE
This has been canceled by the bank and prop. e~~y
owner.
refinance and they do not need the inspections.
Pleaee make the necessary arrangements for a refund.
Thank you. ~
SIGNE[
REPLy
Receipt ~53751
Carolyn J. Brown
1801 West 48th Avenue
99503
Redif,~'m® 4S 471
SIGNED =
SEND PARTS 1 AND 3 WITH CARBON INTACT -
PART 3 WILL SE RETURNED WITH REPLY.
It is a
DATE
August 4~ 1979
Charles
1~01 west 4~th Av%~nue
.~chora%~e, Alaska 99.~u3
Subject: t~)t 1 Block 2 Upper Eagle River I~stateS Subdivision
~.e s~ptic ~ ~k on the s%~b~ct lot is too clos~ to the existing
~11. It will need to be r~loca~ed fifty(50) f~et away from
~]e ~el!. A 1,250 gallon, two(2) compartment tank must be
~ adequacy test must be ~rfor~%ed by one of %he folloi~,ing
If there ara any qllestions, please contact thi~ office
at ~64-4720.
Sincerely~
San~arian
RCP/tJ~
~zzs~ Natzonal Ban~ of Anchorage
~outhcent~r Branch
Post Office E~): 4-2090 99.,,09
Da~e
ALASE
EPARTMENT OF HEALTH AND SOCIAL S' qCES
DIVISION OF PUBLIC HEALTH
Lab. No.
BACTERIOLOGICAL WATER ANALYSIS
Office
PLEASE MAIL RESULTS TO:
NAME
ADDRESS_
ZIP CODE
Sample collected by
Phone No.
Date Collected
Sampling Address
//
Specific place of collection
REASON FOR SAMPLE SUBMISSION:
[] lllness suspected
[] Health Regulated Establishment
[] Other ·
WATER SAMPLE SOURCE
[] Welt Type of casing
[] Improved (Enclosed, Covered) Spring
3 Surface (Reservoir, stream, lake)
[] Holding Tank
[] Other
Analysis shows this WATER SAMPLE to be:
[] Satisfactory
[] Unsatisfactory
[] Questionable [] submit other sample
[] Sample too long in transit to indicate reliable results.
Sample should not be over 48 hours old at time of
examination.
Bottle broken or leaked in transit.
[] Other
SANITARIAN'S REMARKS
8anitadan's Signature:
~,EAD INSTRUCTIONS
3EFORE
COLLECTING SAMPLE
06-1220 (b) BACTERIOLOGICAL WATER ANALYSIS RECORD
Rev. 1978
Date Received ~0 ~ ,/ -/ Time Received / ,.P'n~'PLab'_. NO,
Presumptive 10mi 10mi 10mi 10mi 10mi 1,0mi 0,1mi
Confirmatory
Broth 24 hours· Broth 48 hours:
()/ lOml Tubes Positive/Total lOml Portions
BGB
Date
REQUEST FOR APPROVAL
DIRECTIONS: Complete all parts on page 1.
ADDRESS
1 o/
PROPERTY RESIDENT (If different
BUYER
MAILING A[
?
MAILING A[
MAILING
I I,
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
825 L Street - Anchorage, Alaska 99501
ENVIRONMENTAL ENGINEERING DIVISION
Telephone 264-4720
IAL WATER AND SEWER FACILITIES
Please allow ten (10) days for processing.
PHONE
PHONE
t PHONE
5. LEGAL DESCRIPTION
TREET LOCATION
6, TYPE OF RESIDENCE
SINGLE FAMILY
[] MULTIPLE FAMILY
'
[] Other
Five
Six
7. WATER ~S/UPPLY
[~ INDIVIDUAL*
[] COMMUNITY since June 1975. Fe
[] PUBLIC UTI LITY depth (attach log able.)
8, SEWAGE DISPOSAL SYSTEM
I~ INDiVIDUAL/ON-SITE** **~f individual/on-site, give installation date -/~,f~-./~ ~.
If system is over two (2) years old an adequacy test is required
[] PUBLIC UTI LITY by this Department.
Jired for all wells drilled
r to that date, give well
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. '~
72-010(3/78) ...
THIS SIDE FOR OFFICIAL USE ONLY "'
DATE RECEIVED
INSPECTION APPOINTMENTS
TIME TIME TIME
DATE DATE DATE
INSPECTOR INSPECTOR INSPECTOR
DIRECTIONS:
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2. WATER SUPPLY
[] INDIVIDUAL ~ DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBL. IC UTILITY
Connection Verified __ LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[]INDIVIDUAL/ON -SITE DATE INSTALLED
[]PUBLIC UTILITY
Connection Verified INSTALLER
E]SepticTankor []HoldingTank
Size: If Tank is homemade SOILS RATING
give dimensions:
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
4. DISTANCESwELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line
Absorption Area to nearest Lot Line
S. COMMENTS
[] APPROVED FOR BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
[] DISAPPROVED
DATE BY (Title)
LEGAL DESCRIPTION
72-010 (Rev. 3/78)