HomeMy WebLinkAboutWALTER G PIPPEL Block 6 Lot 5
DAI:E RECEIVED
~ INSPECTION APPOINTMENTS
DAT~ ~ DATE DATE
MUNICIPALITY OF ANCHORAGE
825 L Street - Anchorage, Alaska 99501
ENVIRONMENTAL P~OTECTION
ENVIRONMENTAL SANITATION DIVISION
Telephone 264-4720 1 0 1979
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND
DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be proce~ed, Please allow ten (10) days for processing,
PROPERT~RESIDEN~ (If different from abov~ ~ PHONE
4. REAL/~AGENT '~~ PHONE
i
5. LEGAL DESCRIPTION~
STREET LOCATION
6. TYPE OF RESIDENCE
/ -- ~} NUMBER OF,BEDROOMS ~J
[] One [] Four [] Other
SINGLE FAMILY [] Two [] Five
MULTIPLE FAMILY [] Three [] Six
7. WATER SUPPLY
INDIVIDUAL*
[] COMMUNITY
[] PUBLIC UTI LITY
* ATTACH WELL LOG. A well log is required f~r all wells drilled
1975. For wells drill~'~"~ior to that da~J~give well
since
June
depth (attach log if available.)
8. SEWAGE DISPOSAL SYSTEM
[] INDIVIDUAL/ON-SITE**
PUBLIC UTILITY
-y
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
THIS SIDE FOR OFFICIAL USE ONLY /
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] SINGLE FAMILY BI ONE [] THREE [] FiVE E~ OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2. WATER SUPPLY
[] INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTILITY
Connection Verified LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
F~INDIVIDUAL/ON -SITE DATE INSTALLED
[]PUBLIC UTILITY
Connection Verified iNSTALLER
[~]Septic Tank or [] Holdin§ Tank
Size: If Tank is homemade SOILS RATING
[live 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
5. COMMENTS
FOR BEDROOMS
[] CONDITIONAL APPROVAL (letter must at, company certificate)
B~;~ISAPPR OV ED ///z/ ~
.
72-010 (Rev, 6/79)
A' G .HI~__~_-~J_ & G~OLOGICAL LABORATORIES OFAI2.SKA~ INC.
~ PARK BLVD.
P.O. BOX 4-1276 ANCHORAGE, ALASKA ggE0g 464B B~?ESS
Drinking Water Analysis Report for Total Coliform Bacteria
TELEPHONE
(907) 279-4014
TO BE COMPLETED BY WATER SUPPLIER
I.D. NO.
Public ~a;ter System Name ,
City State
Mo. Day Year
SAMPLE TYPE: ~
[] Routine
[] Check Sample (for routine samplE
with lab ref. no.
[] Special Purpose
NO. LOCATION
5 L
[] Treated Water
[] Untreaee Water
Zip Code
Time Collected
Collected By
~.BE COMPLETED BY LABORATORY
L!~BORATORY:
/c,
· /&
Date Received
-
Tih~e Received
A~alytica Method:
~.~ E Fermentation Tube
~ ~Membrane Filter
~ab Ref, No. Result* Analyst
READ INSTRUCTIONS
BEFORE
COLLECTING SAM PLE
Form No. 18-310 ($78!
0~-1220 (b) BACTERIOLOGICAL WATER ANALYSIS RECORD
Rev. 1978
,:Time: ' /" ~' ~ a.m.
December 11, 1979
Marianne Christian
% Realty Center
8301 Arctic Blvd.
Anchorage~ Alaska
99502
Su~.j'ect~ Lot 5, Block 6, %~';alter Go Pippel ~1
, Thomas/Irene Green
i}~) The water analysis rep~Lrt be delivered to this office
/ from Ch~a Lab, 5633 B Street, for our review.
(2) ,/Expose the well for our inspection to determ~:ae proper
.. / eonstruction~ also to insure the minimum distance
/'/ requirenlents are met bet%~een your well and set..~er system.
P'l~ase notify this department for a re-inspection when the:
nQ'~ted descrep.~iey has b~en corrected. If there are ~.ny
· further questions~ please contact this office at 264-4720.
S ink,rely
?
Robert C. Pratt,
Associate Specialist
nCP/kas
ccF Alaska State Bank % Donna Crystal
318 E. Northern Lights
99503
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3500 Tudor Road· Anchorage, Alaska 99507 279-8686
Date Received August 27, 1973
Time of Insgection
Date of Inspection
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
CMRO
1. Anproval Requested By: R, J, Harps ,
Aadress~ BOX 451, E~qle River AK 99577
2. Pronertv O~ner: SAME
3, Legal Description: Lot 5. Block 6~ P~pp]e Subdivision
4, Location:
5. Type of Facility to be Inapected:S~lfl_~~liBg
Number of 9edrooms: Three (3~
6. Well Data:
A, Tyne Drilled B. Depth
C. Conatructlon D. Bacteria] Analysis
7. Sewage Disgosal.System:
Installed P blic S- ~
A. B, Installer
C. SeptiC Tank: 1. Size 2. Manufacturer
D. Seepage Pit: 1. Size , 2, Material ,
q. Disposal Field: Total Length of Lines
Distances:
A, ~el] To:
Septic Tank _
· Nearest Lot Line
Foundation to Septic Tank
2:00 p.m.
August 27, 1973
Phone: 694-2290
Phonet
Absorption Area
· Other Contamination
"~ Absorption Area
Absorotion Area to Nearest Lot Line
Satisfactory 8-29-73
· Sewer Lines
~_ _,.~.q~st for Approval o~ l~vlouai aewer ~--'Pa~e Two
9. mCommentS: . Lot 6, B]~ck 5~ PJpp]e
Ao~rov~ , Disapproved
Approval Valid for One Year From Date Signed
Greater Anchorage Area Borough, Department of Environmental Quality
D~AGRAM Of SYSTEM
t certify that the information contained in this request for approval to be a true
and accurate representation of the subject sewer and water fac~}.tties located at:
Siqned Date