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Home My WebLink AboutWALTER G PIPPEL ADDITION BLK 6 LT 9 '~' L'I~ -~' ~ ~,v, ~ '/~"UY ~""~ 0 DAT~ RECEIVED " INSPECTOR ~ INSPi. OR / INSPECTOR .~ ~ ~ ~ ~UNICIPALITY OF ANCHORAGE ENVIRONMENTAL F;,OTECTION ~ (] ~ ~ ~ ~f 82~LStreet-Anchorage, Alaska99~01 ,..~, ~ ~// ~'-~ ENVl RONMENTAL SANITATION DIVISION ~ ~ Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES MAILINGADdR~SS ~/ j~ . 5, LEGAL DESCRIPTIO STREE~ LOCATION 6. TYPE OF RESIDENCE NUMBER OF~BEDROOMS [] One [] Four ~"' SINGLE FAMILY [] Two [] Five [] MULTIPLE FAMILY ~ Three [] Six [] Other 7. WATER SUPPLY ~" INDIVIDUAL* *ATTACH WELL LOG. A well log is required for all wells drilled [] COMMUNITY since June 1975. For wells drilled prior to that date, give well [] PUBLIC UTI LITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM [] INDIVIDUAL/ON-SITE** YEAR ON-SITE SYSTEM WAS INSTALLED. J~ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(Rev. 6/79) ~/~ ~L~3 -- )--,~_~ . THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBBR 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 [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] INDIVIDUAL/ON -SITE DATE iNSTALLED []PUBLIC UTILITY Connection Verified INSTALLER []Septic Tank or [] Holding Tank Size: If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4, DISTANCESwELLTO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5, COMMENTS [~ APPROVED FOR _~ BEDROOr~5 [~-~'~ONDIT[ONAL APPROVAL (letter must ~.¢/comJ~any certificate) 72-010 (Rev. 6/79) CHEMICAL & Gi~.~OGICAL LABORATORIES ~ ALASKA, INC. TELEPHONE {9071-279-4014 ANCHORAGE INDUSTRIAL CENTER 274-3364 5633 B Street Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER WATER SYSTEM: Water System Name I.D. NO. ':.,~,.~- ~ .,~, ~?~/~.,~ ~'~ .~ /J~ Phone No. Mailing Address City State Mo. Day Year Zip Code SAMPLE TYPE: [] Routine [] Check Sample (for routine sample with lab ref. no. ) [] Special Purpose [] Treated Water [] Untreated Water SAMPLE NO. t I 4 I I LOCATION I' Time Collected Collected By TO BE COMPLETED BY LABORATORY A~alysm snows this Water SAMPLE to be: ~/Satisfactorv [] Unsatisfactory [] Samr)le too long n transit; sample should eot be over 48 hours old at examinauon to indicate reliable results Please send ne~v sample Date Received Time Received Analytical Method: [] Fermentation Tube [] Membrane Filter Lab Ref. No. Result* Analyst I ','/r~?!'-,.,,uI ~ · I I I-[-1 READ INSTRUCTIONS BEFORE COLLECTING SAMPLE 06-1220 (b) Rev. 1978 BACTERIOLOGICAL WATER ANALYSIS RECORD Presumptive 1Omi /Omi 1Omi 1Omi 1Omi 1.0mi O.lml 24 HOURS 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 264-4111 GEORGE M, SULLIVAN, MAYOR DEPARTMENTOF HEAt. TH AND ENVIRONMENTAL PROTECTION July 16, 1980 Gary D. Ferguson % Jane H. Melarvie Century 21/John De Bene and Company 4791 Business Park Boulevard #3 Anchorage, Alaska 99503 Subject: Lot 9 Block 6 Walter G. Pippel Subdivision The well casing needs to be extended twelve(12) inches above ground level and sealed with a sanitary seal so that it is water tight. The ground surrounding the well casing needs to be filled in so that it slopes away from the well casing. If there are any further questions, please call this department at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw cc: Coast Mortgage Company 4797 Business Park Boulevard 99503 825 "L" STREET ANCHORAGE, ALASKA 99501 (907} 264-4111 GEORG~ M. SULt. IVAN, [)[PA[qTMEN¥OF HEAl TH AND ENVIRONMENTAL PROrECTION June 18, 1980 Gary D. Ferguson % Jane It. Melarvie Century 21/John De Bene and Company 4791 Business Park Boulevard #3 Anchorage, Alaska 99503 Subject: Lot 9 Block 6 Walter G. Pippel Subdivision Approval for the individual sewer and water facilities can not be granted until the following items have been completed: (1) The water analysis report be delivered to this ~:~L, department from Chem Lab, 5633 B Street, for our review. Exposeor locate the well for our inspection to determine proper construction. Please call this office for a re-inspection when this is completed. If there are any further questions, please call this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw CC: 4797 Business Coast Mortgage Company Park Boulevard 99503 FHA Form 2573 ~r~/' FEDERAL HOUSING ADMINISTRATION ~"~ ~J' ,%rrn Approved Rev. July 1958 Budget Buceau No. 63-R296.8 HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM PART I.--TO BE COMPLETED BY FHA INSURING OFFICE J ,~ ORTGAGEE SERIAL NO. Anchoraffe Alimlm at;ional of Alaeka An°borage 60, )O7 8 MORTGAGOR OR SPONSOR PROPERTY ADDRESS Ja~ee C, ~ppeX ~l!le ~ PaXme~ Jtight~tR /t~0h0~,a~e~ .~leEa SUBDIVISION NAME BLOC~)NO. LOT NO. ~. G, l~ppel SubdtFle~on 9 TOTAL NUMBER: X BASEMENT [] New installation [~] Yes ~-]No additional bedrooms? (If Yes, how many~) SYSTEM DESIGNED FOR WATER SUPPLY BY: [] Individual J~ Public system [] Cormnunity system NO. OF SD..~$. GAgeAGE OlSPOSAt SEWAGE DISPOSAL BY: [] Public system [] Community system [] Individual [] ?es [] No PART II.--TO BE COMPLETED BY HEALTH DEPARTMENT H.,L?LTH DEPARTMENT INSPECTOR'S SKETCH / ~ It is the opinion of the [~ State [] County [] Local Department of Health that this individual water-supply system [] is [] is not satisfactory as a domestic water supply for the subject property. It is the opinion of the .~. State tern with proper maintenance: ~Can be expected to function satisfactorily, and is not likely to create an insanitary condition ]County [] Local Department of Health that this individual sewage-disposal sys- -]Cannot be expected to function satisfactorily NOTE: The health authority should complete the appropriate opinion statement above and affix date, signature and title tn tho spaces provided. Use of the above grid for Health Department Inspector's sketch as well as use of the back of this form is at the option of the health authority. PART Ill.--FOR USE OF FHA OFFICE TO THE CHIEF UNDERWRITER: I have reviewed the foregoing and the pertinent FHA Compliance Inspection Report, and recommend that 'the Individual water-supply system be considered [] Acceptable [] Not Acceptable Sewage disposal be considered [] Acceptable [] Not Acceptable. DATE SIGNATURE HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM REPORT OF INSPECTION~INDIVIDUAL SEWAGE-DISPOSAL SYSTEM PRIMARY TREATMENT consists of.[~ Septic tank. [] Cesspool. Septic Tank~ Distance from well, ' ' feet. Material, ,./ ,~ , ' //,, ' :' ' gallons. Capacity inlet compartment, .feet, Inside width, feet, Liquid depth, Total liquid capacity, Inside length, C®sspooh Distance from: Well, Inside diameter, / Number of compartments / gallons. feet, feet; foundation, feet; nearest lot line at [] front, [] side, [] rear, .feet. feet. Depth, .feet. Liquid capacity, gallons. Lining material $[¢ONDARY IR[AIM[Ihll consists of ~ Tile disposal field. ~ Seepage pits. Other Trio Disposal Field: Dis~nce from: Well,. feet; foundation, feet; newest lot line at ~ front, ~ side, ~ rear, f~t, Total length of tile lines feet. Number of lines, Distance between lines, .feet. Trench width, inches. Total effective absorption area in bottom of trenches, .square feet. ~ngth of each line, .feet. Depth, top of tile to finish grade, inches. Ty~ of filter material: ~ Gravel. ~ Broken stone. Other. Depth of filter material ~neatb tile,v inches. Depth of filter material over tile,, inches. Numar of pits J Outsid~ .diameter, (' ~ J(~ feet. Depth,. r'~ feet. Lining material ,r// "~ ~,'r' ~':~ r ' '~ ' '2''" / Distance from: Well, ,/'-' ':¢ feet; building foundation, ~5~ ~'J feet; nearest lot line at ~ front, ;~ stde( ~rear, / . REPORT OF INSPECTION--INDIVIDUAL WATER-sUPPLY SYSTEM Distance to nearest public water main, -~--' feet. Size of main, inches. Individual wells .[~ are [] are not customary in neighborhood. Give most recent record of fadure of wells m ~mmedlate wcmlty to furmsh adequate supply of water ,,.. t .... . . ,,,~ ..,, .... /,, ~ . Properties in neighborhood e~ are [] are riot being developed with both individual water-supply and sewage-disposal/, systems. ,/ t'; /.7 feet wi~e, //,' ,,i,: feet deep. Dwelling set back from front property line, jT~'~r .';' feet. Lot Individual water supply from: [~J Drilled well. [] Driven well. [] Dug well, [] Bored well. t Distance of well from~ Building foundation, ~) cast iron sewer,. . ) t · feet; tile sewer, seepage pit, ! feet; cesspool, feet; nearest lot line at [] front, ~]'side, [] rear, '=,~ !"// ?:'~'/ 'feet; septic tank. /'% 5/'::7-'feet; disposal feet; other sources of possible pollunon, /~3,'~.~ ,;.,/, C.), feet. feet, -feet; Diameter, (iI.~ roches. Total depth, ,; ~ feet. Type of casing, ' ' :2:._ , Depth of casing, (' '5' feet. Approximate depth to pumping level of water in well,~-feet. Approxim/ate yield, / gallons per minute, Sealed watertight to 4~pth of ~ '? feet. Exterior space around casing sealed with: [] Cement grout. [] Puddled clay. r[~Ordinary backfill. Well cover: [] Concrete. [] Wood. ]~ Metal. Openings in well cover watertight: ~Yes. [] No.. Pump: [] Shallow well. J~ Deep well. Length of drop pipe, ?' (7 .feet. Pump capacity ~ "t "'-' 3~fi ~ons/~e'f 6, rote Located m: ~ Basemeht. [] pumproom off basement. [] pumphouse above ground. [~/Pump p~t. pumproom properly drained: [] Yes. [] No. Pump mounting watertight: [5~] Yes. [] No. ,, . ,/. ?, Type of storage:,~]~ Pressure. [] Gravity. Capacity, gallons. Has bacteriological examination of water been made? ~ Yes. [] No. If answer is "yes," give date Quality of water [] is [] is not satisfactory for human consumption, . lnstallatlon.J~] does [] does not comply with approved exhibits, if any. Inspection made by:/[]xState. [] County. [] Local Health Authority. Date of inspection nvDrvmuAn WATEe S r LY ALASKA DEpARTMENT OF HEALTH Section of Sanitation and Engineering ACTION ON REQUEST FOR BACTERIOLOGICAL WATER ANALYSIS Lab. mo. 18217 Southcentral Regional Your recent request for an analysis of a sample from the Individual P~ivate Water Supply serving ~Ot 9, Block 6, was ~. G. Pippel Subd. ,Palmer H~y. received lU/]-~/~ and ex~ation has been complete~. ~r. James C~ Pippel Star Route Anchorage, Ala~ca Records in this office indicate this Individual P~vate Water Supply to be of Salisfactozy__i~uestionable Unsatisfactory sanitary status. / - Analysis shows tkls SAMPLE to be 1/ ,Satisfactory, Question~le. .Unsatisincto~y. I~ an "Unsaflsfactor~" or "~uestionable' status ~ ~dicated ~ove, you should take Jmmedinte action as recommended below. I. Boil or chemically treat YOUr water supply to protect your fam~y from wate~-bo~ne diseases as ou~ined ~ en- closed leaflet, "Dr~k It Pure." 2. Improve your sprig -- See bulletin HSE-6-2 3, Improve your cistern ~ See buHe~ HSE-6-3 4. Impiove your dug well~ See bulletin HSE-6-4 5. Improve your driven well ~ See buHel~ HSE-6-5 · 6. ~prove your drilled well ~ See buHe~ HSE-6-6 7. Relocate your well to a safe location ~ =elaflonship in your sewage dhposal system ~ See bullelin HSE-15 8. Bottle broken ~ tr~sit, please send new s~ple.. 9. S~ple too long in Ir~sltl s~ple should not be ovel 48 hours old at examin~ion to Indicate reli~le ~esults. Please send new sample. 10. Contact your nearest ~ Loc~ Heal~ Deponent or ~ Alaska Health Depar~ent, S~itatlon~ office fo~ bullet~s, consultation, ~d assist~ce. 1 !- Tkis is a surtace water source ~d subi~ct to poHution by m~ ~d an~s. An ~proved water supply source 10-55 - SM INDIVIDUAL WATER. SUPPLY ALASKA DEPARTMENT OF HEALTH ACTION ON REQUEST FOB BACTERIOLOGICAL WATER ANALYSIS OFFICE from the Individual Pxlvate Water Supply received and examination bas been completed, A~e~ ~& Records in this office indicate this Indlvidual, j~ivatu Water Supply to be o! Satisfactory Questionable Unsatisfactory sanitary status. Analysis shows this SAMPLE to be ~ Satisfactory Questionable. Unsatisfactory. II an "Unsatisfactory" or "Questionable" status is indicated above, you should take immediate action as recommended below. 1. Boil or chemically treat your water supply to protect your family from water-borne diseases as outlined in en- closed leaflet, "Drink It Pure." 2. Improve your spring -- See bulletin HSE-6-2 3. Improve your cistern -- See bulleBn HSE-8-3 4. Improve your dug well- See bulletin HSH-6-4 5. Improve your driven well -- See bulletin HSE-6-5 6. Improve your drilled well- See bulletin HSE-6-6 7. Relocate your well to a safe location in relationship to your sewage disposal system-- See bulletin HSE-15 8. Bottle broken in transit, please send new sample. 9. Sample too long in translt~ sample should not be over 48 houzs old at examination to indicate reliable results. Please send new sample. 10. Contact your nearest [] Local Health Department oK [] Alaska Health Department, Sanitation office for bulletins, consultation, and assistance. 11. This i~. q s/,u~face wa~r source~ and subject to pollution by man and anim,~ts. An approved water supply source shoal 'dev · ' ' -~/ SANITARIAN S REMARI~c'---' . LOot Completely. · Section of Sanitatio~ and ~,n~ineering Please LOOk on Reverse o! Sheet for Sample Collection Instructions. ~).. Reauest for Bacteriological Analys~s _~_~,c~J. ~ ~ ~ I~b. No .......................................... ~. Water sa p Y ........ "~me ~-~erson collecting~ie) (Date) (Time) Water sampte collected from ~ Kl~hen tap; ~ Bathroom tap; ~ Basement tap; ' ~ Other (l~t) ................... u":r'""~'"""':' ................... ~ ........ 'Px'T'""~'""e ........ ~'"-'~:7~'"7~ .... , ~ .... ......................... ........... U Please place an "X" tn ~e box before items which b~t describe your water supply: SO,CE: Well ~ ~ Dug, ~ Driven, ~ Drilled, ~ Bored [~ Spring, ~ Cistern, ~ Other (list) ..................................... ~ ......................................................................... ~ Creek, ~ River, ~ Lake, ~ Pond ................................................................................................................. DUG ~LL OR CISTERN CONS~UCTION: Walls ~ ~ Wood, ~ Concrete, ~ ~tal, ~ ~le, ~ Brick or Concrete Block Top ~ ~ Wood, ~ Concrete, ~ Metal, ~ Open Top LOCA~ON: ~ In basement, ~ Basement offset, ~ Under ~o~e, ~ In yard Other .................................................................................................................................................................................... DIST~CE TO: Building sewer or other drainage pipe...~.~feet, Septic ~nk ._.~..fe~t, Tile field .............. feet, Seepage pl~ .............. feet, Cesspool ~.~.~. feet, Pri~ .............. feet. Other p~sible sources of contamination (l~t) ............................................................................................................................................. ~TER~:Building sewer ~ ~ Cast ~on, ~ Wood, ~ T~e, ~ ~bre pipe, ~ Asbestos cement ~oint material ~ ~pe......~/~ ..................................................................................................................................... GE~R~ INFOR~ON: Does water become muddy or discolored? ~ yes, ~ no ~en? ............................................... ~2- ................................................................ .~ ................................ Diameter of well .......................-~'~'~ .................. depth .............).~ ......... _~ ............................. feet Well casing material ............. ~ .............. diameter ..........~. ......depth ............ ~......:~... Length of drop pipe ............. ~ ...................... -~ ..................................................................................... Water depth from bot~m ................... ~.~ ................................................................................. feet Pump location: ~ ~ well, ~j Offset in basement, ~ In basement ~ ~ utility r~m, ~ On top of well ~ Other (l~t) ........................................................................................................ Do you s~pect illne~ from th~ supply? ~ yes. ~ no ~.~em~rks: ......................................................................................................................................................................................................... ~LEASE DRA~ A S~TCH ~ ~ SPACE BELOW. THIS SK~CH SHOED SHOW ~CATION OF HOUSE. WAT~ S~PLY SOURCE. s~PTIC TA~, SE~R, DRAIN LI~S OR O~R SOURCES OF PO~U~ON ~D DIST~CES - ~E'~V~N WAT~ SUPPLY SO,CE AND ~ OF ~0~ FAC~.Vt'l~. '-- sAMPI~ES MUST BE SUBMITTED IN CONTAINERS ]PROVIDED BY THE ALASKA DEPARTMENT OF HEALTH DIRECTIONS FOR COLLECTING SAMPLES OF WATER FOR BACTERIOLOGICAL EXAMINATION Read Carefully and Fo~ow Instructions Exactly DO NOT COl'.r.W~T SAMPLES FROM FIRE HYDRANTS, YARD HYDRANTS, DRINKING FOUNTAINS OR SIMILAP~ OUTLETS WHICH ARE DIFFICULT TO D I S I N F E C T PROPERLY Bear in mind that water analysis deals with materials present in very minute quantities. The least carelessness in collecting and handling may give rise to results which are misleading. Arrangements should be made to have water samples reach the laboratory as quickly as possible. After 48 hours .the significance of the bacteriological analysis is impaired. For obvious reasons the laboratory prefers to receive samples in the early part of the week, but is willing to accept samples ac any time. In collecting samples from TAPS or PUMPS proceed as follows: (a) Thoroughly flush tap or pump by allowing water to run freely for five minutes. (b) Shut off water and flame the outlet with torch or burning paper. The flame should not be merely passed oyer the outlet, but should be applied until fixture shows indication of b'eing hot. Flame should be directed against inside edge. (c) Open fixture so that a small stream flows. (d) Remove bottle from mailing tube. Hold bottle by the lower half in one hand and with the other remove the screw cap with the fingers, leaving paper protecting cover in place. Fill the bottle to the shoulder. Replace cap with paper cover, screwing firmly into place but do not apply pressure which will split cap. (e) Pack bottle carefully in mailing tube enclosing this completed information sheet, being sure that a simple sketch is included. In collecting samples from STREAMS and RESERVOIRS proceed as follows: (a) P~emove cap and hold bottle as described under (d) above. (b) Collect sample by holding bottle in a slanting position and sweeping it below the surface in such a manner that water that has been in contact with the hand is not introduced into the bottle. Avoid collecting surface scum end bottom ~ediment. SAMI'LES MUST BE SUBMITTED IN CONTAINERS PROVIDED BY THE ALASKA DEPARTMENT OF IIF, AJL~t CUSTOMER'S ~RDER NO. 5S33 KEEp THiS SLIP FOR REFERENCE