HomeMy WebLinkAboutWENTWORTH BLK 3 LT 190o8'o
Tir~ Time ~ .~!me
Date Date Date
Inspector inspector Inspector,,_..,
Oomments Oonditional Approval
Date Sswer Installed \.~ Permit No. Septic Tank Size
Holding Tank Size
Soils Rsting Well To Absorption Area Well Log Received
Well to Tank
APPLICAN? FILLS OUT LOWER HALF ONlY
Property Owner /'Z.j~-c~ /-~ ~ c~. "~ Phone
Street Location .~.~/ ~.~ ~.~l
Type. of.Residence
~'Single Family
[] Multiple Family No. of Bedrooms .
[] Other
Water Supply
I~'l'ndividual ATTACH WELL LOG. A well Icg is required for all wells drilled since June
[] Community 1975. For wells drilled prior to that date, give well depth (attach Icg if
[] Public Utility available.)
Sewage Disposal
~pudiVidual Year Individual Installed:
blic Utility When Connected to Public Utility:
[] Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSINS CAN BE INITIATED,
?/2
January 11, 1982
Ray Lee
3115 Sheldon Jackson
Anchorage, AK
Subject: Lot 19, Block 3,
Wentworth S/D
Dear Mr. Lee:
Approval for the individual sewer and water facilities cannot
be granted until the following items have been completed:
~'~he water analysis report needs to be submitted to this
office from the Chem Lab, 5633 B Street, for our review.
Expose the well for our inspection to determine proper
construction, also to insure minimum distance requirements
are met between the well and. sewer system.
Please notify this department for a reinspection when the
noted digcrepancies have been corrected. If there are any
· further questions, please call this office at 264-4720.
Sincerely,
Robert C. Pratt
Associate Environmental Specialist
· · ;?-'-CHE~MICAL & G~.~LOGICAL LABORATORIES~..~: ALASKA, INC.~L
j~ ! TELEPHONE 907 -279-4014 ANCHORAGE INDUSTRIAL CENTER
z,,-'~ ....... ~ Drinking Water Analysis Report for Total Colifc rm Bacteria
TO BE COMPLETED BY WATER SIJ PPLIER
Mailing Address
I.D. NO.
WATER SYSTEM:
Water System Name I Phone No.
l
SAMPLE TYPE:
[] Routine
[3 Check Sample (for routine sample
with lab ref. no.
[] Special Purpose
[] Treated Water
[] Untreated Water
SAMPLE Time
NO. LOCATION Collected
I
Collected
By
TO BE COMPLETED BY LABORATORY
Analysis shows this Water SAMPLE to be:
[] Sat sfactorv
[] Unsatisfactory
[] Sample too long in transit samol¢ should
not be over 48 hours o~o at examination
to indmate reliable results. Please sene
new sample.
Date Received
Time Received
Analytical Method:
[] Fermentation Tube
/~,,~ Membrane Filter
Lab Ref. No. Result* Analyst
I I-i'71
I CCI
READ INSTRUCTIONS
BEFORE
COLLECTING SAMPLE
BACTERIOLOGICALWATER ANALYSIS RECORD
· resumpt Ive 10mi 10mi 10rnl ].0mi /Omi 1.0mi 0.1mi
24 Hours