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Home My WebLink AboutWOODLAND PARK #2 BLK 2 LTS 14 & 15 N2 _.. EAT ' CHORAGE AREA 80ROUG D~pa~t~l.q~f Environmental Quality ~~"~~h~rage, Alaska 99503 274-4561 Date Received March ~'~' ~,¢,~~~~~~[~.. Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF ~DIVIDUAL SEWER & WATER FACILITIES 3, 1976 l. Approval requested by: National Bank of Alaska Mailing Address: Post Office Box 3-3859 Phone: 279-2506 2. Property Owner: J.L. Vondra Phone: Mailing Address: 3209 Wyoming 3. Legal Description: Lot 14 N½ Lot 15 Block 2 Woodland Park #2 4. Location: 3209 Wyoming 5. Type of facility to be inspected Single Family No. of bedrooms 2 6. Well Data: Individual A. Type~ C, Construction 7. Sewage Disposal System:/~P~-~J~ A. Installed B. Depth 80' D. Bacterial Analysis 3- B. Installer C. Septic Tank: 1. Size 2. Manufacturer D. Seepage Pit: 1. Absorption Area 2. Material E. Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank , Absorption area , Sewer Lines , Nearest lot line , Other contamination B. Foundation to septic tank , Absorption area C. Absorption area to nearest lot line LQ-034 (1/74) Page 1 of two pages Page 2 of two pages - Re?-~'st for Approval of Individual .~-~r & Water Facilities Legal ~Descripti0n Lot 14 N½ Lot 15 Block 2 Woodland Park #2 Comments Approve x_~ sapproved Date _~ __ --/- ~ Approval tVgJ-i~or one year from date signed Greater Anchorage Ar~a(-Bdrough, Department of Environmental Quality DIAGRAM OF SYSTEM certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74) J MUN1CI[~AIF[Y OF ANCJlORAG~! MUNICIPALITY OI~ Ai'~CHORAGE DEPARTMENT OF ENVIRONMENTAL QUALITY [~NVIRONME.NfAI, 3330 "C" Street, Anchorage, Alaska 99503 -- ~I /97( INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: CMRO VA 2. Property Owner: Q"< f2~. ~-~' Mailing Address: ~¢~2 o ? ~ 3. Name of Buyer: '--~~ '~Y~ Mailing Address: /¢ ~ ~ '~ ~' 4. Name of Lending Institution: ~~ Mailing Address: ~ ~ - ~ ~ 5. ~of Realtor or Agent: ~, ~ ~~ Mailing Address: 'J~ ~ FHA CONV __ Day Phone Day Phone Legal Description: 7. Type of Facility to be inspected: 8. Water Supply Type of Supply: No. Bdrms. ~ Public Utility Individual If Individual, number of dwellings presently served If Individual, depth of well ~¢:;~ ~ Sewage Disposal System Type of System: Public Utility ~ If Individual, date of installation individual (on-site) EQ-037 (1/74) ~-1220(a) Rev. 1973 DATE ALA~....,~DEPARTMENT OF HEALTH AND SOCIAL S~..,CES DIVISION OF PUBLIC HEALTH INDIVIDUAL AND SEMI-PUBLIC BACTERIOLOGJCAL' WATER ANALYSIS NDIVIDUAL ~-' SEMI-PUBLIC [] CHLORINE RESIDUAL PPM REPORT RESULTS TO i? .... ADDRESS ZIP CODE AnalysTs shows thTs Waler SAMPLE to be: [] Satisfactory [~Unsatlsfactory ~ Questionable ~ Sample too long in transit; sample should not be over 48 hours old at examination fo indicate reliable results~ Please ~s~e~d new sample. ~ Battle broke~ in transit, please send new sample. ~?' "'~ SANITARIAN'S REMARKS COMPLETE THIS SECTION ONLY IF WA~rER IS AN INDIVIDUAL SUPPLY SAMPLE COLLECTED BY ~ ,/~/,:.~. ,: ~' ~ -' DATE COLLECTED "' TIME COLLECTED Diameter of Well Depth Fe~l, Well Casing ,V~aterJal Diameter Depth Lenglh of Water Depth Drop Pipe Offset Jn n Utility .actose Brolh '~ 10cc 10cc 1gcc 10¢c ' IOcc 1.Bce 1.0cc a~-12~0 ~, BA~'~ERIOLOGICAL WATER ANALYSIS RECORD Bate Recelved ~') /r ~ / Time Received ( READ INSTRUCTIONS ON REVERSE SIDE BEFORE COLLECTING SAMPLE EMB AGAR Lactose Broth. 24 hrs.~., 48 hrs. Gram's staTn Coliform Densitz ~·' ~ (Most probable No. per 100cc) MF Results Pos~ Of~ ~x B~3859 A~h~ra~ AXa~ka 99509 / si~c~rely~ STATE OF ALASKA :- DP~,RTMENT OF HEALTH AND WELr~q~E 'DIVISION OF PUBLIC HEALTH BACTERIOLOGICAL WATFR ANALYSIS OFFICE NAME CITY Records in Ibis office indicate this WATER SUPPLY to be of Analysis shows this Water SAMPLE to be: Satisfactory [] Ouesllonable ~ Unsallsfacfory. If an "Unsatisfactory" or ~'Quesllonahle" stalus is indlcaled above you should take immediale action as recommended below. 1,Notlfy consumers water is polluted Boil or chemlca Iy treat this waler as outlined in INa enclosed leaflet "Drink II Pure." SAMPLE COLLECTED 8Y DATE COLLECTED TIME COLLECTED nm pm Weir- [] Dug El Driven [] Drilled [] Bored SOURCE: [] Spring ~ Cislern [] Diker Dug Well or Crslern Construction: BNck or When? Dinmeter at Well. Depth Feet. Well Casing 2. Increase chlorination sufflcienBy Ia meet recommended residual stanc~ards Determine source of contamination and lake aclion necessary.lo mainla~n a safe waler supply at all limes, 3, Check chlorinaBon and Diker mechanical ec]uipmenl Make cerlain it is funcBonlng properw. 4. B after ch&eking equ~pmenl a disinlecling residual is nol obtained, please wire Ih~s officb Ior embrgency asslsiance or advisory services. S. This is a surface '~'ater source and subject lo pollulion by man and anlmals An approved water supply source should be develooed. 6. Improve your El spring O dug well [] driven well [~ driUed well E cislern. 7. Relocate youl well lo a safe IocoUon in relallonship to your sewage disaosal system. [~ see enclosure 8. Sample too long in Iransil; samole should hal be over 48 hours old at examination 1o indicate reliab~_e resulls, please senn new samole, [~ Baffle Broken in transit, please send new sample. 9. Contacl your nearesl ~ Local HeaBh Deoortmenl or [~ Alaska Division of PubEc HeaR}~ sanita~ion office for bullelins, consullaUon and assislance, SANITARIAN'S-REMARKS READ INSTRUCTIONS ON REVERSE SIDE BEFORE COLLECTING SAMPLE BACTERIOLOGICAL' WATER ANALYSIS RECORD Lad os e Br otb ] 0cc 1 Oct 10cc I Oct I Oct 1.0cc 0.1 cc 24 hours EMB. AGAR Lactose Broth, 24 hrs. 48 hrs. Gram's stain - .(Most probable No. per f00cc,) Coliform Densby