HomeMy WebLinkAboutWOODLAND PARK #2 BLK 6 LT 250/oo C/Co Oq
HAL -IONLY
APPLIC FILLS OUT UPPER
' Property 'O~wner /~O~ ~(~ ~'~ ! Phone
Ma~ling Address " ~ ~) ~ ~ ~ Zip Code
~ Zip Code
Address
Lending Institution ~ ~ ~ ~A ~' ~ ' ~ ' Phone
Zip Code
Address ,~ ~ ~ ~ ,
ReaityCo.&A~nt ~'~ ~t/~1 ~'~ 0~ [-/~' ~l{~f¥ Phone
Type of Resi~nce
~ Single Family
~ MulBple Family No. of Bedroo~
~ Other
Water Suppty
~ Individual A~ACH WELL LOG. A w~l log is required for all wells drilled since June 1975.
For wells drill~pr~ to that date, give well depth (attach log if aveilable).
Community
~ Public Utility .
Sewer Disposal
~ Individual Year Individual Installed:
~ Public Utility When Connected to Public Utiqty:
~ Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED.
Time Time Time Time
Date Date Date Date
Inspector Inspector Inspector Inspector
/~/~,..'0 ~ ~./ ENVIRDH;, :~,.,' . . ,~.2'~TION
.RECEIVED
( ) APPROVED BEDROOMS .'~ . . 'CONDITIONS OF ApPROV~AL/
72.023 (3182)
February 17, 1983
~ob Koski
c/o Ken Shaw
Aloha ttawaii Realty
2357 Ilialeah Dr.
Anchorage, AK 99503
Subject: Lot 25 Block 6 Woodland Park ~2
Approval for the individual se%~er and water facilities cannot
be granted until the following items have been completed:
°' The water analysis report needs to be submitted to this
office from tile Chem Lab, 5633 B Street, for our review.
o The %;ell is presently in a pit and the well casing is below
ground level. 5'his v;ell casing needs to be raised to floor
level and the pit must be filled with impervious type soil,
so that water cannot stand around the well casing.
Please notify this Department for a reinspection when the
noted discrepancies have been corrected. If there are any
further questions~ please call this office at 264-4720.
Sincerely,
JR99/p/EI{1
Jim Roberts
~peclallst
Associate Environmental ¢ ....
· CHEMICAL & GEolOGICAL LABORATORIES (,. ALASKA, INC.
TELEPHONE (g07)-27g-4014 ANCHC RAGE INDUSTRIAL CENTER
274-3364 5633 B Street
Drinking Water Analysis Report for Total Coliform Bacteria
TO BE COMPLETED BY WATER SUPPLIER
I.D. NO.
Water System Name Phone No.
Mailing Address
Mo. Day Year
SAMPLE TYPE:
~"Routine
/~ Check Sample (for routine sample
with lab ref. no.
[] Special Purpose
[] Treated Water
[] U ~treated Water
SAMPLE
NO. LOCATION
3
4
5
Time Collected
Collected B~y
I
I
I
I
TO BE COMPLETED BY LABORATORY
Analysis snows this Water SAMPLE to be:
~ Satisfactory
[] Unsatisfactory
[] SamDle too long ~transrt; sampeshould
not be over 48 i~ours old at examination
to ~ndmate reliable resuKs Please send
new sample.
Date Received
Time Received
Analytical Method:
[] Fermentation Tube
ID' Membrane Filter
I
Lab Ref. No.
I
Result* Analyst
*NO of colonies/tOO mi. or NO of Positive Portions
READ INSTRUCTIONS
BEFORE
COLLECTING SAMPLE
06-1220 (bi
Rev, 1978
BACTERIOLOGICAL WATER ANALYSIS RECORD
Date Collect ~1 Source
24 Hours