HomeMy WebLinkAboutWOODLAND PARK LT 16Go'&n,n o
t
APPLIC..,~IT FILLS OUT UPPER HAL iONLY
Address
Ty e of Resi~nce
Single Family
~ltiple Family No. of Bedroo~ ~
~ Other
Phone
Zip Code
Zip Code
Zip Code C}~) 4~0 ~
Phone
Phone
Water pply
Individual
[] Public Utility
ATTACH WELL LOG. A well Icg is required for all wells drilled since June 1975.
For wells drilled prior to that date, give well depth (attach Icg if available).
/ <2.50' ~s ·
Sewer Disposal .!
ublic Utility/'
Year Individual Installed:
When Connected to Public Utility:
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQOEST BEFORE PROCESSING CAN SE INITIATED.
Time Time Time Time
Date Date Date Date
Inspoctor Inspector Inspo3tor Inspoctor
Field Notes:
/'":/;~ MUNICIPALITY OF ANCHORAGE
~/~-/~ f ;i,/~' DEPT. OF HEALTH
ENVIRONMENTAL PROTECTIO~
AUG 2 2 1983
RE£E! E[)
( ,~ ) APPROVED BEDROOMS *CONDmONS OF APPROVAL
( ) DISAPPROVED
( ) CO N DITION A~: AP P~ROVAL *
DATE ~/~ ~'~'~ ~
(.,,
~,/. 33 AVE
62
~ 74 ~ 76 Spenard Area Reference Map-P1
COPYRIGHT 1981
August 26~ 1983
George *,.[. and Audrey ~.
3404 ~oodland Park
Anchorage~ Ail 99503
Coffin
Sub3ect~ Lot !6~ ~4oodland Park
Approval for the individual se~.';er a~ld ~ater facilities cannot
be granted until the follo%,;in9 items have been co~pleted:
je¥;ell casing needs to b~. e~t~-~(led twelve (i2) inches
ove ground level. ~ ~, .
e notify this Departs,lent ~or a re~nsl~ect~on ~-/nen i.~]e
noted discrepancies have been corrected. If there arc any
further questions, please call thi~% office at 264-4720.
JR].4/ej/Env
l~earthside Inc.
(~allery of Ho~es
j. ,~. i{obert.~
Associate Environ~ental Specialist
CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC.
TELEPHONE (607) 562-2343 ANCHORAGE INDUSTRIAL CENTER ~
5633 B Street
Drinking Water Analysis Report for Total Coliform Bacteria
TO BE COMPLETED BY WATER SUPPLIER
WATER SYSTEM:
W~Systom ~o
I.D. NO.
State
City
MO. Day Year
Z~p Code
SAMPLE TYPE:
~E?Routlne
- [] rou,,ne .rap,e,
[] Special Purpose
[] Treated Water
[] Untreated Water
SAMPLE Time Collected
.o., i /._ / ~ ~..OCAT,O" :2~~ t Co,,ec,e, ey
TO BE COIM PLETED BY LABORATORY
Analys~s shows this Water SAMPLE to De:
~]~Satisfactory ~.
~ Unsatisfactory
[] Sample'too long in,transit; sample should
not be over 4_8'¢hours old at examination
tc indi'c~t~ r~li~a'Dl~'(esults.' Please send
r3ew sample
ate .ece ved '/ /
Time Received ,/ ~O'~
Analytical Method:
[] Fermentation Tube
;g:] Membrane Filter
Lab Ref. No. Result' Analyst
I ~
BACTERIOLOGICAL WATER ANALYSIS RECORD
READ INSTRUCTIONS
BEFORE
COLLECTING SAMPLE
F nat Membrane Filter R.u~t, ?. ' (f ~ Colirorm/].OOml