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Home My WebLink AboutDEBORA #4 LT 19lir I 1 Y� yfM1 Lvr4ll� oso or -i zoo F- S� U�)Lv ,L r�. GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 FOSTER HOME Date Received July 28, 1976 Time of Inspection 4,.; do SIM Date of Inspection �[LL--f n �c REQUEST FOR APPROVAL OF I?1t6n. INDIVIDUAL SEWER & WATER FACILITIES FOR Fo,AL AWE Antl I Nx Aceic� 1. Approval requested by: Mailing Address: Phone: 2. Property Owner: Merle S. or Lillie M Fielding Phone: 7454077 Mailing Address: Star Route A Sox 1120, Palmer 99564 8 694-2974 3. Legal Description:/-e%/9ttd Debora Subdivision 4. Location: Upper Juanita Loop — Eagle River 5. Type of facility to be inspected No. of bedrooms Z 6. Well Data: A. Type Qn.41� C. Construction 7. Sewage Disposal System: B. Depth 90 D. Bacterial Analysis A. Installed _ B. Installer C. Septic Tank: 1. Size D. Seepage Pit: E. Disposal Field 8. Distances: 1. Absorption Area Totalrlength of lines 2. Manufacturer 2. Material 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 EQ -034 (1/74) Page 1 of two pages ,,_-.. _.. .- ...._. - ..... ... Page 2 of two pages - Rc"�t for Approval of Individual '%-,;r & Water Facilities ,Legal Description Comments Approved Debora Subdivison Disappro Date -10-74C Approval,Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM N� I 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 EQ -034 (1/74) Da to o_ MUNICIPALITY OF ANCHORAGE ,y C!DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTE .. I CFN°:.Lt"2510 East Tudor Road, Anchorage, Alaska 99504 276.2221 G 0*o .'ENTAL REQUEST FOR APPROVAL OF jJ!, 8 19/INDIVIDUAL SEWER and WATER FACILITIES 19161 Lz Jnr \ I / f 1. TypRfinsgliiiinF D.- CMRO VA FHA CONY. , . . . , , . 2. Property Owner: r , —) r i=r rni. a ire MailingAddress:5QA Soy741h _ /91MP✓. Ak Day Phone: % V477 3. Name of Buyer: Mailing Address: Day Phone: 4. Name of Lending Institution: Mailing Address: Phone: 5. Name of Realtor or Agent: "Ve, wr Mailing Address: Phone: 6. Legal Description:f� /lt/� I nation:—!/ d/[n l) �:/lll t•�'/S//1v I 19 vc ULr1/.afF{'u I 7. Type of Facility to be Inspected: No. Bdrms. 8. Water Supply Type of Supply: Public Utility Individual Em If Individual, number of dwellings presently served If Individual, depth of well Sewage Disposal System Type of System: Public Utility Individual (on-site) If Individual, date of installation 72.003(3176) 06.1220(a) Rev. 1973 DATE ALA"'NDEPARTMENT OF HEALTH AND SOCIAL S" -IES DIVISION OF PUBLIC HEALTH INDIVIDUAL AND SEMI-PUBLIC BACTERIOLOGICAL WATER ANALYSIS INDIVIDUAL Q SEMIPUBLIC ❑ CHLORINE RESIDUAL PPM REPORT RESULTS TO NAM ADDR Cm ADDRESS OF SOURCE COMPLETE THIS SECTION ONLY IF WTER IS AN INDIVIDUAL SUPPLY SAMPLE COIIECTED BY—ry.f/I j ✓ I DATE COLLECTED -QQ��J !T D �" TIME COLLECTED—/.-30-AFe•re Sample Collected From @a1 schen Top ❑ Bathroom Tap O Basement Top Q Other (List) Well - 8 Dap 8 Driven ❑ Drilled E3 Bared SOURCE: Sp,i Cistern ❑Other Duo Well ar Cistern Conthwliont Wall. -S Wood ❑ C.c,.to B Metal ❑ Tib bits ar Too ❑ Wood ❑ C., of. Mesal ❑ Own Top ❑ Const. LOCATION: ❑ In Ba.ment E3 Detentions Off.t ❑ Under Hou. ❑lo Yard ❑ Other Building S.wsr Septic DISTANCE TO: or Other Drainage Pipe Feet. Tank Fest. Tib Sespoo. Ce. - field Feet. Pit F.1. Pool First. Privy F.t. Other Possible Sources of Contamination MATERIAL: Building Sower- ❑ Gap Iron ❑ Woed []Tile ❑ Fibre ❑ Asbestos ❑ Plastic Joint Material - Type Cement GENERAL: Does Water Became Muddy or Discolored? ❑ Yes ❑ No WMn? Diameter of Well Depth Feet. Well Casing Material Diameter Depth Length of Water Depth Drop ripe From Bosom Fest. Olftsl in In Utility PUMP LOCATION: ❑ In Well ❑ B..m.nt ❑ 1. B..ment ❑ Ream On Top p Of W.e ❑ Other PURPOSE OF EXAMINATION: Illness Suspected? ❑ Yes ❑ No Hew Sow. of Supply? O Yet ❑ No Repairs to SYa.m? ❑ Yrs ❑ No I>e Signature Lab No 5695 OFFICE Analysis shows $his Water SAMPLE to be: ❑ Satisfactory ❑ Unsatisfactory ❑ Questionable ❑ Sample too lone In transit, temple should not be over 48 hours old of enaminatlon to Indicate callable results. Please send new temple. ❑ Bottle broken in transit, please send new temple. SANITARIAN'S REMARKS 06-1240(a) Rev. saes ALh ;DEPARTMENT OF HEALTH AND SOCIAL S'ES r. DIVISION OF PUBLIC HEALTH ` INDIVIDUAL AND SEMI-PUBUC DATE BACTERIOLOGICAL WATER ANALYSIS INDIVIDUAL ❑ I NAME LADRESS Y — SOURCE SEMI-PUBLIC ❑ CHLORINE RESIDUAL PPM REPORT RESULTS TO ZIP CODE COMPLETE THIS SECTION ONLY IF WATER IS AN INDIVIDUAL SUPPLY SAMPLE COLLECTED BY DATE COLLECTED TIME COLLECTED Sample Collecl.d From 0 Kitchen Top 0 Bathroom Tap ❑ Rosemont Top 0 Otho (List) Well — Q Dug B Driv« a Ddllsd C)Bord SOURCE: ❑ Spring Cistern Otho, Duyy W.N « Cistern C.nonxIion, Wall.—Wood Canoele ❑Metol Tile Brick or Top — ❑ Wood B Comer O M: 8 Open Top 0 Conae» LOCATION: 0 In Basement ❑ Easement Offwt ❑Udo House []In Yard 0 Otho Building Sewer Septic DISTANCE TO: or Otho Drainage Pipe F"t. - Tank feet, Tile S«page Ce» - field P«t. Pit Feet. Pool i«t. Priry -F«t. Other Po..ible 5aurces of Contamination MATERIAL, Building Sewer- 0 Cast Iron 0 Wood 0 Tib 0 Fibre 0 Asbestos 0 Plostic Joint Mat.riot - Type Cement GENERAL: Doe% Water Reactors Muddy or Diuolored? 0 Y« 0 No When? Diameter DF Well Depth f«t. li Well Casing material Diamebr Depth length of Water Depth Drop Pipefrom Bottom foot. OHwt in In Utility PUMP LOCATION: 0 In Well 0 Basement 0 In Ba»menl 0 Room On Top 0 Of Well 0 Other Lab No. OFFICE Analysis shows this Water SAMPLE to be: 0 Satisfactory Unsatisfactory 0 Guestlonoble Sample too long In transit; sample should not be over 48 hours old at esaminatien to indicate reliable "suits. Plea» send new sample. Bottle broken in transit, please send new sample. SANITARIAN'S REMARKS PURPOSE OF EXAMINATION: Illness Suspected? 0 Yes 0 No New Sour» of Supply? 0 Y« 0 No Repo;" to System? 0 Y« 0 No Sfgnotur. READ INSTRUCTIONS 06.1x20 (b) BACTERIOLOGICAL WATER ANALYSIS RECORD Rnv, 1977 4i am Date Recelrd --il e � � n � � - _ Time Roeird / P:^ lobs No. Lxto» Broth I IDcc J 10cc I IN, J 10%< I INc I 1.Occ I.0cc ON 14 Hour. i As Hours � Brilliant Green REVERSE SIDE 74 Hours 48 Hours EMB BEFORE Lata. Broth, 24 hrs. Coliform Comity MF Re»Its COLLECTING SAMPLE Reported by This analysis Idicat« Coliform Organism. to be: 4B hr.. Dote.' / Abunt P"»est Crani. stain _ Imam Drababb No. per ION,) a.m. August 120 1976 4.1 Morle Fielding star Route A Box 1120 Palmer, Alaska 995G4 Subject: Lots 19 and 20 Debora Subdivision Dear Mr. Fielding: The Well casing must have a sanitary Seal and cap installed. 'The exact location of the sewer system LG unknown. In order for this department to determine the pro- - tective distances and dequacy of the saner system, the top of the entire septic tank must be exposed and a standpipe installed. Also required is a standpipe for the neepa;e pit. Code ra,uirements are 50' well to any septic tan}: and 1000 well to any sewer syston. Uatil a detarrination of the nearer in made and th_ system found adequate:, this dopartaant can not approve the facilities. If there are any further questions, please contact this office at 276-2221, extension 286. sincerely, Leet t2. Sucln:olz, Sanitarian L2aili jh cc: health Department/roster Home ludo Perry