HomeMy WebLinkAboutH J PIKE LT 14
(4M) :
Lab. No., 17658
INDIVIDUAL WATER SUPPLY
,-. , ~-:. '~ South~entr~ Reg~on~
8~ion of 8aMmfloh and ~eerlng ov~i~
A~ION ON REQUEST FOR BA~ERIOLOGIC~ WATER ~YSIS
Your recent request ~or an analysis of a sample
from the Individual Private Water Supply I~, F~anoia
servin~lO~ ~6th, Avenue w~ 5~rd~, Alaska
receivea 9/~/~ and
exmination has been completed.
Records in this o~ce indicate this Individual Private Water Supply to be of. ~ 8atisfacto~ Questionable i'~(,UnsatisfactolT
sanitary status. .-
Analysis shows this 8~LE to be. (' ..... Satisfacto~. Questionable Unsafisfacto~.
If an "Unsatisfactory" or "Questionable" stares is indicated above, you should take i~nediate action ~ recommended below.
1. Boil or chemically treat your water supply to protect your f~ily from water-borne diseases as outlined in en-
closed leaflet, "Dri~ h Pure."
2. Improve your spring~ S~ bulletin HSE-6-2
3. Improve yo~ cistern~ See bu~etin HSE-6-3
4. ~prove your dug well ~ See bu~etin HSE-6-4
5. Improve your driven we~See bu~etin HSE-6-5
6. Improve yoor drilled we~ ~ See bu~etin HSE-6.6
7. ~elocate your well to a safe location in relationship to your sewage disposal system~See bu~etin HSE-15
8. Bottle broken in transit, plebe send new s~ple.
9. Sample t~ long in transit; sample should not be over 48 hours old at examination to indicate reliable results.
Ple~e send new s~ple.
10. Contact your n~rest ~ L~al Health Department or ~ Alaska Health Department Sanitation o~ce for
bulletins, consultation, and ~sistance.
11. This is a surface water source and subject to pollution by man and animals. An approved water supply source
should be developed.
Signature
[] In uZility room, [] On top o£ well
[] Other (ltst) ........................................................................................................
?URPOSE OF EXAlVlINATION: Illness suspected? [] yes,
./,~ . Repairs to existing systen~? [] yes,
Re/narks: .,.//~........~..,....Z~.,..~.~.O.:~.:?...~..
PLF, ASE DRAW A SKETC~ m ~E SPA6E BELOW. ~IS SK~CH SHOULD SHO~ ~)CATION OF HOUSE, WA~
SOO C .
· ~ w~'x'~ ~UF~L~ ~O~C~, AND ~ OF ~OVE FACeit.
SAMPLES MUST BE SUBMITTED IN CONTAINERS PI~,~VIDED BY TI~E ALASKA DEPARTMENT OF HEALTH
ADH-HSB-6-~I (t)
ACTION
Lab. No,
INDIVIDUAL WATER SUPPLY
ALASKA DEPARTMENT OF HEALTH
Section of Sanitation and Engineering
ON REQUEST FOR
, :t70o7
Your recent request for an analysis of a sample
from the Individual Private Water Supply
serving ]'103 36th. A'W. was
receives 9/19/60 ~nd
examination has been completed.
Southoontrat Regional
OPPICB
BACTERIOLOGICAL WATER ANALYSIS
Mr. Francis Oregg
]103 36th. Avenue
Spenal~l, ;ulaska
Questionable 'i Unsatisfactory
Records in this office indicate this Individual Private Water Supply to be of
sanitary status.
Analysis shows this SAMPLE to be Satisfactory__ --.Questionable
Satisfactory
:;~ Unsatlsfactow'
If an "Unsatisfactory" or "Questionable" stares is indicated above, you should take irmnediate action as recommended below.
1. Boil or chetnically treat your water supply to protect your family from water-borne diseases as outlined in en-
closed leaflet, "Drink It Pure."
2. Improve your spring--See bulletin HSB-6-2
3. Improve your cistern--See bulletin HSE-6-3
4. Improve your dug well- See bulletin HSE-6-4
5. Improve your driven well--See bulletin HSE-6-5
6. Improve your drilled well--See bulletin HSE-6-6
7. Relocate your well to a safe location in relationship to your sewage disposal system- See bulletin HSE-15
8. Bottle broken in transit, please send new sample.
9. Sample too long in transit; sample should not be over 48 hours old at examination to indicaie reliable resuks.
Please send new sample.
10. Contact your nearest [] Local Health Department or [] Alaska Health Department, Sanitation office for
bulletins, consultation, and assistance.
11. This is a surface water source and subject to pollution by man and animals. An approved water supply source
should be developed.
?.
8ANITARIAN'S REMARKS / ~ / / -' .~' '
' Signatare ,' , .9'
PURPOSE OF EXAMINATION: Illness suspected? [] yes, ~r~o New ~ouree o£ supply? ['~ yes, [] no
Repairs to existing system? [] yes, ~ no
PLEASE DRAW A SKETCH IN THE SPACE BELOW. THIS SKETCH SHOULD SHOW ~CATION OF HOUSE, WATER
SUPPLY SOURCE, SEPTIC TANK, SEWER, DRAIN LINES OR OTHER SOUI%CES OF POLLUTION AND DISTANCES
BETWEEN WATt~ SUPPLY SOURCE AND ANY OF ABOVE FACILITIES.
SAMPLES MUST BE SUBMITTED IN CONTAINERS PROVIDED BY THE ALASKA DEPARTMENT OF HEALTH
GREATER ANCHORAGE HEALTH DISTRICT
217 E Street P,O. Box 968
Auchorage~ Alaska BR 6-3351
V~A~ LO~N INSPECTION ~ORM
Appointment set for 10:00 AM
Monday, Sept. 19, 1960 w/ Mr. Gregg, Buyer
Mr. Gregg and Mr. Smith came into
office 9/1.5/60 3:30 PM, requesting
inspection.
File Reference: 3046-261
x~i~kR~x DL 130 557 AAA
D/L
WATER
Name of Buyer: Francis L. Gre~
Name of Seller: Ernest Smirch -,..Mail: P.O.. . _ Box· ..... 1063~ Anchorage ......
No house number
1103 W. 36th Ave. (C~rner Dor,.brandt & 36th Avenue)
Property Address: ....
Legal Description of Property: x~x Lot 14, Pike. Subdivision
Phone number where buyer can be contacted: FA 2-~p~{Buyer,hap. b~,e~ renting_
property for about 2~ years.
B~=~.~_ -. 1%03 W. 36t~.Avenu~
Mailing Address of ..... Same
WELL - 105 ,Feet Deep; Driller now in Arizona; owner will check to see if he has
any info as to well log.
SEPTIC TANK ~ CESSPOOL
INSTALLED AND NOT USED
UNTIL GREGGG MOVED IN.
WILL CHECK RECEIPTS FOR
EVIDENCE OF INSTALLATION.
prope~y ~once~ned, .taC~n~ ~ h~ ~i~l connect
lo~a/ d~c~t~p~Lon of ~ 1~, ~Lke Subd~v/mion. wa~ ~d~ on ~ept~be~ LS~
~/ndar ch~e conditions, th-~ ~er ~upp/y ~1?, aloo b~ ~ppro~d, Fip~t
approval ~t~ chi~ ~ace~ ~upply ~/11 ~ ~iven ~m p~op~cy i~ cofln~tctad
Vmry c~oly your%
~.0. Box 1063
1960=