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Home My WebLink AboutBELLA VISTA #1 LT 16A , i . "'"~ ' I NSPECTiONAPPOINTMENTS . DATE DATE DATE ' INSPECTOR INSPECTOR INSPECTOR .., ' ' ut?f. OI~ HEALTH & ~ CHORAGE ENVIRONMENTAL PEOTE~T MU._ICIPALITY OF AN . ~ , *. ~ ~ DEPARTMENT OF HEALTN & ENVI RONM~TAL PROTECTION ~__: ~% 825LStreet-Anoho"~.Alaskage,01 JUN n ' , ! ~// ENVIRONMENTAL SANITATION DIVISION ~-- . ..... REQUEST FOR APPROVAL OF INDIVIDUAL wATER AND SEWER FACl LITI ES DIRECTIONS: Complete all parts on page 1. Incomple~ requ~M will ~t beproc~d. Please allow ten (10) days for processin'g. PROPERTY RESIDENT ( f d fferent from a6ove) - ' - PHONE '2. B~YER ' ' ~ ~HONE 3, LENDING INSTITUTION ' ' * * ~ ''1' PHONE' MA~ LING ADDR ESS 4. REALTOR/AGENT--' ' ' ' ' ' ~ I PHONE ' MAILING ADDREss~/~/~ ' ' ' ~ 5. LEGAL DESCRIPTION, ,S (,_ STREET COCATION 6, T PE OF RESIDENCE " ' NUMBER OF~BEDRO0~S ' ' ' ~ One ~ Four ~ Other . I ~' SINGLE FAMILY ~ Two ~ Five ~ MULTIPLE FAMILY 7. WATE~UPPL~ ~ Thr~e ~ Six ~ INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled ~ COMMUNITY since June 1975. For wells drill ed prior to that date, give well ~ PUBLIC UTI LITY depth (atta~ log if available.) ~, SEWAGE DIS~SALSYETEM ' ' ~ ~ INDIVIDUAL/ON-SITE** / ~ YEAR ON-SITE SYSTEM WAS INSTALLED. PUBLIC UTI LITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 [Rev. 6/79) 1. TYPE OF RESIDENCE [] SINGLE FAMILY [] MULTIPLE FAMILY 2. WATER SUPPLY [] INDIVIDUAL [] COMMUNITY [] PUBLIC UTILITY Connection Verified 3. SEWAGE DISPOSAL SYSTEM [] INDIVIDUAL/ON -S_[T E []PUBLIC UTILITY-~- .~__~__ Connection Verified []Septic Tank or [] Holding Tank Size: If Tank is homemade give dimensions: TYPE OF TANK TOTAL ABSORPTION AR EA 4. DISTANCES WELLTO: Absorption Area to nearest Lot Line THIS SIDE FOR OFFICIAL USE ONLY NUMBER OF BEDROOMS [] ONE [] THREE [] FIVE [] TWO [] FOUR [] SiX [] OTHER PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED PERMIT NUMBER NSTALLER SOl LS RATING MANU FACTU RER MATERIAL Septic/Holding Tank IAbsorption Area [Sewer Line Nearest Lot Line 5. COMMENTS [~//APPROV ED FOR DATE BEDROOMS [b~CDiOsNADpI;~vN~)t/APPROVALBy ~____/y(letter mustacco~certificate) 72-010 (Rev. 6/79) CHEMICAL & GE, .,OGICAL LABORATORIES L ALASKA, INC. TELEPHONE (907)-279,4014 ANCHORAGE INDUSTRIAL CENTER /~.~.~ 274-3364 5633B Street ~,.o.A,o...~,,~ Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER WATER SYSTEM: I.D. NO. Water System Name , ' Phone No. ,, ' r Mailing Address City State Mo. Day Year SAMPLE TYPE: [] Routine [] Check Sample (for routine sample with lab ref. no. [] Special Purpose ) [] Treated Water [] Untreated Water SAMPLE NO. I I LOCATION ' Time Collected Collected By TO'BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: I~l'"Satisfactory [] Unsatisfactory [] Sample too long ~n transit; sample should not be over 48 hours old at examination to indicate reliable results. Please send ,nfew sample. Date Received ~' ~ ' " Time Received Analytical Method: [] Fermentation Tube r~,' Membrane Filter Lab Ref. No. Result* Analyst I~;' -~'?~; '? ~ r-~~ I I FT'] I I I-T-I ,, *No, of colonies/lO0 mi or No, of Positive portions. O6-1220 (b) Rev. 1978 BACTERIOLOGICAL WATER ANALYSIS RECORD READ INSTRUCTIONS BEFORE COLLECTING SAMPLE Date Collected. Source Date Received Time Received __ o.m. Lab. No. Presumptive 10mi 10mi 10mi 10mi 10mi 1.0mi 0.1mi 24 Hours 48 Hours Confirmatory ~ 24 Hours 48 Hours EMB Broth 24 hours: Multiple Tube Report: Membrane Filter: Direct Count Verification: LTB Final Membraqa, Fllter Result! Reported By~ ' ' · ;" Broth 48 houri: 10mi Tubas Positive/Total 10mi Portions Collform/100ml BGB Date .' ;' , Time: "r' : :"' I ~ ~ Collform/lOOml REQUEST FOR APPROVAL OF INDIVIDUAL SEWAGE AND WATER FACILITIES (Fill out in Triplicate) "'~"~. Name of person requesting approval ..... W. il!iam L. Grad~ ' '~ 2."" Uame of ro eft · owner John R. Halterman (Ph 344-3357) , P P Y,' ..................... ! c 3. Legal descriptioR West 1/2 of Lot 16, Bel!a Vista Subdivision (914 E. 7St.h) Number.of~ ]~edrooms in house 3 . a. Bact~ri~l~ . b. Detergent ' "' . a. Type . ' c. Casing Size ..... . d. Distance from well to closest existing or proposed: 1. Sewer line .... . 2 Septic tank 3. Seepage Area . . 4. 5. Property Line 6. Other sources of possible, contamination, i.e., creeks, lakes, houses, barn, drainage ditch, etc. __ .... . Septic tank capacity in gallons . ~ Name of septic tank manufactum, e.r 1, If "home made" show diagram on reverse side of this form. Disposal, field or seepage pit size and type ~-~ ~ Sewage a. b. c. 1. Distance to property line to house foundation ~-// . e, Peroolatto~ · f. Percolation Test performed by ~-~,~." ...... ~ ~ .........~ ~ .... J ~, , ~-~ Use the ~eve~se ,~d~ o~ ~b~S f'o~ ~'-~he foJ. l~i~g ~nfo~t~on,' ' ' p~ope~ty lines~ .well location, house location, ~ic tank tocat-lon, disposal area location~ location of percolation test, a~ di~ction of ground slope. 9. The tnfo~tion on this form is true and comrect to the best of my knowledge. TO BE PIBLED OUT BY HEALTH DEPARTMENT PERSON,NEL ~ '--~e above described, sanltarc¢ facilities are hereby approved, subject to the ...........___~ ~w~n ~,, ~o~.~:~.;__~.:~ ~, ......... ~ ........ ~ Conditions: The above described sanitary facilitles are disapproved for the following reasons: Approval is valid for one year following the date of approval. CPJ:cw December 26, 1968 8r, Da~ P~palee Local Representative Votoran's Administration P, O, ~ox 1399 Anchorage, Alaska 99501 Water and Sewage Disposal John R, aattermen (William L. arady). Dear Mr. Rapalee~ Personnel of the Greater Anchorage A~ea Borough Health Depa~men~ have recently received a letter from Mr. Maurice Xoon, the excavator who installed the sewage disposal system at the subject location. From this letter end a discussion with ~r. Koon, we a~e able to approve the subject sewer and water facilities. Sincerely, DAVID R, h. DUNCAN, M.D. Medical Director Sanitarian D~H/cc December 5. 1968 Mr. Dan Rapalee Local Representative Yeterans Administration Po O. Box 1399 Anchorage, Alaska 99501 SUBJECT= Sewage Disposal System Serving West 1/2 of Lot 16, Bells. Vista ~ubd., John R. Halterman (William L. ~rady) Dear Mr. Rapalee{ Personnel of the Greater Anchorage Area Borough Health Department in co-operation with the Anchorage ~al~y have attempted to determine the exact size and location of the sewage ~acility serving the subject location. Mr. (~ransbury of the ~ealty has supplied us with infor- mation stating that a 1,000 gallon steel septic tank was installed by a Mr. Maurice Koons in 1966. Mr. Gransbury further stated that, to his knowledge, the system was installed to VA ~tandards. Our inspection shows the existence o~ one standpipe located 60 ~eet ~rom the drilled well. ~e were unable to determine whether or not this standpipe is for the septic tank or the seepage area. If it is ~r a seepage pit, it would be located too close to the existing well. We have Dean unable to contact Mr. Koons and believe he may no longer he in Anchorage. Our complete approval o£ the systea could onl7 be secured by a state- ment £rom Nr. Koons as to the exact location of the system or by excavating work in the sprinE to determine the location o£ the complete sewage ffacility. The water sample tested satis~actorily. Sincerely, DAV;D R. L. DUNCAN, M. D. Medical Director David ~.' Harkn,'~s ..... Sanitarian DBH/srr February 9, 1972 Greater Anchorage Area Borough Department of Environmental Quality 3500 Tudor Road Anchorage, Alaska 99507 Dear Sir: This letter is to confirm the agreement that I, Mr. Walter Stephen will upgrade the construction of the well located on .Lot 13, Bella Vista Subdivision #1, within the regulations of applicable State and Borough codes to obtain an approved constructed well for the apartments on the above mentioned lot, no later than August 1, 1972. DATE: February 9, 1972 Sincerely, Mr. Walter Steph~n¥'-'-~ This is to certify that on the 9th day of February, 1972, before me, the undersigned Notary Public in and for the State of Alaska, duly commissioned and sworn, personally appeared Mr. Walter Stephen, known to me and to me known to be the individual named in and who executed the foregoing instrument, and acknowledged to me that he signed and sealed the same as his voluntary act and deed for the uSes and purposes therein set forth. IN WITNESS WHEREOF, I have hereto set my hand and official seal the day and year first above written. aska Commission Expires: :~, ~m~.~,~Q?4