Loading...
HomeMy WebLinkAboutSWISS AIRE LT 14 DEPARTM~ ' OF HEALIH AND ENVIRONMEN' L PROTECTION 8~5~JL Street, Anchorage, Ala~c~ 99501 279-2511, ext. 224 or 225 Date Received: May 4, 1977 11:00 a.m. ~2: Time #3: Time 5-5-77 Thurs. Date Date Insp Dixson Insp Insp REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES Note: please be on time or a little early Lending Institution Request: Amfac Mortgage Corporation Mailing Address: Property Owner: Mailing Address: 705 West 6th Avenue Phone: Alden/Patricia Gray Phone: 2949 East 88th Street 277-8588 277-2549 3. Legal Description: 4: Single Family Residence: (x) Multiple Family Residence: ( Lot 14 Swiss-Aire Subdivision Number of Bedrooms: Number of Bedrooms: Well System: Individual well ( ) Connnunity/Pnblic System Permit ~ --_~/j~D~e~pt_h~Well /// Well Log on File Construction ~/q~%4I~ Bacterial Analysis 6. Sewage Disposalt~'S~y, stem: On-site System/~) Public ..... ~x) Permit # ~x~ ~'l~TInsta!led ,/Installer ~Y Septic Tank Size /' / / Absorption Area Distances: Well to Sep'~ to Sewer Line /~ to Neares~ Lot Line / Manufacturer ~' Soils Rate.' ~/" Material ~ ~k I/ ~ /~A~orption Area// .~e~~ ~'~/ Absorption Area P~ge. .. T~o Department of Request for Approval Health and Environmental Protection of Individual Sewer and Water Facilities Legal Description: Lot 14 SwissZAire Subdivision Comments: Affadavit Attached Approved: Disapproved: Letter Attached: ( ) D ars: ':~/.~.~Y Date: Department Worksheet: MUNICIPALITY OF ANCHORAGE · DEPARTMENT OF ENVIRONMENTAL QUALITY I)~PT, Pc 3330 "C' Street, Anchorage, Alaska 99503 -- 274-4561- REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1, Type of Inspection: CMRO. VA 2. Property Owner: Alden and Patrlcia Gray Mailing Address: 2949 ~. 88th Street 3. Name of Buyer: (~Russell E. Minkeman XX FHA CONV Day Phone (Her) 277-2549 Mailing Address: 337 IL 24th Apt #1 AMI;AC Mortgage Corporation Name of Lending Institution: Mailing Address: 705 W. 6th Avenue Sulte 201 Day Phone 276-6611 x 223 Phone 277 8588 5. Name of Realtor or Agent: None Mailing Address: Phone 6. Legal Description: Lot 14 Swiss-Aire S/D Location: 7. Type of Facility to be inspected: Single Family Res. 8. Water Supply Community Type of Supply: lCg~ Utility If Individual, number of dwellings presently served If Individual, depth of well 9. Sewage Disposal System Type of System: Public Utility Tx' If Individual, date of installation No. Bdrms. ~ Individual Individual (on-site) EQ-037 (1/74) ._. DIVISION OF PUBLIC HEALTH -- BACTERIOLOGI CAL .WATER ANALYSIS OEFICE DATE Records in this attica indicate this WATER SUPPLY to be of: [] Eafisfactor~ [] O Jesfionable [] Unsalisfadory Sanitary Slatus. SAMPLE COLLECTED BY DAT~ COLLECTED TIME COLLECTED Waits [~ Wood E] Concrme [] ~Aelal [] Tile [] Concrete [~ Of Well [] Other PURPOSE OF EXAMINATION: Illness Suspecled? [] Yes [] No 3 Check chlorination and olher mechanical equipment. Make certain it is 5. This is a surface water source and subject to pollution by man and animals. An approvea wa~er supply source should be developed. b. Imoroveyour [] spring [] dug well [] driven well E~ arilled well [] cistern. disposal system ~] see enclosure B. Sample too ~ong in franslh samo~e should not be over 48 hours old af examination tc indicate reliable results, please send new sarnp[e. [] BoHle Broken in transit, o~ease send new sample. 9. Contact your neares~ ~ LocaIHea[thDepartmentor [~] Alaska SANITARIAN'S REMARKS [ Signature READ INSTRUCTIONS ON REVERSE SIDE BEFORE COLLECTING SAMPLE BACTERIOLOGICAL WATER ANALYSIS RECORD Laclose Broth 10cc I 10cc 10cc 10cc 10cc J 1 0cc 0.1cc I I 24 hours 48 hours Bri~liont Green 24 hours 48 hours t)IRkC IUiXh~, FeN (;OLL~!~'fliq(i; SANiPl. L:S OF WA'Fi:iR I"ON BAC'iEliIIOLOGICAL EXA~INA'flON Rood Carefully end Follow Insh'ucfions Exactly AI;.ngenlents shoulcl I)o nl(ide ~o hove woter s(llnples ~each the laboratory os quickly os i)ossihlo. A[IcH 48 houJ s ihu (;oJJy peril c)[ lbo week J)ut is willing to oCCel)f scm/pies el (11/~/ time. In colleding san~plos flora lAPS o~ PUMPS proceed as follows: (a) Ihomughly IIm, h IclI) o~ pump by ollowh~g ',vofel Jo lun [16ely ~ot five (b) Shut off WCliUl (lllcl [JCIII10 lho outlel wilh Io~ch o~ buillh](~ [)el)el. The flame ShOlJlCJ oulle~ hul should be applied until fixlme shows in4icalinn o¢ being hoh Fi(line shouJd bo (Jh'.(k:(J (l~]Cl[h~;l insi,l, edge, (c) (gl)On fixlm o so lhol u snlclll sheam flows. (el) Remove bottle from moiling lube. IIold holllo by the It),:,,r~t half in one h(m4 cop v/ilh lbo tillgol s, ~¢;ovhlg j)Clj)Ol i)~olo( i~ q cove plclce, Fiji lbo I)ollJe cow)l, screwing tilmJy ink) place bul cio noi cH)ply i)rossule whicJl will si)Iii cap. (e) P¢,c~ botlJe coJefiJlJy in n!rdlinq lube (moles ]g ~ s coJ /pi led intolmolion sFmol. In calJoclin(j SOml]les f,om 5fRI AMS ond II[~5EI4VOIRS pro(cod c,s Follows: Remove c.p clnd holcl hollle (b) Coiled scii/]l)lo lay holding bottle in a slcmtinO position o.d sWCOl)ing it below file SUliilciJ hi such . mrmnm Ih.I wolel th.t hcls boon in contclct with Ihe huncl is nol inhocluce(J into th.; boise, Avohl collt(lin9 ~u,ioce scum .nd I~oilom sodinl e~ll. SIERll E WAFIR SAMPl E BOTII tis ARE AVAILABLE LJP©I".I RE(bUEST FROM: Oopk of Ib:Jllh & Welfare SOU¥1tEAS'IR~N REGIONAL lABORATORY POUCIt J JUNEAU, ALASKA 99801 I-I(~pt, of Ileallh & Welfare SOUIIICENfRAL REGICNAL LABO[fAiORY