HomeMy WebLinkAboutOCEAN TERRACE LT 3
APPLI(' NT FILLS OUT UPPER HAr ONLY
Property Owner /~,,/// ,, '~ /////. ( I:<~', / ~(y~"~-'
Ma~ing Address /~)('~) /~ C)/ ////~-~'-) ~::-,..~ ':< /-'i ./~/~'. // Zip Code
Buyer
Address
Zip Code
Phone
Lending Institution
Address
Zip Code
Realty Co. & Agent
Address Zip Code
Legal Description ~__ ,.-:2 7 -~ ~.~,',,~ /.?/://,./ ~"/~Ff?/'r.'~:)(' .¢.~'
Street Locatio~
Phone
Phone
Type of Residence
(~.'Single Family
~ Multiple Family
t~ Other
No. of Bedrooms
Water Supply ~ Individual
~ Community
[] 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).
Sewer Disposal ~ Individual
[~J Public Utility
~ Holding Tank
Year Individual Installed:
When Connected to Public Utility:
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
Time
Time
Time
[)ate Date Date
Inspector Inspector
Field Notes:
Inspector
Time
Date
Inspector
MUNICIPALITY OF ANCHORAGE
DEPT. OF H%~,LTI'{ ~,
ENVIRONM2NTAL PROTECTION
RECEIVED
(~2~) APPROVED BEDROOMS
( ) DISAPPROVED
( ) CONDITIONAL APP. BOVAL'
· CONDITIONS OF APPROVAL
Soils Rating
Dale Sewer Installed
Well '1'o Absorplion Area
Well to Tank
Well Log Received
Septic Tank Size
72-023 (318~.)
ACHEMICAL & GF:~..OGICAL LABORATORIES ¢ ALASKA, INC~
¢' 5633 B Street
Drinking water Analysis Report for Total ColifOrm Bacteria
TO BE COMPLETED I~y WATER SUPPLIER
WATER SYSTEM: I--1 .ii Illl
"1;[~. NO.
Water System Name - / _ Phone No.
Mailing Address
City State Zip Code
Mo. Day , Year
SAMPLE TYPE:
[] Routine
[:3 Check Sample (for routine sample
with lab ref. no ..... )
[] Special Purpose
[] Treated Water
[] Untreated Water
SAMPLE
NO. LOCATION
Time Collected
Collected By
TO BE COMPLETED BY LABORATORY
A~qalysis shows this Water SAMPLE to be:
~i Satisfactory
[] Or~atisfactory
[] Sample too long in transit; sample should
not be over 48 hours old at examination
t.o indicate reliable results. Please send
oew sample.
Time Received _ / ?''
Analytical Method:
[] Fermentation Tube
[~: Membrane Filter
Lab Ref, No.
Result* Analyst
*No ofcolomes/tO0 mi or No of Posdive portions
READ INSTRUCTIONS
BEFORE
COLLECTING SAMPLE
06-1220 (b}
Rev,~978
BACTERIOLOGICAL. WATER ANALYSIS RECORD
Date Collected Seurce
Date Received Time Rl~elved ____ p,m, Lab, NO.
Presumptive 1Omi 1Omi 1Omi 1Omi 1Omi 1.Omi O,lml
24 Houri
48 Houri
Confirmatory
24 Hours
48 Hours
EMB Broth 24 houri=
Multiple Tube Report=
Membrane Filter= Direct Count
Verification= LTB
Final Membrane Filter ~elultl_ (~-)
Reported
By
_Broth 48 houri=
10mi Tubal Positive/Total 10mi Portlonl
Collform/t00ml
.BGB
Collform/l O0~nl