The URL can be used to link to this page

Home My WebLink AboutOLMSTEAD Lot 1 Legal Description Property Owner Name & Address: ) ERR Y _\.Tv 15 1:;2,0 q C_1,00J� � ME- & r �,'o o a 2 <.? * S-0 -:s Pump Installation Date:`7113// 'W Pump Intake Depth Below Top of Well Casing: /,q Yfeet Pump Manufacturer's Name: AY Pump Model: A\jj in S -0,r-1112 V I Pump Size hp Pitless Adapter Burial Depth: 1 0 feet Pitless Adapter Manufacturer's Name: Pitless Adapter Installer: A_}A Well Disinfected Upon Completion? Yes F-1 No Method of Disinfection: Comments: IPump Installer Name: 0"� ANCHORAGE WELL &PUMP SERV. 330 EAST 76THAVENUE ANCHORAGE, AK 99518 PHONE: 907-243-0740 AWPS.COM Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Mark Begich Anchorage, AK 99507 S A F E T Y Mayor www.murii.org/otisite (907) 343-7904 Pump Installation Log Well Drilling Permit Number: SW Date of Issue: Parcel Identification Number: 010 - f 12 - � 3 Legal Description Property Owner Name & Address: ) ERR Y _\.Tv 15 1:;2,0 q C_1,00J� � ME- & r �,'o o a 2 <.? * S-0 -:s Pump Installation Date:`7113// 'W Pump Intake Depth Below Top of Well Casing: /,q Yfeet Pump Manufacturer's Name: AY Pump Model: A\jj in S -0,r-1112 V I Pump Size hp Pitless Adapter Burial Depth: 1 0 feet Pitless Adapter Manufacturer's Name: Pitless Adapter Installer: A_}A Well Disinfected Upon Completion? Yes F-1 No Method of Disinfection: Comments: IPump Installer Name: 0"� ANCHORAGE WELL &PUMP SERV. 330 EAST 76THAVENUE ANCHORAGE, AK 99518 PHONE: 907-243-0740 AWPS.COM Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. TIME DATE INSPECTOR --~/-, _RECEIVED ' NSPECTION APPOINTMENTS ~'r~- 'IME ' DATE DATE NSPECTOR NSPECTOFt MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH& ENVIRONMENTALPROTECl'IONDEPT' OF HEALTH & 825 L Street - Anchorage, Alaska 99501 [!NVIRONMEN~AL mtorECTION ENVIRONMENTAL SANITATION DIVISION /~,!.J(~ ~_ ~ 19G1 Telephone 264-472.0 DIRECTIONS: Complete all parts on page 1. Incomplete requests will not I)e processed. Please allow ten (10) Days for processing. LPHONE 1, PRQ.EI:.RTY OWNER PROPERTY RESIDENT (If different from above) .HON E BUYER PHONE 5. LEGAL DE,~CRIPTION 6. TYPEOF RESIDENCE ~,~ SINGLE FAMILY [] MUL_TIPLE FAMILY 7. WATI-'fl SUPPLY INDIVIDUAL'~ COMMUNITY PUBLIC UTILITY s u L] One E] Four '~ ', [~ Other [] Two C~ Five /) UJ Th~'~ [] S~x ~ ATTACH WELL LOG. A well log is required for all wells drilled since June 1975, For wells drilled prior to that date, give wel der)th (attach log if available, I 8. SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON-SITE** PUBLIC UTILITY YEAR OK.SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED, THIS SIDE FOR OFFICIAL USE ONLY 1, TYPE OF RESIDENCE [] SINGLE FAMILY [] MULTIPLE FAMILY 2, WATER SUPPLY [] INDIVIDUAL COMMUNITY PUBLIC UTILITY Connection Verified 3. SEWAGE DISPOSAL SYSTEM [] I NDIVI DUAL/ON -SITE []PUBLIC UTILITY Connection Verified []Septic Tank or E~] Holding Tank Size: If Tank is homemade give dimensions: NUMBER OF BEDROOMS [] ONE [] THREE [] FIVE [] TWO [] FOUR [] SIX PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED PERMIT NUMBER DATE INSTALLED INSTALLER SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL Septic/Holding Tank 4. DISTANCES WELL TO: Absorption Area to nearest Lot Line Absorption Area Sewer Line [] OTHER INearest Lot Line 5, COMMENTS --/~APPROVED FOR ~BEDROOMS ~ CONDITIONAL APPROVA~iletter must accompany certificate) [] DISAPPROVED DATE ALASKA, INC. CHEMICAL & GE~.~,OGICAL LABORATORIES ~_ ~ Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER WATER SYSTEM, I--Jl I I I I I.D~ NO. Water System Name Phone No. Mailing Address Zip Code City SAMPLE DATE: MO, Day SAMPLE TYPE: [] Routine [] Check Sample (for routine sample with lab ref. no, [3 Special Purpose State Year [] Treated Water [] Untreated Water SAMPLE NO. 1 L 4 I I LOCATION 'rime Collected Collected By TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: [] Satisfactory [] Unsatisfactory [] Sample too long in transit; sample should not be over 48 hours old at examination to indicate reliable results. Please send new sample. Date Received Time Received Ana!ytlcal Method: [] Fermentation Tube [] Membrane Filter Lab Reft No. Result* Analyst * No ol ¢olonm$/100 mi or NO of Positive portions READ INSTRUCTIONS BEFORE COLLECTING SAMPLE 06-1220 (b) Rev, 1978 BACTERIOLOGICAL WATER ANALYsiS RECORD Date Collected Source Oats ReCeived .Time Received 3,rn. Lab. No. >rssumptlvs lOml lOml ].Omi lOml 1Omi 1.Om('[ O,lml 24 Hours 48 Hours ;o~flrmatory 24 Hours 46 Hour..~~ ~ EMB Broth 24 hours: Multiple Tube Report= Mambrai3s Filter= Direct Count Verification: LTB Final Membrane Filter Results__ Reported By Broth 48 hours:__ 10mi Tubes Positive/Total 10mi Portions Collform/100ml BGB Collform/lOO~nl Date p.m, /\NCflORAGE, ALASKA 99501 (90/) 264 411i August 13, 1981 Graham Mower 3801 Mc Cain Road Anchorage, Alaska 99503 Subject: Portion of Lot 10lmstead Subdivision Approval for the individual sewer and water facilities cannot be granted until the fo]lowing items have been completed: (2) The water analysis report needs to be submitted to this office from the Chem Lab, 5633 B Street, for our review. The well sea[L needs to be t.[ghtened to that it is water tight. This will need to be re]nspected upon complet ion. If there are any further questions, please call this office at 264.-4720. SinceFely, Robert C. :Pratt, R.S. Associate Specialist RCP/ljw cc: National Bank of Alaska Pouch 7-025 99510 Chuck Lastufka % Dall Realty 700 West 41 Avenue 99503