HomeMy WebLinkAboutROBERTS #2 Block 2 Lot 19
/-"iMUNICIPALITY OF ANCHORAGE~-'I
DEPARTMEN.'OF HEALTH AND ENVIRONMENI,~.! PROTECTION
825
L Street, Anchorage, Alaska -99501
279-2511, ext. 224 or 225
Date Received: April 13. 1977
#2: Time II[~/~/~ #3: Time
Date ~-~-77 c~. Date
Insp WP,~t~,, Insp
REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES
1. Lending Institution Request:
Mailing Address:
Phone:
Property Owner: Robert E. Halbert
Mailing Address: 3506 Indiana
Phone: 274-4279
3. Legal Description: Lot 19 Block 2 Roberts Subdivision
4: Single Family Residence: Sx) Number of Bedrooms:
Multiple Family Residence: ) Number of Bedrooms:
5. Well System:
Permit #
Construction
Public/Community System: ( ) Individual Well: (x)
Depth of Well 140' Well Log on File
Bacterial Analysis
( )
6. Sewage Disposal System:
Permit #
Septic Tank Size
Absorption Area
Installed
On-site System ( ) Public Utility (x~
Installer
Manufacturer
Soils Rate Material
Distances: Well to Septic Tank to Absorption Area
to Sewer Line Nearest Lot line Absorption Area
to Nearest Lot Line
.~age~ Two
Department of Health and Environmental Protection
Request for Approval of Individual Sewer and Water Facilities
Legal Description: Lot 19 Block 2 Roberts Subdivision
Comments:
Affadavit Attached:~/' )
Approved: ~ ~_ ~
Disapproved:
Letter Attached: ( )
Date:
Date:
Department Worksheet:
D~AR~£~ ~ ~£A/~ AND ~NV~O~£~A/?R~O~
2510 East Tudor Road, Anchorage, Alaska 99504 276-2221
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER and WATER FACILITIES
FHA ,/'X CONY
Day Phone'~ ~'/~- ~7/f~
3. Name of Buyer:
Mailing Address:
Day Phone:
4. Name of Lending Institution:
Mailing Address:
5. Name of Realtor or Agent:
Mailing Addressr-~ ~)/
6, Legal Description:
Location:
Phone:
' Phone:~'-~
Type of Facility to be Inspected: //"Y/~/~ ~'~
Water Supply
Type of Supply: Public Utility
If Individual, number of dwellings presently served
, ~nd~vidue~, depth of we, / ¥ 0 '/~,.J-'
Sewage Disposal System
Type of System: Public Utility
If Individual, date of installation
.No. Bdrms. ~
Individual /~.
Individual (on-site)
Iv~UNICIPALII~( OF ANCHORAG2
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
APR 1 ~ 1977
gECEIVED
72-003(3/76)
b~y 19, 1977
Mary Elliot
Executive Realty
2810 C Street
Anchorage~ Alaska
99503
Subject: Lot 19 Block 2 Roberts Subdivision
P%lblic water is not available to th~ subject property.
It would not be economically feasible to bring ~¢ater to
that lot.
If there are any further questions, please contact this
office at 279-2511, extension 224 or 225.
Sincerely~
Robert C, Pratt~
Sanitarian
RCP/ljh
g~-1220(a) Rev. 1973
DATE
ALA,,..,d DEPARTMENT OF HEALTH AND SOCIAL S,._4CES
DIVISION OF PUBLIC HEALTH .ab No.
INDIVIDUAL AND SEMI-PUBLIC
BACTERIOLOGICAL WATER ANALYSIS
OFFICE
INDIVIDUAL [], . SEMI-PUBLIC [] CHLORINE RESIDUAL PPM
REPORT RESULTS TO
,-,j ..~ ~...?,,,M~,-.?
ADDRESS ' ~ ~) r _ .
CITY ZIP CODE
Analysis shows thls Water SAMPLE to oe:
~SalJsfactory
[] Unsatisfactory
[] Questionable
[] Sample too long in translt; sample should hal be over 48
hours old al examination to indlcale reliable resulfs. Please
[] Bottle broken in translb please send new sample.
SANITARIAN'S REMARKS
COMPLETE THIS SECTION
ONLY IF WATER IS ~N INDIVIDUAL SUPPLY
SAMPLE COLLECTED BY, I~ 'I~/
DATE COLLECTED / ~' ': TIME COLLECTED
LOCATION:
[] Of Well [] Other
PURPOSE OF EXAMINATION: Illness Suspecled?
New Source of Supply? [] Yes
READ INSTRUCTIONS
ON
REVERSE SIDE
BEFORE
COLLECTING SAMPLE
[] Yes ~ No'-
06-1220 (b) BACTERIOLOGICAL WATER ANALYSIS RECORD
Date Received ~/~ ~. ~1 -' ~ '~ Time Received ~-/ am~_ , ,. , r%, ./.~
48 Hours
DIRECTIONS FOR COLLECTING SAMPLES OF WATER FOR BACTERIOLOGICAL EXAMINATION
Read Carefully and Follow Instructions Exactly
Bear in mind that water analysis deals with materials present in very rnlnute quantities. The least care*
lessness in collecting and handling may give rise to results which are misleading.
Samples are accepted at the regional laboratories in the early part of the week (Monday. Wednesday)
unless there is an emergency or prior arrangements have been made. Arrangements should be made to
have the water samples reach the laboratory as qulck[y as passible and within 4~B hours after collection.
After 48 hours, the significance of the bacteriological analysis is impaired.
In collecting samples from TAPS or PUMPS proceed as follows:
(a)
(b)
Thoroughly flush tap or pump by allowing water to run freely for five minutes.
Shut off water and flame the outlet wJth torch or burning paper. The flame should not be
merely passed over the outlet but should be applied until fixture shows indication of being
hot. Flame should be directed against inside edge.
(c) Open fixture so that a small stream flows.
(d) Remove bottle from mailing tube. Hold bottle by the lower half in one hand and wilh the other
remove the screw cap with the fingers, leaving foil protecting cover in place. Fiji the bottle to
the shoulder. Replace cap with foll cover, screwing firmly into place but do not apply pres-
sure which will split cap.
(e) Pack bottle carefully in rnaillng tube enclosing this completed information sheet.
DO NOT COLLECT SAMPLES FROM FIRE HYDRANTS, YARD
HYDRANTS, DRINKING FOUNTAINS OR SIMILAR OUTLETS
WHICH ARE DIFFICULT TO DISINFECT PROPERLY.
STERILE WATER SAMPLE BOTTLES ARE AVAILABLE UPON REQUEST FROM:
Dept. of Heallh & Social S0rvices Dept. of Health & Social Services Dept, of Health & Social Services