Loading...
HomeMy WebLinkAboutSPRUCE ACRES LT 5o14-z3i-3a-Wa Mayor Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.muni,oro/onsite (907) 343-7904 Pump Installation Log Well Drilling Permit Number: SW Date of Issue: _ Parcel Identification Number: Legal DescriptionProperty Owner Name & Address: S p 6q. U R 6251 Tj i=N.VI 5 jh o mPsora% 6x),10 5tlnl>y 0-- Pump Installation Date: �) • F 9 • 15 Pump Intake Depth Below Top of Well Casing: �7 feet Pump Manufacturer's Name: CK Ql� Pump Model: go r— 3 1} 8 5 1 rg- Pump Size `/ 11hp Pitless Adapter Burial Depth: 7 feet Pitless Adapter Manufacturer's Name: Pitless Adapter lastailer: / Well Disinfected Upon Completion? ! V? Yes C] No Method of Disinfection: CL Vg2i hi R O TTS Comments: ,Q Anchorage Well & Pump Service, Imi, Pump Installer Name: ((% ti 330 East 76th Avenue Anchorage, AK 99518 Phone: 907-243.0740 Fax: 907.243-0742 Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. APPLI( x1NT FILLS OUT UPPER HA'-'-'lONLY �lji�� Property Owner la� �y}/ / �/%� 46/ L Phone Mailing Address1Y� ��/L/ �� �! Zip Code��SG //� Buyer 5(117 Z/A-11d Address � - `/' S Zip Code Lending Institution 7/ Phone ��]� (�j��%�� ��/c. �J �L� -1{%.. Zip Code Address /t Realty Co. & Agent Phone Address f Zip Code Legal Description/ Street Location Type of Residence t�Single Family O Multiple Family No. of Bedrooms_ ❑ Other Water Supply Individual H WELL LOG. A well lag Is required for all wells drilled since June 1975. FFor ❑ Community lls drilled prior to that date, give well depth (attach lag if available). ❑ Public Utility Sewer Disposal ❑ Individual Year Individual Installed: �. 'V Public Utility When Connected to Public Utility: ❑ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time L Jj Time c Date Date Date 9- Date Uk-1=9,2,� rnQtk- Inspector Inspector Inspector Inspector. PTa � S Field Notes: v t NCHORAGE / DEPT. OF HEAT. A< ENVIRONMENTAL PROT CTION APR 6138 L 4P �-r� RECEIVED ( - APPROVED BEDROOMS -P-- S 'CONDITIONS OF APPROVAL ( DISAPPROVED ( ) CONDITIONAL CC22SS11`"3LAPPRQV 6©._ DATE >>> BY: C Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received Septic Tank Size Well to Tank 72 023 csiazl I t CHEMICAL & GE,,--,,OGICAL LABORATORIES ALASKA, INC. TELEPHONE (907)-279-0014 ANCHORAGE INDUSTRIAL CENTER 274-3364 5633 B Street Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER TO BE COMPLETED BY LABORATORY WATER SYSTEM: I.D. NO. Water System Name I ne No. S'.)- Y C) h �., i�r'/ -L-z, Mailing Address City State SAMPLE DATE: W % e —? Mo. Day Year Zip Cale SAMPLE TYPE: ❑ Routine ❑ Check Sample (for routine sample with lab ref. no. i ❑ Treated Water ❑ Special Purpose ❑ Untreated Water SAMPLE Time Collected NO. LOCATION Collected y 2 3 4 5 READ INSTRUCTIONS BEFORE COLLECTING SAMPLE Analysis shows this Water SAMPLE to be: ASatisfactory ❑ 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 �J 0 Analytical Method: ❑ Fermentation Tube O -Membrane Filter Lab Ref. No. Result'.. Analyst Z 4L I I m I I m I J m I J m .No. of <olonlW100 ml. or Noof oon.ons 06-1220 (b) BACTERIOLOGICAL WATER ANALYSIS RECORD Rev. 1978 Date Multiple Tube Report: Membrane Filter: Dlre t Count verification: Final Membn Reported By Broth 24 hour$: Broth 48 hour: 10ml Tubes Posltive/Total 20ml Portipna Collform/loornl August 30, 1983 Leon Thompson 8210 Sandy Place Anchorage, AX 95507 Subject: Lot. 5, :spruce Acres Subdivision Approval for the individual sewer and water facilities cannot be granted until the following items have been completed The depression or pit around the well casing needs to be filled with impervious type soil so that it slopes away from the well casing. Please notify this Department for a reinspection when the note=d discrepancies have been corrected. If there, are any further questions, please call this office at 264-4720. :sincerely, Corry Oillis, R.S. w—I c :x e v 61,_1 � Ol el asp - GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received Ah7 Time of Inspection ( 4 Date of Inspection j; REQUEST FOR APPROVAL OF IIVIDUAL SEWER & WATER FACILITIES FOR �% �f ,. r,. A. -21 1. Approval requested by: �il��� A6L--x %��tr.✓ V Mailing Address: [.J, YtA(�, Phone: o777-DsS�� 2. Property Owner: /y (S V /Phone: 3�y- 99�oZ / i 61 Mailing Address: baso �J 3. Legal Description: 4. Location: d:,e 5. Type of facility to be inspected 6. Well Data: ' 0 Type —LZ. B. Depth No. of bedrooms 3 C. Construction W D. Bacterial Analysis 7. Sewage Disposal System: A. Installed B. Installer C. Septic Tank: 1. Size D. Seepage Pit: 1. Absorption Area _ E. Disposal Field: Total length of lines 8. Distances: 2. Manufacturer 2. Material 7 A. Well to: Septic tank Absorption area Sewer Lines Nearest lot line Other contamination B. Foundation to septic tank , Absorption area C. Absorption area to nearest lot line EQ -034 (1/74) Page 1 of two pages Page 2 of two pages - Requ_A for Approval of Individual r & Water Facilities fK Legal Description Comments Approved Disapproved Date Approval.Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM 1 M to L,o�> I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED EQ -034 (1/74) Date GREATER ANCHORAGE ARL;, BOROUGH Department of Environmental Quality 3330 "C" St., Anchorage, Alaska 99503 - 274-4561 6. Legal Description: Lot 5, Spruce Acres Subdivision, Anchorage, Alaska Location: 8240 Sandy Place, Anchorage, Alaska 7. Type of Facility to be inspected: well No. Bdrms. 3 8. Water Supply Type of Supply: Public Utility individual xxxxx If Individual, number of dwellings presently served 1 If Individual, depth of well unk. 9. Sewage Disposal System Type,of System: Public Utility xxxx Individual (on-site) If.Individual, date of installation REQUEST FOR APPROVAL OF 11'F 197 � INDIVIDUAL SEWER & WATER FACILITIES AN GD1EA/E DEPT. OFNVl'7' AREA UAAITY80"0 1. Type of Inspection: CMRO VA xxxx FHA _ CONV 2. Property Owner: Bobby D. Janeway and Sharon Janeway Mailing Address: 8240 Sandy Place Anchorage Day Phone 344-9952 3. Name of Buyer: Leon Thompson and Gladys I. Thompson Flailing Address: 6001 Miley St., Anchorage Day Phone 333-4020 4. Name of Lending Institution: Spokane Mortgage Co,. Mailing Address: 523 W. 8th Avenue, Anchorage Phone 277-0543 5. Name of Realtor or Agent: Hal Graser Realty - Bill Foster or Wik Congdon Mailing Address: 2409 "c" St., Anchorage Phone 279-0491 6. Legal Description: Lot 5, Spruce Acres Subdivision, Anchorage, Alaska Location: 8240 Sandy Place, Anchorage, Alaska 7. Type of Facility to be inspected: well No. Bdrms. 3 8. Water Supply Type of Supply: Public Utility individual xxxxx If Individual, number of dwellings presently served 1 If Individual, depth of well unk. 9. Sewage Disposal System Type,of System: Public Utility xxxx Individual (on-site) If.Individual, date of installation 06-1220(a) Re, 1973 ALA ;APARTMENT OF HEALTH AND SOCIAL SI. TS DIVISIOW OF PUBLIC HEALTH Lab No INDIVIDUAL AND SEMI-PUBLIC BACTERIOLOGICAL- WATER ANALYSIS OFFICE INDIVIDUAL [I SEMI-PUBLIC 0 CHLORINE RESIDUAL PPM REPORT RESULTSTO- - NAME C! 0y/U/� NIt? ADDRESS 3 • 7 -it �f.1 �/" - CITY ZIP CODE -, s ADDRESS -7 ! I✓7r I/J/� i/ �J iIC . OF SOURCE =" '�� / /% • �' Analysis shows this Water SAMPLE to be: 0"• Satisfactory E] Unsatisfactory - - ❑ Questionable 0 Sample too long in transit, sample should not be over 48 hours old at examination to indicate reliable results. Please send new sample. ❑ Bottle broken in transit, please send new sample. SANITARIAN'S REMARKS COMPLETE THIS SECTION ' ONLY IF WATER IS AN INDIVIDUAL SUPPLY -- ) SAMPLE COLLECTED BY 3�� I,j- h DATE COLLECTED ' TIME COLLECTED. - - - Sample Collected From - .O., Kitchen Tap ❑ Bathroom Tap L] Basement Tap e ' ❑ Other (List) - Well — 0 Dug 0 Driven ,Drilled r ❑ Bored , SOURCE: - 0 Spring ❑ Cistern ❑ Other -- Dug Well. or Cistern Construction: - Walls -0 Wood ❑ Concr le Metal 0 Tile B, ", - - Top — E) Wood ❑ Concrete -W Metal 0. Open Top 0 Concrete LOCATION: - - - - E) In Basement 0 Basement Offset ❑ Under House ( In Yard ❑ Other Building Sewer Septic - DISTANCE TO: or Other Drainage Pipe Feet. Tank. Feet Tile - Seepage Cass- field es Field Feet. Pit Feet. Pool Feet. Privy Feet. Other Possible Sources of Contamination MATERIAL: Building Sewer- ❑ Cast Iron ❑ Wood ❑ Tile Q"Fibre ❑ Asbestos" Cement ❑ Plastic Joint Material - Type GENERAL: Does Water Become Muddy or Discolored? 0 Yes El No When? Diameterof Well Depth -Feet. Well Casing - Material Diameter Depth Length of - - Wafer Depth - Drop Pipe From Bottom Feet. Offset in In Utility PUMP LOCATION: ❑ In Well ❑ Basement El In Basement ❑Boom (% On Top E] Of Well 0 Other PURPOSE OF EXAMINATION: Illness Suspected? 0 Yes 0 No New Source of Supply? ❑ Yes 0 No Repairs to System? ❑ Yes ❑,No Signature' — 06-1220 rot BACTERIOLOGICAL WATER ANALYSIS RECORD Rev. 1973 1 READ INSTRUCTIONSDate Received / Time Received pra gab. No. — ON -( REVERSE SIDE BEFORE COLLECTING SAMPLE lactose Broth lice IOcc IOcc lice LDcc 1.0cc 1.Occ 24 Hours - 48 Hours Brilliant Green -. 24 Hours 48 Hours WAR Lactose Broth, 24 his. 48 Coliform Density MF Results Gram's stain — (Most probable No. per 100cc) a.m. Reported by �� � 7 1 Dale P.m. This analysis indicates Coliform Organisms to be:. <- Absent Present 06-1220 (a)5_IAIt UI'ALASRA �J/ DEF`4 LENT OF HEALTH AND SOCIAL Sf 'CES Lab" N°"T DIVISION OF PUBLIC HEALTH DATE" ' BACTERIOLOGJCAL WATER ANALYSIS PUBLIC ❑ SEMI"PUBLIC ❑ INDIVIDUALS ' O - REPORT RESULTS TO NAME ADDRESS CITY ADDRESSl.- r19 qA1 IRDF 1 Records in this office indicate this WATER SUPPLY to be of".': - II] Satisfactory ❑ Questionable - ❑ Unsatisfactory Sanitary Status. ` XAnalysis shows this Water SAMPLE to be: -atisfactory ❑ Questionable ❑ Unsatisfactory. ZIP If an "Unsatisfactory" or "Questionable" status is indicated above - —CODE You should take immediate action as recommended below. 1. Notify consumers water is polluted. Boil or chemically-- .- treat this water as outlined in the enclosed leaflet "Drink It Pure." hlorination sufficiently to meet recommended residual standards. SAMPLE COLLECTED BY 2. Increase c Determine source ofcontamination and take action necessary to maintain DATE COLLECTED / TIME COLLECTED r r P. - a safe water supply at all times. Sample Collected From ❑ Kitchen Tap ❑ Bathroom Tap D Basement Tap 3. Check chlorination and other mechanical equipment. Make certain it is - 0Other (List) _ functioning properly. Well D Dug D Driven D Drilled SOURCE: ❑Spring F] Cistern DOther- Dug Well or Cistern Construction: y This is a surface water source and subject to pollution by man and animals. Walls— O Wood C] Concrete F] Metal Top— ❑ Wood 11 Concrete ❑Metal LOCATION: - - D In Basement D Basement Offset E] In Yard. ❑Other D Open Top Building Sewer Relocate your well to a safe location in relationship to your sewage disposal D Under House DISTANCETO: or Other Dn,m.ge Pipe Fee Tile - Seepage 8. Cess - Field Feet Pit Feet. Pool Other Passible , Sources of Contammabon MATERIAL: Building Sewer— Olmn ❑Wood Cl Plastic Joint Material —Type GENERAL: Does Water Become Muddy or Discolored? D Tile D Yes D No Diameter of Well 4. If.afterchecking equipment a disinfecting residual is not obtained, please - Well Casing Material - - wire this office for: emergency assistance or advisory services. - - - D Bored y This is a surface water source and subject to pollution by man and animals. Drop Pipe From Bottom An approved water supply source should be developed. - - - PUMP LOCATION: Brick or 6. Improveyour Ospring Odugwell Odrivenwell Odrilledwell ❑cistern ❑ Tile ElConcrete- - D Open Top 7, Relocate your well to a safe location in relationship to your sewage disposal D Under House system. O see enclosure - 8. Sample too .long in transit; sample should not be over 48hours old at xic - nk- Feet.-. examination to indicate reliable results, please send new sample: :t. Privy. Feet" O Bottle Broken in transit, please send new sample. your nearest - D Local Health Department or - ❑ Alaska -9..Contact Ci Fibre_. ❑Csmant Asbestos Division of Public Health, sanitation office for bulletins, consultation and assistance. - ---' SANITARIAN'S REMARKS- - - - - D Yes D No Diameter of Well Depth ,.Feet. Well Casing Material Diameter Depth Length of - Water Depth - _ Feet. Drop Pipe From Bottom - PUMP LOCATION: _ Offset In In Basement -.❑ In Wall D D Basement D In Utility Room O On Tap ❑Other Of Well PURPOSE OF EXAMINATION: Illness Suspected? - ❑Yes ❑No New Source of Supply? 'D Yes D No Repairs to System? ❑Yes ❑ No _ ' JV Signature f% READ INSTRUCTIONS ON REVERSE SIDE BEFORE COLLECTING SAMPLE 06-1220: (b) BACTERIOLOGICAL WATER ANALYSIS RECORD - - f Time Received --� " labl No - Lactose Received ! Lactose Broth - 10cc -. locc Tom 10cc locc 1.0cc 0.lcc 24 hours - 48 hours Brilliant Green - 24 hours 48 hours - - - EMB —Lactose Broth, 24 fire. '41 —Coliform Density —MF results Detergent Test - - —Reported by - %%��%�1 D, iThis analysis indicates Coliform Organisms to be: AGAR rs. Gram's stain (Most probable No. per 100cc.) (____Absentl4 Present