HomeMy WebLinkAboutSPRUCE ACRES LT 10014-?_51 - !-7-oo o
, GRE/~R ANCHORAGE Area bo[~%JgH
DEP,A, RTMENT OF ENVIRONMENTAL QUALITY PERMIT NO.
[~'~1~11~111'~/~1 TELEPHONE 274-4561 ~ ~ ~
TO ,E ,.STALLED BY
NOTE; THIS PERMIT
INSTALLATION OF: SEPTIC TANK
TYPE AND SIZE OF FACILITY TO BE SERVED
FINANCED THROUGH
SOIL TEST RESULTS
COMPLETION DATE ANTICIPATED
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE , TYPE SEEPAGE AREA SIZE TYPE
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE Pit
SEPTIC TANK TO SEEPAGE Pit WALL
SEPTIC TANK , SEEPAGE PIT
ORA,N F,ELD
WATER MAIN TO SEPTIC TANK
DRAIN FIELD
SEPTIC TANK, , SEEPAGE PIT DRAIN FIELE
TO RIVER, LAKE, STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP
EXCAVATION !5 FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
DIAGRAM OF SYSTEM
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GRE~ER-A~I~ORAGE AREA BOROUGH ORDINP
DATE ~[ r~ ~ ~ APPLICANT'S SISNATURE
28-68 AND THAT THE ABOVE
~ob K~lly
On S~pte'ml)~r 8, 1975 yo~ tc~k Out a well perm£~ from
be approve~.
06-1220[a) Rev. 1973
BACTERIOLOGIC.AL' WATER
ALL.~:DEPARTMENT OF J.IEALTH AND SOCIAL ~;~_.iCES
DIVISION OF PUBLIC HEALTH L,,b No.
INDIVIDUAL AND SEMI.PUBLIC
A N A L Y S I',S ?7,CE
INDIVIDUAL ~ SEMi-PUBLIC [] C '~LORINE RESIDUAL PPM
REPORT RESULTS TO
NAME .>/~.Z~- ~' ' r. ] g ?;. i /x~'~.-~(.7/
:>, .... .,. :' "' ? -//.
. ~ z.,' -",.../It:~E. -
ADDRESS z ~
OF SOURCE '' ' ;
Analysis shows this Waler SAMPLE to be:
[] Satisfactory
[] Un~atlsfaclory .
[] Questionable
[] Sample lOB long in transit; sample should not be over 48
hours old at examination to indicate rellable results. Please
send new sample.
[] Bolfle broken in transit, olease send new sample.
. - :_ SANITARIAN'.S REMARKS
COMPLETE THIS SECTION
ONLY IF WATER IS AN INDIVIDUAL SUPPLY
SAMPLE COLLECTED BY · - ~ '~ "~
[] Fibre [] Asbeslos
Cemenl
PUMP LOCA:rI(~N: E] In Well · 3asement [] In Basemenl [] Room -
[] Of Well ~ Other
~URPOSE OF EXAMINATION: Illness Suspected? [] Yes [] No
READ INSTRUCTIONS
ON
REVERSE SIDE
Absent
EMB ' AGAR
Coliform Density _ //..-~ //_~) ' (Most probable Ho. per 10Oct)
Lactose Broth :' :~' i0cc 10cc 10cc 10¢c 10cc 1 .Bec 1.0cc
48 Hours ' - J '/-
Brilliant Green
48 Hours
COLLECTING SAMPLE
BEFORE
o6-122o (b~ BACTERIOLOGICAL WATER ANALYSIS RECORD
/'1 '7 /~/---}..3 ~ ........ C_.~=' ~ om £~b.
Dale Recelved __ ?' W~' ~- Time Received .,~m
-- STATE OF ALASKA U:. ~,., ~
ADHW - LAB - 2W~z
': ..... - DE~""~TMENT OF HEALTH AND WELFf"-'~
DIVISION OF PUBLIC HEALTH
~/~~ /'~>
/.,. /L:? BACTERIOLOGICAb;WATER ANALYSIS
Walls - ~ Wood ~ Concrete ~ Melal ~ Tile ~ Concrele
GENERAL: Does Water Become Muddy or Discolored? ~ Yes ~ No 5ANITARIAN'S RE~RKS
READ INSTRUCTIONS
ON
REVERSE SIDE
BEFORE
COLLECTING SAMPLE
BACTERIOLOGICAL WATER ANALYSIS RECORD
/,--://,. ' _
/
Brilliant Green
24 hours
48 hours
EMB AGAR
Lactose Broth, 24 hrs. 48 hrs. Gram's stain
Coliform Densily. (Mosf probable No. per 100cc.)