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Home My WebLink AboutCAMPBELL LAKE Tract 6An DATE RECEIVED · INSPECTION APPOINTMENTS )ATE DATE DATE ,NSPECTOR ,NSPECTOH INSPECT fn MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE ~,~, ,~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIONDEpT- OF HEAt. TH & 825 L Street * Anchorage, Alaska 99501 ENVII~ONMENTAL P;OTECTION /'//~'1~ ~ '~_ _~/~r~t ENVIRONMENTAL SANITATION DIVISION OCT ? 1980 Telephone 264-4720 .EouEsT Fo. A...OVAL OF DIRECTIONS: Complete all parts on page ~. Incomplete r~qu~ts will not be proces~KI. Please ~llow ten (10) days for processing. to PROPERTY OWNER I PHONE Theodore R. DunnI ----- MAILING ADDRESS Out:-o£-St:at:e .... Cont:act: Real Est:at:e Agent: £or add,ess -I~ req~d. PROPERTY RESIDENT (11 different from ~bove) PHONE 2. BUYER ~*'~1 ~ PRONE Dale K. & Bet:t:y J. Edwards 276-5909 MAILING ADDRESS 4622 Sheliko£ St:., Anchorage, A~ 99507 3. LENDING INSTITUTION IPR°NE Lomas & ~ett:le~on Co. 274-766! MAILING ADDRESS /+4~9 BUSinBBB ?a~k Boulevard, Anchorage, A~ 99503 4. REALTOR/AGENT I PHONE Elliot C. Lavson/ JACK WHTTE CO['~'ANYI 277-1553 MAILING ADDRESS 3201 C St.~ Anchorage, AK 99503 PLEASE CONTACT E. C. LAWSON, JACK WHITE CO., FOR ACCESS TO HOME FOR WATER SAMPLE S. LEGAL DESCRIPTION · Tract: 6At Campbell Lake Tract:s TRENT LOCATION 9631 Vici:or Road (Dimond Blvd. to Vici:or Road .... home ts on lake side) 6. TYPE OF RESIDENCE NUMBER OF~BEDROOMS [] One ~,, Four ~, SINGLE FAMILY [] Two [] Five [] MULTIPLE FAMILY I--~ Three [] Six [] Other 7. WATER SUPPLY / ~O ~'~' '1~ INDIVIDUAL· · ATTACH WELL LOG. A well log is required for all wells d~illed [] COMMUNITY since June 1975. For wells drilled prior to that date, give well [] PUBLIC UTI LITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM 1-'1 INDIVIDUAL/ON-SITE** ~_~ ~/. ~ YEAR ON-SITE SYSTEM WAS INSTALLED. ~ PUBLIC UTILITY ~ ~J~'~ ~'~:) ~[[.. ~3~.~ ~(t.~rt.'~ ,,. ~, ~,~\~.,~.. 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 NUMBER OF BEDROOMS [] ONE [] THREE [] FIVE I--I TWO [] FOUR [] SIX [] OTHER 2. WATER SUPPLY r-I INDIVIDUAL .. [] COMMUNITY r-I PUBLIC UTILITY Connect[on Verified 3. SEWAGE DISPOSAL SYSTEM []INDIVIDUAL/ON -SITE []PUBLIC UTILITY Connection Verified []SepticTank or •HoldingTank Size: If Tank is homemade give dimensions: PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED PERMIT NUMBER IAb$orpti:n Area ISewer Line INearest Lot Line DATEINSTALLED INSTALLER SOILS RATING TYPEOFTANK MANUFACTURER MATERIAL ~eptic/Holding Tank TOTAL ABSORPTION AREA 4. DISTANCES WELLTO: 5. COMMENTS DATE [~APPROV ED FOR ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) I-'1 DISAPPROVED 72.010 (Rev. 6/79) /V cipalieYo Anchorage DEPARTMENTOF HEALTH AND ENVIRONMENTAL PROTECTION ~'}/'~ !~.~ ~.o October 13, 1980 Thedore R. Dunn % Elliot C. Lawson Jack White Company 3201 C Street Anchorage, Alaska 99503 Subject: Tract 6A Campbell Lake Tracts Subdivision Approval for your individual sewer,and water facilities cannot be granted until the following items have been completed: (1) The water analysis report be delivered to this department from Chem Lab, 5633 B Street, for our review. (2) Locate and expose the well for our inspection to insure proper construction and distance requirements. If there are any further questions, please call this department at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw cc: Lomas and Nettleton 4449 Business Park Boulevard 99503 . . C=HEMICAL & GLo, LOGICAL LABORATORIES~ ALASKA, INC. i ~ TELEPHONE (g07)-279-4014 5633 S Street. TO BE COMPLETED By WATER SUPPLIER WATER SYSTEM: Water System Name Mailing Address City ..... ;': - · S~ate Mo. I:~y ' Year · ' ' Zip Cede SAMPLE TYPE: D Routine [:3 Check Sample (for routine sample with lab ref. no. [3 Special Purpose ) Treated Water Untreated Water T°' BE COMPLETED BY LABORATORY A, na'lysis shows this Water SAMPLE to be: ~].~atisfactory I'-] 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 .. J',~ /.., ., 43 Analytical Method: [3 F~rmentatlon Tube ~'~ Membrane Filter SAMPLE NO. LOCATION Time CoflecteC 4I I -. I I Lab Ref. NO. Result* Analyst I ~ I ~ BACTERIOLOGICAL WATER ANALYSIS RECORD _READ INSTRUCTIONS _BEFORE 4, ,.,,~,, _COLLECTING SAMPL F a) Remove any aerators or screens attached to the'outlet. b) Thoroughly flush tap or pump b,~ allowing water to run freely with a fully opened outlet for three or four minutes. ' ci Reduce flow so :that Small stream flows, d) Remove bottle from mailing tube, Hold bottle in one hand while removing cap with the other, -' AvOid touching the neck of the bottle and tho inside of the' cap, e) Fill the bottle to its shoulder while attempting to avoid splashing, Immediatel;/replac_e.cap,.b. eing - ~ sure that It is tight, but not so tight as to split the cap, -fi- 'Complete the'po-rtion of the lab ~o~n~ Which is indic,~ted "TO BE COMPLETED BY SUPPLIERS" - Fill in all appropriate blanks carefully, including your public water system identification number (ID No,), Contact the Alaska Department of Environmental Conservation if you do not know your ID number, (Public water suppliers only) ._ g) Pack bottle ,carefully in mailing ;tube With lab form,~ ~-;' ' -- The requirements for analysis of public water systems for total coliform bacteria are defined in the Drinking Water regulations administered by the Department of Environmental Conservation, .... ~ . Directions for Collecting Samples of Water for., .,~ t' Col m ' " ' "- :- To al ifor Bacteria Examination This water anaiySis deals with materials present in verY minute quantities. Carelessness in collecting and handling may lead to misleading results. Water samples will have to reach the laboratory as quickly as possible within 48 hours after collection. After 48 hours, the Significance of the bacter~olog'cal analysis is impaired and resampling will be nec- essary. Send to Laboratory fastest way: {i.e. special delivery mail.} In collecting samples from TAPS or PUMPS pr eed as follows: