HomeMy WebLinkAboutRINNER RANCH ESTATES LT 3
January 4, 1982
Gold Crown Enterprises
2916 E. 68th Ave.
Anchorage, AK 99507
Permit % 8111.66
Subject: L3 Rinner Ranch Est.
A permit issued by this department for a well and/or sewer
system has expired as of December 31, 1981.
Permits are issued on a calendar year basis, as stated on
the permit, by authority of Municipal Ordinance.
If you have drilled the well, a welt log should be sent to
this department to document the installation date.
If an engineer inspected the installation of the on-site
sewer system, please have them send us the as-builts for our
files.
If there are any further questions, please call this office
a~ 264-4720.
sincerely,
Sewer and Water Program
Enclosure: Copy of Permit
THE;
d
D~.~E F~ECEIVED
INSPECTION APPOINTMENTS
TIME TIME TIME
bATE bATE
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
825 L Street - Anchorage. Alaska 99501
ENVIRONMENTAL SANITATION DIVISION
Telephone 264-4720
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS'. Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing.
1. PROPER~YOWNER , /' / PHONE
MAI~NG~R~SS - / - - ' ~'
PROPERTY RESIDEN~ (If different from above PHONE
~ING.AODRESS . _.
MAILING ADDRESS
5, LEG,~L DESCRIPTION _
STREET ~I~CATION
6. TYPE OF RESIDENCE NUMBER OF~BEDROOMS
E~] One [] Four
~ SINGLE FAMILY [] Two [] Five
[] MULTIPLE FAMILY ~ Three [] Six
Other
7. WATER SUPPLY ~ INDIVIDUAL~'
[] COMMUNITY
[] PUBLIC UTILITY
* ATTACH WELL LOG. A well log is required for all wells drilled
since June 1975. For wells drilled prior to that date, give well
depth (attach log if available.)
8, SEWAGE DISPOSAL SYSTEM
[] INDIVIDUAL/ON-SITE**
~ PUBLIC UTILITY
YEAR ON-SITE SYSTEM WAS INSTALLED,
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010 (Rev. 6/79)
THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2, WATER SUPPLY
[] INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTILITY
Connection Verified LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[] INDIVIDUAL/ON -SITE DATE INSTALLED
[]PUBLIC UTILITY
Connection Verified INSTALLER
[]Septic Tank or [] Holding Tank
Size: If Tank is homemade SOILS RATING
give dimensions:
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line
Absorption Area to nearest Lot Line
5, COMMENTS
I.-.'~APP R OV ED FO R'~ BEDROOMS
[] CONDITIONAL APPROVAL (letter must ac~mpany certificate)
[]
72-010 (Rev. 6/79)
Rv ) 4 ] /V'/
INC.
CHEMICAL & GI~ DGICAL LABORATORIES L~ ALASKA,
'-- TELEPHONE (907)-279,4014 ANCHORAGE INDUSTRIAL CENTER '
Drinking Water Analysis Report for Total Coliform Bacteria
NO,
Water System Name Phone No,
Mailing Address
City State Zip Code
Mo, Oay Year
SAMPLE TYPE:
[] Routine
[] Check Sample (for routine sample
with lab ref, no. )
[] Special Purpose
[] Treated Water
[] Untreated Water
SAMPLE
NO,
1
2
3
4
5
LOCATION
Time Collected
Collected ay
TO BE COMPLETED BY LABORATORY
Ana ysls shows this Water SAMPLE to be:
[] Satisfactory
[] Unsatisfactory
[~ Sample too long in transit; sample should
not De over 48 hours old at examination
to ndicate reliable results. Please send
new samole.
Date Received
Time Received
Analytical Method:
[] Fermentation Tube
[] Membrane Filter
Lab Ref. No. Result* Analyst
J
READ INSTRUCTIONS
BEFORE
COLLECTING SAMPLE
06-1220 (b)
Rev, 191S
BACTERIOLOGICAL WATER ANALYSIS RECORD
Date Collecte~ Source
Prelumptlve 10mi 10mi 10mi 10mi 10mi 1.o~m 0,1mi
24 Hours
48 Hours
Confirmatory
24 Houri
48 Hours -----
EMB Broth 24 hours:
Multiple Tube Reporb
Membrane Filter= Direct Count
Varlflcat Ion= LTB.
Final Membrane Filter Rasulti
Reported By
Broth 48 hours:
10mi Tubes Positive/Total 10mi Portions
Collform/100ml
Date
Collform/100ml