HomeMy WebLinkAboutRINNER RANCH ESTATES LT 10
t"!:!:i'.,iZi"!I..II'"I [:, ): :E;-t'FIi'.,!C[~{ Ef:E~ I"l,.![i:[~t'.-! i:::1 l,.llli]._L F:I?.,II:::, F:!I'-,I"? (]N-...::~;:i:Tf_:i: :SE!.,.iFI(:ili!!: [:,!~SF'O:ii;Fi!.... :.~!;"r':5"!"E:h!
::L!!iu3 F'!i!!:!:::T F'!3Fi: I::! F'I:;~'.I',,,'FTI'[i: !.,.iEiJLL. Gi:;;: ::[.tS(i!~ T'O ;;?.0~;:3 l::' [ii: E '!" i::'FtCfi"I I:::! l:::'t..If.'~i~L. :[ (3 i.,.!!:ii;L.!...
UF:'ON ~'i"I[E 'i'"?!:::'E: OF:: F'UE',L.:[C t,.!E:L.t
i"'Ii!:i",!]:!"!1...!1"1 I:::, :I: :i~;'FFfl",!(:::E: F:'.[;i:I:;:~i'"! F:I F't:~:I',,,'FI"I"li: HI_:EI._.L. TO FI F'F:):',,,'FI"FI~: :!i;!!'~:h.ff.E!::i: I....J:NE: :!:~!; Zi:!!!;.; F' [!; [:i: !" FiND
TO i:::1 COHHLtN:I:'T"~" ~.~;E!,.IE:Fi: !.... :l: l",lfi: :[~!; 7!!!; ?iE:E:'T'.
t.,.I[i::L.L I...(]13:~:i; !::tFiI[:~: i:;?.Ii.~(;:!U:i:F:E:D F:IND h'll...rJ~';'T Eq!ii: [;:E:'T'UF.:N[E[:, "f"CI Tl.-l!!i: [:,Ei:!:::'FI!:;;:"FHI.:::i'.,!F I,.! ~ 'T'FI /: ?.J ?3
O1'::' THE: I,.!E:L.L. COHF'LIE'I"ICIN.
OTI-.][i~:f::: l:;i:[ii:t;:!t...i :f: F:..:Ei:HEH'T:!!; !"!!:::1'.~.' FI!:::'F'L.'.r'. 'i!;F:'[i:C ]: !:::' :1: CI::IT ]: ON:iT; F:IN[:, CONrE;TI:~:I...iC T' ]: ON [:, ]: F:!(.~l:;:t::-ll',!:ii;
F:I'v'F! :t: L. FIE~I..!i~: 'T'O I !'.,!:SU.r.;~:E: i::'l:;~:Ol::'l~iF: ]: NE;'TF::IL.L.I::'!'F i diN.
Size Casing
Static Water Level ?"!?' feet
Date gl Completion
W.W.B.
Water Well Brilling
Phone 349-3809
Anchorage, AK.
Depth of Hole / . 2 2/ Cased to "
Well Test ; 4.¢5) 6al per Minute for / ''f' ',
feet
Hours
WELL LOG
AUTHORIZATION TO DRILL
hereby authorize W.W.D. Drilling to proceed with the above work. Payment shall be made in the following manner:
Rig up Minimum (50% of anticipated depth) _ .feet. @ per foot
Balance due upon completion.
In the event it is necessary to institute legal proceedings to collect any amounts due on this contract, I agree to pay an additional
sum of Ten percent (10%) of the original contract price as attorney's fees, plus costs, for legal proceedings.
Name
Date Address
· DATE RECEIVED
, INSPECTION APPOINTMENTS
DATE DATE DATE
INSPECTOR INSPECTOR INSPECTOR~i
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTI~'/IROF' ' ~ ~:~CI'~ON
82~ L Street - Anchorage, Alaska 99501
:',',
ENVIRONMENTAL SANITATION DIVISlO~
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS: Complete all parts o~l page 1, Incomplete r~quests will not be processed, Please allow ten (10) days for processing,
MAILING AOD~ESS~
PRdPERTY(~S~D~N~ (If differe'nt from above) PHONE
2.:BUYER : :~ ~_ : ~: -- ~ PHONE
MAI LING ADDRESS ·
3, LENDIN~ E~S~ITU~I~N PHONE
4, ~LTO~/AGENT PHONE
5. LEGAL DESCRIPTION
iTR F~ET LO OATI O~',,I.
TYPE OF RESIDENCE NUMBER OF~BEDROOMS
~ 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.)
SEWAGE DISPOSAL SYSTEM
[] INDIVIDUAL/ON-SITE**
I~ 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
[~]/~ING LE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2. WATER SUPPLY
,{~,r INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTILITY
Connection Verified LOG RECEIVED
3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
pNDIVIDUAL/ON -SIT~;~, ~- DATE INSTALLED
UBLIC 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 Septic/Holding Tank IAbsorption Area Sewer Line I Nearest Lot Line
I
WELL TO:
Absorption Area to nearest Lot Line
5. COMMENTS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
[] DISAPPROVED
72-010 (Rev. 6/79)
/CHEMICAL & GI~,_ LOGICAL LABORATORIES 0~.¢ ALASKA, INC~ ~
Drinking Water Analysi Report for Total Coliform Bacteria ~
TO BE COMPLETED BY WATER SUPPLIER
; I.D. NO.
Water System Name Phone No.
Mailing Address
City State Zip Code
Mo. Day Year
SAMPLE TYPE:
[] Routine
[] Check Sample (for routine sample
with lab ref, no. )
E] Special Purpose
[] Treated Water
[] Untreated Water
SAMPLE
NO. LOCATION
1
4 I
Time Collected
Collected By
TO BE COMPLETED BY LABORATORY
Analysis shows this Water SAMPLE to be:
~ Satisfactory
[] 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
Analytical Method:
[] Fermentation Tube
E] Membrane Filter
Lab Ref, No. Result* Analyst
I I
READ INSTRUCTIONS
BEFORE
COLLECTING SAMPLE
06-1220 (b)
Rev, 1978
BACTERIOLOGICAL WATER ANALYSIS RECORD
Date Received Time Received P.m. Lab, NO,
Presumptive 10mi 10mi 10mi 10mi 10mi 1,0mi 0,1mi
24 Hours
48 Hours
Confirmatory
24 Hours
~ 48 Hours
Multiple Tube Report=
Membrane Filter= Direct Count
Verification= LTB
Final Membrane Filter Results
Reported By
Broth 24 houra=
Broth 48 hours~
10mi Tubes Positive/Total 1Omi Po~tlona
Collform/100ml
BGB
Date
Collform/~.00~l
PLA T APPROVAL
De/to Rad~$ &ength Ta~geal
04° 03' 24" 50. OD' ~.54' 1.77'
~ 06' 24" 50.00' 55.00' ~8.~5'
46~45' 55" 50.00' 40.81'
LO'[
LlflE
LI N O0°04' 54" W 2 51'
L2 N 89° 55~ 06" E ~5.00'
ACCEPTANCE OF DEDICA T/ON
Dated ~ Anchorage, Alaska th/s~ day of
~ /:.~11 ~1~'~' '
CONTRACTING E~INEERS & AS~CIA~S
~12 E. ~N~RNATiONAL ~R~RT
ANCHO~, ALASKA 9950~ {90~562-21~