HomeMy WebLinkAboutUS SURVEY 3043 LT 27Onsite File
J,5 Survey 3U"43
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t;AjMIrA P"W t •% JJW
& eEOLOGICAL L RATORIF~ OF ALAS~ INC.
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Drinking Water Analysis Report for Total Coliform Bacteria
TELEPHONE
(gO7) 279-4014
Malllng~
Zip Code
City / State
MO. Day Year
SAMPLE TYPE:
[] Routine
[] Check Sample (for routine sample
with lab ref, no.
[] Special Purpose
[] Treated Water
[] Untreated Water
SAMPLE
NO. LOCATION
I
I
Time Collected
Collected
I/;~
TO BE COMPLETED BY LABORATORY
'LABORATORY:
NAME
: ~ . :~ ~ ~ :~--~
ADDRESS
CITY
Date Received
Time Received /
A_palytical Method:
[] Fermentation Tube
~.~x,Membrane Filter
Lab Ref. No. Result*
I I-[3
I
Analyst
READ INSTRUCTIONS
BEFORE
COLLECTING SAMPLE
Form No, 18-310 (3-78)
06-1220 (b)
Rev, 1978
BACTERIOLOGICAL WATER ANALYSIS RECORD
Date Collected Source
DATE:
TO:
FROM:
SUBJECT:
N anic pafity Anchor ge
MUNICIPALITY OF ANCHORAGE
MEMORANDUM DEPI C~F .... L::! &
January ll, 1979
John Lynn, Dept. Health & Environmental
Jeep Reid, Anchorage Sewer Utility
Protection
Sewer Availability, Lot 27, U. S. Survey 3043
Sewer service will be available to Lot 27, U. S. Survey 3043, with
completion of construction of the Girdwood/Alyeska L.I.D. 60-1,
Phase II. The construction is more than 50% complete at this time.
Completion of construction is expected during the 1979 construction
season.
Sincerely,
Design Engineer
Anchorage Water & Sewer Utilities
RGR:nrs
91~)10 (5/78)
MUNICIPALITY OF ANCHORAGE ,MUNIcIPALiTY OF ANCHOR~,~f;- i )~ '~ ~'
DEPARTMENTOFHEALTH& ENVIRONMENTALPROTECTION DEPT. OF H~ALTH & ~
825 L Street - Anchorage, Alaska 99501 ENVIRoi'~MENTAL 9~
P~OTECTION
ENVIRONMENTAL ENGINEERING DIVISION JAN 4 197
Telephone 264-4720 -
)IRECTIONS: Complete all parts on page 1. ~completp requests will not be processed. Please agow ten (10) days for processing.
1. PROPE OWNER ,
PHONE
PHONE
PHONE
2. BUYER
MAI LING A DDR ESS
4. REALTOR/AGENT
PHONE
MAILING ADDRESS
6. TYPE OF RESIDENCE
J~ SINGLE FAMILY
[] MULTIPLE FAMILY
7. WATER SUPPLY
~[~] INDIVIDUAL~
COMMUNITY ~---
PUBLIC UTILITY
8. SEWAGE DISPOSAL SYSTEM
NUMBER OF BEDROOMS
[] One [] Four [] Other__
[] Two [] Five
Three [] Six
*ATTACH WELL LOG. Awell log is required for all wells drilled
;inca June 1975. For wells drilled prior to that date, give
depth (attach log if available.) ~"'//'-' -- 7~)~
[] ND V DUAL/ON S TE** **If individual/on-site, give ~nstallat~on date
..~ If system is over two (2) years old an adequacy test is required
~ PUBLIC UTILITY by this Department.
72~10(3/78)~ ~ --
THIS SIDE FOR OFFICIAL USE ONLY
DATE RECEIVED
INSPECTION APPOINTMENTS
TIME TIME TIME
DATE DATE DATE
INSPECTOR I NSP ECTOR I NSP ECTOR
DIRECTIONS:
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
~ SINGLE FAMILY [] ONE [~ THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2. WATER
DEPTH OF WELL
[] INDIVID~
~'~(v~Y DATE DRILLED
~'~PUBLIC U-TI LITY
~ ~tm~ti~ Verified LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM/ PERMIT NUMBER
~ INDIVIDUAL/ON -SITE /~ ~ DATE INSTALLED
~PUBLIC UTILITY
Conn~~ - iNSTALLER
~ti~an~ or ~Rolding ~nk
Size: If Tank is homemade SOILS RATING
give dimensions:
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
4. DISTANCESwELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line
Absorption Area to nearest Lot Line
~..CONDI*IONAb'APPR~VA~--(4em~must.,~ accompany certificate)
~ DISAPP O~ED
LEGA~ DESORIPTION
'72;0 t0-(Re~3'/7~)