HomeMy WebLinkAboutEAGLE RIVER HEIGHTS BLK 5 LT 21
Rev. JuJy 195~. FEDERAL HOUSING ADMINISTRATION Budget Bureau No. 63-R296.8
HEALTH AUTHORITY APPROVAL
INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM
PART I.--TO BE COMPLETED BY FHA
INSURING OFFICE MORTGAGEE SERIAL NO.
ino~ AluJm, ]latiom~l ~m~k of iZaeh ~'rJ-OO06hg-203
MORTGAGOR OR SPONSOR PROPER~ ADDRESS
~DIVISION NAME J BLOCK NO. LOT NO.
~.n ~1~ or other .~. be m.de In~o
TOTAL NUMBER: BASEMENT ~ New ins[a]ladoR additional bed~oms?
LIVING UNITS ~EDROOMS BATHS (If Yes, how many~)
WATER SUPPLY BY: ~YSTEM DESIGNED FOR
~ ~blic system ~ ~mmuniw system ~ Individual ,o. oF BD,~. GARBAGE DISPOSAL
SEWAGE DISPOSAL
g Individual No
PART II.~TO BE COMPLETED BY HEALTH DEPARTMENT
HEALTH DEPARTMENT INSPE~OR'S SKETCH
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It is the opinion of ~e ~ State ~ Coun~ ~ Local Department of Health that this individual water-supply system
~ is ~ is not satisfactory as a domestic water supply for the subject propers.
It is the opinion of the ~ State ~ County ~ Local Department of Health that this individual sewage-disposal sys-
tem with proper maintenance:
~C~ be expe~ed to hnction satisfactorily, and ~ Cannot be expected to function satisfactorily
~s not likely to create an insanita~ condition
NOTE: The health ~thom~ should eomplete the appraprlate opinlon statement above and affix date, signature and tiHe in the
spaces provided.
Use of the above grld for Health Department Inspeetor's sketch as well as use of the back of this form is at ~he option of the
health authority.
PART III.~FOR USE OF FHA OFFICE
lO TNE {81EF UN~ERWRIIER~
I have reviewed the foregoing and the peninent FHA Compli~ce Ins~ion Repoa, and recomend that 'the
Individu~ water-supply system ~ considered ~ Acceptable ~ Not Acceptable
~wage dis~sal ~ considered ~ Acceptable ~ Not Acceptable.
DAlE S~GN~TURE ~ CHIEF ARCHITECT
DEPU~ FOR CHI~F ARCHITECT
HEALTH AUTHORITY APPROVAL
INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM
FHA Form 2S73
Rev. Ju~y 1958
REPORT OF INSPECTION--INDIVIDUAL SEWAGE-DISPOSAL SYSTEM
PRIMARY TREATMENT consists of 1~ Septic tank. [] Cesspool.
Septic Tank:
Distance from well,__feer. Material ~¢~--- I
Total liquid capacity~ ~vOO gallons. Capacity inlet compartment,
Inside length~ feet. Inside width, feet. Liquid depth,
Ce~$p~l:
Distance from: Well,
Inside diameter,
Number of compartments
feet,
_gallons.
feet; foundation, feet; nearest lot line at [] front, [] side, [] rear, .feet.
feet. Depth,. feet. Liquid capacity, gallons. Lining material
SECONDARY TREATMENT consists of [] Tile disposal field, all'Seepage pits. Other Tile Disposal Field:
Distance from: Well, feet; foundation~ feet; nearest lot line at [] front, [] side, [] rear, feet.
Total length of tile lines, feet. Number of lines, Distance between lines, feet.
Trench width, in~:hes. Total effective absorption area in bottom of trenches, square feet.
Length of each line, feet. Depth, mp of tile to finish grade, inches.
Type of filter material: [] Gravel. [] Broken stone. Other
Depth of filter material beneath tile,, inches. Depth of filter material over tile, inches.
Seepage Pits:
Number of pits J . Outside diameter,. _~'_ feet. Depth, /~ feet. Lining material
Distance from: Well, feet; building foundation. ~ '~' feet; nearest lot line at [~ront, [] si~e,~ rear,.~lr-feet.
Insp~dion made by: ,[11~ State. [--I County. FI Local Health Authotity. __ /y //'~
r~ Inspected by ~ ! ~ ,
Date of insp=ion
REPORT OF INSPECTION--INDIVIDUAL WATER-SUPPLY SYSTEM
Distance to nearest public water main, feet. Size of main, inches.
Individual wells [] are [] are not customary in neighborhood.
Give most recent record of failure of wells in immediate vicinity to furnish adequate supply of water
Properties in neighborhood [] are [] are not being developed with both individual water-supply and sewage-disposal systems.
Lot size' feet wide, feet deep. Dwelling set back from front property line,, feet.
Individual water supply from: [] Drilled well. [] Driven well. [] Dug well. [] Bored well.
Distance of well from:
Building foundation
cast iron sewer,
seepage pit,.
Well constr, cflon:
feet; tile sewer,.
feet; cesspool,
feet; nearest lot line at [] front, [] side, [] rear, feet,
.feet; septic tank, feet; disposal field, feet;
feet; other sources of possible pollution, feet.
Diameter, inches. Total depth, feet. Type of casing,
Approximate depth to pumping level of water in well .feet. Approximate yield,
Sealed watertight to depth of feet.
Exterior space around casing sealed with: [] Cement grout. [] Puddled clay. [] Ordinary backfill.
Well cover: [] Concrete. [] Wood. [] Metal. Openings in well cover watertight: [] Yes. [] No.
Pump: [] Shallow well. [] Deep well. Length of drop pipe, feet. Pump capacity,
Located in: [] Basement. [] Pumproom off basement. [] Pumphouse above ground. [] Pump pit.
Pumproom properly drained: [] Yes. [] No. Pump mounting watertight: [] Yes. [] No.
Type of storage: [] Pressure. [] Gravity. Capacity,. _gallons.
Has bacteriological examination of water been made? [] Yes. [] No. If answer is "yes," give date
Quality of water [] is [] is not satisfactory for human consumption.
Installation [] does [] does not comply with approved exhibits, if any.
Inspection made by: [] State. [] County. [] Local Health Authority.
Inspected by
Date of inspection 19__
Depth of casing, .feet.
_gallons per minute.
.gallons per minute.
,19
(TITLE)
~A~hb
October 19, 1962
Mr. Paul R. Timmins, Director
Federal Housing Ad~istration
716 Fifth Avenue
Anchorage, Alaska
Dear Sirl
A properly designed individual sewage system can
be expected to function satisfactorily on the
following described property.'
Eagle River Heights Subdivision; Block
5, Lot 22
Yours very truly,
EDWIN O. ~CK$, M.D., Dr. P.H.
DIRECTOR
John R. Kuhn
District Sanitarian