HomeMy WebLinkAboutSUNNY SLOPES LT 12
Budget Bureau No. 63-R296.8
FHA Form 2573 *~ FEDERAL HOUSING ADMINISTRATION
Rev. July 1958.
?.. HEALTH AUTHORITY APPROVAL
INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM
PART I.--TO BE COMPLETED BY FHA
iNSURING OFFICE M~ RTGAGEE 1 SERIAL NO.
Anoho~e~ All,ko ~t }]~%~Lon~l ~nk of ~o~e 111-~00~0~ ~0~
~ORTGAGO~ OR SPONSO ._ ~u~h of CO~do, ~t.12~.~y Slo~s S/D,
VAND~ NO~n ~ ~ ~ ~ ' ~ ...... I B~ocK NO. i LOT NO.
, b~o ~ Subdivision c~m., ar~a ~ made Into
TOTAL N ~ ~ ~~di~n.l bedrooms?
~Public system
] Community system
PART II.~TO BE COMPLETED BY HEALTH DEPARTMENT
HEALTH DEPARTMENT INSPECTOR'S SKETCH
It is the opinion of the [] State [] County [] Local Department of Health that this individual water-supply system
[] is [] is not satisfactory as a domestic water supply for the subject property.
It is the opinion of the [] State' [] County [] Local Department of Health that this individual sewage-disposal sys-
tern with proper maintenance:
[] Can be expected to function satisfactorily, and [] Cannot be expected to function satisfactorily
is not likely to create an insanitary condition
DATE SIGNATURE
NOTE: The health authority should complete the appropriate opimon statement above and amx dote, signature and title in the
spaces provided.
Use of the above grid for Health Department Inspector's sketch as we~l as use of the back of this form is at the option of the
health authority.
PART Ill.--FOR USE OF FHA OFFICE
TO THE CHIEF UNDERWRITER:
I have reviewed the foregoing and the pertinent FHA Compliance Inspection Report, and recommend that'the
Individual water-supply system be considered [] Acceptable [] Not Acceptable
Sewage disposal be considered [] Acceptable [] Not Acceptable.
DATE r SIGNATURE I [] CHJEF ARCHffECT
HEALTH AUTHORITY APPROVAL
INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM
Distance from well,
Total liquid capacity,.
Distance feom: Well,
Inside diameter,
REPORT OF INSPECTION~INDIVIDUAL SEWAGE-DISPOSAL SYSTEM
PRIMARY TREATMENT consists of~ Septic tank. [] Cesspool.
- feet. Mater<_S l C-e/-- N.mherofcomp tment
7'g--O gallons, Capacity inlet compartment,__
_feet. Inside width,_ _feet. Liquid depth, feet.
_gallons.
feet; foundation, feet; nearest lot line at [] front, [] side, [] rear, feet.
feet. Depth,. _feet. Liquid capacity, gallons. Lining material
S[CONDARY YREATMENI consists ot ~ Tile disposal field, l/~ Seepage pits. Other_
Tile Dlsposul Field:
Distance from: Well,_ feet; foundation feet; nearest lot line at ~ front, ~ side, ~ rear,, feet.
Total len~h of tile lines, feet. Number of lines Distance between lines, feet.
Trench width, inches. Total effective absorption area in bottom of trenches,~ square feet.
~ngth of each line,~ feet. Depth, top of tile to finish grade,~ inches.
Ty~ of filter material: ~ Gravel· ~ Broken stone. Other.
Depth of filter material beneath tife,~ -inches. Depth of filter material over tile,~ inches·
Soep~ge Pits:
~'e ~[o~:Ss~,, Q~ide diamet~,,~ ~ ~ .feet. Depth,~ ~ feet. Lining material ~ ~ ('~:~
· , feet; budding foundation,~ -feet; nearest lot ne at ~ front, ~ side, ~ rear--feet
(xrr~)
REPORT OF INSPECTION~INDI¥1DUAL 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
Distance of well from:
Building foundation,
cast iron sewer,__
seepage pit,
Well construction:
Diamecer,_
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 llne, feet.
Individual water supply from: [] Drilled well. [] Driven well. [] Dug well. [] Bored well.
feet; nearest lot line at [] front, [] side, [] rear, feet,
feet; tile sewer, feet; septic tank, feet; disposal field, feet;
feet; cesspool, feet; other sources of possible pollution, feet.
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: [] ShaIlow well. [] Deep well. Length of drop pipe, .feet, Pump capacity,_
Located ill: [] Basement. [] Pumproom off basement. [] Pumphouse above ground. [] Pump pit.
Pumproom properly drained: [] Yes. [] No. Pump mounting wate~ight: [] 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,
--gallons per minute.
gallons per minute.
· 19
feet.
14-8.
August 20, 1963
First National Bank of Alaska
B~x600
Anchorage, Alaska
Attention: Miss Sally Sloan
' ~HA Department
~en~lemen:
A properly designed individual se~age system can be
expected to f~nctio~ satisfac%ori]~ ~n the following
described property:
Virgil ~lint -- Lot 12, Sunr~
~lopes ~ubdivision, Eagle River
BDA~hm
Yours very trulF,
Bruce D. Adams, Supervisor
Regional Sanitation Services
Division of Public Health