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Home My WebLink AboutROLLING HILLS ESTATES BLK A LT 7rI icl C OWner of Land Address Well Site Date Started Date Ended oog o~ Drilling by Morrison DriA~ng Thomas Goresen Depth of Well 102 Feet Sand Lake 8~a~ Level of Water West Side Violet Drive, Sand Lake Draw Down Ft. 5 October 28, 1960 Gals per hr. 1200 November 5, 1960 15 Kind of Casing 6? Black, 18 Pt 9 Kind of Formation: From 0 to 18 Feet From 18 to 42 feet From 42 to 57 feet From 57 to 60 feet From 60 to 71 feet From 71 to 74 feet From 74 to 92 feet From 92 to Gray Sand B~own Clay Brown Sand Brown Clay and Gravel Brown Sand Pea Gravel and Sand Coarse Gravel and Sand 102 Feet Nice Uniform Gravel -'Water /s/ Woodrow Morrison Rev. Jul~t,~95~ FEDERAL HOUSING ADMINISTRATION Budget Bure~b t~.~63~R296.8 .... HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER,SUPPLY AND SEWAGE DISPOSAL SYSTEM PART I.--TO BE COMPLETED BY FHA INSURING OFFICE MORTGAGEE Anohora~e o Alaska MORTGAGOR OR SPONSOR Violet X.' aoresen SUBD,¥1SJON NAME Ro]llng H~:~ 1 ~ Estates LIVING UNITS BEDROOMS BATHS WATER SUPPLY BY: [~ Public system SEWAGE DISPOSAL BY: [] Public system [] Community system F~rst ~ational Bank of Anohorage SERIAL NO. 60-o09:~9 BASEMENT [~ New installation Yes [~ Community system PROPERTY ADDRESS Violet Drive J Anehorage, Alaska BLOCTO' LOT ~0' Can attic or other area be made into additional bedrooms? (If ~Yes, how many~) [--']Yes [~-'] No ; SYSTEM DESIGNED FOR ] Individual No. BDRMS, GARBAGE OISPOSAL [] ndividual I--1 [] PART II.--TO BE COMPLETED BY HEALTH DEPARTMENT HEALTH DEPARTMENT iNSPECTOR'S SKETCH It is the opinion of the ~1 State ['--] County [-'1 .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 N County tern with proper maintenance: [~Can be expected to function satisfactorily, and DA is not likely to create an insanitary condition [] Local Department of Health that this individual sewage-disposal sys- --]Cannot be expected to function satisfactorily J SIGNATURE ~ ./ ~, j TITLE ~,, ~ NOTE: The health authority shoUld complete the appropriate.~pinlon statement above and affix date, signature and title in the spaces provided. Use of the above grid for Health Department Inspector's~0ketch~ . as well as use of the back of this form is at the option of the health authority. PART I~I~sE 07~h~ ~FFICE THE CHIEF UNDERWRITER: ~4 ! 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 F-] Not Acceptable. DATE SIGNATURE CHIEF ARCHITECT r --J DEPUTFOR CHIEF ARCHITECT HEALTH AUTHORITY APPROVAL FHA Form 2573 uop~adsu! JO a~Q ~al~m jo Xlddns alenbape qs!u:nj ol Xl!up!a alr!patutu! u! Slla~ jo aJnl!~J jo p~o,aJ lua>aJ lsotu 'pooq~oqq2!au u! ~mmsn~ ~ou oJe [] 011~ silam lenp!A!pui 'saqau!' -- 'u!~m jo az!$ 'laoj' _ u!~uJ Jo~ >!lqnd lsaaeau m WalSAS Alddl'iS-tl:BIY~ 1YIIOIAIONI--NOI13tdSNI :lO J.tlOd:3ti uaaj 'suoiie~ sluauglJ~dmoo jo ~aqtunN '$uotulJl~dtllo:> lalU! A&>uduD 'st 91[~b'---' 'loodssaD [] WIISAS 1VSOdSla-IoYMIS 1YnQIAlaNI--NOI.L:)tdSNI tO ltiOdltl AD, H--HSE~o-FI (e) IThis Form Must Be Filled Out Completely. TAKE WA"i hSl ~)AL PLE TO: (~ of person collecting sample) (Date) (Tlme~ Water sample collected from ~Kitchen' tap; ~ Bathr~m tap; ~ Basement tap; Other (list) ......................................................................................... ~ .......................................... D (Mr.) Mail repor~ to (~) ~ ~ ,5 (Name) tBox ~. or street address) (City) Please place an "X" in the box before it~which b~ desc~be your water supply: SOURCE: Well ~ ~ Dug, ~ Driven, ~lled, ~ Bored ~ Spring, ~ Ciste~, ~ Other (list) ............................................................................................................... ~ Cree~, ~ River, ~ Lake, ~ Pond DUG ~LL OR C~TERN CONS~UCTION: Walls ~ ~ Wood, ~ Concrete, ~ ~tal, ~ ~le, ~ Brlck or Concrete Block Top ~ ~ Wood, ~ Concrete, ~ Metal, ~ ~en Top LOCA~ON: ~ In basement, ~ Basement offset, ~ Under ~o~e, ~yard DIST~CE TO:~ Building sewer or other drainage pipe .............. feet, Septic ~nk .............. feet, ~le field .............. ~.~ feet, Seepage pit .............. feet, Cesspool .............. feet, Privy ..............feet. Other p~sible sources ~ ~/~/-x~ of contamination (l~t) ............................................................................................................................................. ~R~:~' --~ild~ ing sewer--~ast iron, ~ Wood, ~ Tile, ~ ~bre pipe, ~ Asbestos cement J~nt material -- ~pe ................................................................................................................................................. , ..... ......................................................... Dtameger of well ................ .~ ................................. depgh Well easing material .......... ~.~:.g.~ .......... dtame~er ...... ~...~ ...... depm .......Z~T ..................... Benggh of drop pipe .................. .~.? .................. ~ ............................................................................ Wa~er depth from ~mm ....... ~ ........................ : .......................................................................... fee~ Pump location: ~ well, ~ Offseg ~ basement, ~ In baaemeng ~ ~ u~l~g~ ~m, ~ On gop of well ~ O~her {l~g) .................................................................. .~ ................................... P~RPOS~ O~ EXAMINATION: Illness suspected? ~ 7es, ~o New source of supply? ~s, ~ no Remarks: ... ' ~. ......................................................................................................................................................................... PLEASE DRAW A SKETCH ~ ~E SPACE BELOW. ~IS SKETCH SHOULD SHOW ~CATION OF HOUSE, WA~ SUPPLY SOURCE, SE~IC TANK, SE~R, DRA~ LI~S OR O~R SOURCES OF POLLU~ON ~D DIST~CES BE~N WAT~ SUPPLY SO.CE AND ~ OF ~OVE FAC~. SAMPLES MUST BE SUBMITTED IN CONTAINERS PROVIDED BY THE ALASKA DEPARTMENT OF HEALTH