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HomeMy WebLinkAboutRAYMOND TEDROW BLK 1 LT 1 S25 W 1P v PCP' F R O REPLY SIGNED SEND PARTS 1 AND 3 INTACT - Form Approved Budget Bureou No. 63-R296.8 FHA Form '2573 F[D[P. AL ItOUSII'4G ADN~INISTRATION ~'~'~ ~ HEALYH ~THO~YY APPROVAL ~V~DUAL WAY~R ~PPLY A~O SEWAGE D~SPOS~L SY~Y~ ~ PAR¥ I.--TO BI COMPLETED BY FHA -- .... ---- -- ] SER AL NO. ~ ~ ORTGAGEE Anchorage, Al~s~ ~ Anchorage, A~ska . ~z .... p OPERTY ADDRESS ~OR~GAOOR OR~P~NSOR ~ ~l)', ~,ti~'~V otho' are. be made Into ms · ~ __ (If Yes, how many~) ~ATER SUPPLY SEWAGE DISPOSAL BY: Public system ~ Community system PARY II.--lO BE COMPLETED BY HEALTH DEPARTMEN~ ~EALTH 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 N State ~ County [~ Local Department of Health that this individual sewage-disposal sys- tern with proper maintenance: ~1 Can be expected to function satisfactorily, and is not likely to create an insanitary condition []Cannot be expected to function satisfactorily - .~.,,I.~ .~r~t~lete the appropriate opinion statement above and affix date, signature and title in the ..... , ......... ~,~ .ue at ~J tront, [] side, [] rear, feet. ,-,~.v orm)c, ter ....... feet. Depth ........ feet. LMuk{ ca!~acity, .... gallons. Lining material S~CONDARY TREATMENT consists of ~ 'File disposal riehl. ~ Seepage pits. Other ~ ~ ............ Tile Disposal Flold: To~a] len~[~ oF t~]e bnes .... ~ee~. ~umbo~ o~ bnes,~ ~. ~st~nce between Hnes,~ ~ Feet. Trend~ wMtb .inches. Tot~ ~f]~dve M~so~p~ion ~rea ~n bottom o~ tm Khes ~ _squsre ~eet. I.en< ~ o~ ~acb linc.._ ~(eet. I)epth, top of tile to finish grade, T}iK. of fiher material: ~ Gravel. ~ Broken stone. Otber ~ -inches. Depth of filter materhl beneath tile, -incbes. Depth of filter material over tile,~ inches. So~pnoo Piti: ~ N.ml~r of pits_~_ Outside dian eter.~_~_reet' Deptb.~feet. Lining material ~ <2"~ Distance from: YgeII,~_ ~ feet; building foundatJon,~ket; nearest lot line at~ front, ~ side, ~ rear,~/$ _feet. In~po~tlon m~do by: ~State. ~ County. .- fl .~) ~ Local Heald, Authori~,. - % (TITLE) REPORT OF INSPECTION~INDIVIDUAL WATER-SUPPLy SYSTEM Dist,nlcc- to nearest public water ntain ..... feet. Size of main,____ inches. Jmlividual wells [] are [] are not custcmlar,,, in neighborhood. Give mr)st fL'cent record of failure of wells in immediate vicimty to furnish adequate supply of water Propertiu3 in nei~cbb )rh~x)d ,~ are L~ are not being developed with both individual water-supply and sewage-disposal systems. l.()t 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. Dtsfanco of well from: I~uilding ~mmlatmn ........... leer: nearest lot line at ~ front, ~ side, ~ rear,~ cast ir, m Sewer.. -~_ feet; tile sewer ...... feet; septic tank -feet; disposal field, secpa,~e pit ~fec. t; cesspool. --feet; other sources of possible pollution Well construction: ~ .feet. l)im~ctcr. _ . roches. Total depth ........ feet. Type of cas/ng,~ ~ Depth of casing, ~ Appruximatc depth to pump ng level of water in well -f~t. Approximate yield,~gallons per minute. Scaled watertight to deptb of feet. l[xterMr 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. ~ l)eep well. Length of drop pipe. feet. ~nnp capacit),,~gallm]s per minute, ~)cated m: ~ Basement. ~ Pumprooo~ off basement. ~ Pumphouse above ground. ~ ~unp pit. Pumproom re)ix, riv dr,fined: ~ Yes. ~ No. Pump monnting wate~ight: ~ Yes. ~ No. Typu of storage: ~ Pressure. ~ Gravity. Capacity ~_ga Ions Il:ts b.{tteriologit examit~atio~ of watcr been made? [] Yes. ~ No. If answer is "yes/' give date Quabty of water ~ is ~ is not satislSKtorv fbr human consumption. Installation [] does ~ tMes not comply with approved exhibits, if any. Inspc'ttion made by: ~ State. ~ County. ~ Loca/ Health Autboritv. Date of mspetthm ~ Inspected by 19~_ 19. feet; feet. ('tITLE/ Ma~¢h 25, 1963 L. Gagnon, Director l~. E]nner ,' Federal Housing Administration PO Box 779 Anchorage, Alaska Dear Sir: A properly desiEned individual se~,mge systel~ can be expected to ftmction satisfactorily on the following described property: Lot 1, Block 1, Rs,ymond Tedrow Subdivision BDA:~ Yours veE~ truly, THOMAS t{o MCGOWAN, M.D., Dr. P.H. REGIONAL ttEALTH OFFI' R , Bruce D. Adams, Supervisor Regional Sauitation Services Division of Public Health SHACKLETON ® ® ® ® ,: }