HomeMy WebLinkAboutRAYMOND TEDROW BLK 1 LT 1 S25 W 1P v PCP'
F
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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
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