HomeMy WebLinkAboutBLUEBERRY HILL BLK 4 LT 6
Tom Fink,
Mayor
Ntunicipality of Anchorage
Department of Health and Human Services
825 "L" Street
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
February 5, 1992
David F. Wolfe
PO Box 1572
Anchorage, Alaska
99510
Subject:
Lot 6 Block 4 Blueberry Hill Subdivision
Permit 9SW910016, ' PID 9050-202-08
The subject permit, issued February 5, 1991, by this office for a
single family well and/or on-site wastewater system, has
expired as of February 5, 1992.
A new. permit must be obtained from this office for a well
and/or on-site wastewater system NOT installed by the
expiration date.
If you have drilled the well, a well log.must be sent to
this office for documentation of the installation and to
close the permit.
If a licensed Professional Engineer has inspected the
installation of the on-site wastewater system, the original
as-built inspection report must be sent to this office for
review., approval and documentation. All inspection reports
must be submitted within 30 days of construction completion.
When applying for a new permit, the fees are: $90.00 for an
on-site wastewater permit; $50.00 for a well permit; $140.00
for a combined on-site wastewater and well permit.
If you have any questions, please call this office at 343-4744.
J~n Smith~ P. E. V
PEogram Manager
On-site Services
enc: Copy of Permit
PATE.': :; SSUE i) ." 2/05/'::i;' !.
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Municipality of Anchorage
Dept. of Health and Human Services
P.O. Box 196650
Anchorage, AK
99519-6650
Attn. John Smith
Program Manager, On-site Services
re: Lot 6, Block 4, Blueberry Hills
February I, 1991
Dear Mr. Smith:
In accordance with agreements worked out since my initial
facilities-proposal submission of October 22, 1990, for the
subject lot, details in the following enclosures should meet with
the approval of your office. Please find enclosed:
1~ MOA Sewer Permit Application;
2. Description of proposed facilities;
3. Spec. sheet for Little John Incinerator Toilet;
4. Superstructure plans;
5. Plot-plan with proposed building sites noted, and
6. Maintenence 'letter of agreement' signed by concerned parties.
As per AMC 15.65~100<c), and requirements of The Sanitarians
Handbook, v. 4, the proposed vault shall be a "watertight
corrosion resistant" vault (see proposed facilities), "maintained
in a sanitary condition" as described in the maintenence letter
of aqreement.
Year-round access is available to the subject lot, enabling
the importation of fresh (city) water and the exportation of gray
water. Gray water wiil be collected and disposed of in sewer-
line-connected or septic-system drains.
These facilities are to service a one-room, one-bedroom
residence.
Should you need further details, please contact me as noted
David Wolfe, Landowner
P.O. Box 10-1572
Anchorage, Alaska
99510-1572
272-7698
Proposed Facilities
'Lot 6, Block 4, Blueberry Hills Subdivision
Servicable Thermoformed Polyethylene Vault Privy.
Vault dimensions: Depth=3 feet; Diam.=2 feet.
Vault capacities: Net=55 gal. ; gross=58 gal.
Sidewall and head are 0.040 inches thick.
Previously used to transport Ethylene Glycol (antifreeze).
Self-contained propane-fired combustion tiolet ("Little
John", model I01),
A dual system will provide a back-up facility during service
or maintenance periods and increase overall capacity potential.
Both units will be enclosed and protected from the elements
to enable year-round use, with a 'service door~ providing access
to the vault (see Superstructure plans).
cc Sanitary Pumpers, Inc.
!.ON TOILET
~.~E DISPOSAL
14EMiC~LS"OR
¢onstnKfio, sites, piatics, g(df r. mm4s.
uses standard tiltings
.Weight ' 55 Ibs.~
Height .16 inches
WIM 14 inches
Length 21 inckes
GENERAL INFOR~L~TION
': 'iq-' ..Move unit away, drill or start holes where marked. (The unit'~h, oul, d ~av
l: '..'!., at least one hold-down at the front and one hold-Gown at the rear.
Replace unit~ where located.
6. Install at leas~ two screws throuqh floor'ing to hold-down unit.
7. Install a 3 inch stove pip~ and a 5 inch stove piFe.from the top of the
u~it vertically up through the ceiling or at a 45 degree ~ngle up through
~ ~ .... ~ ~he 'wall. The pipe should extend .three to six f~et. above, its exit,.
.through a sloping roof. A rain cap is advised at the top Q~ the sto~e
~ ~ .~, pipe. ' ?~:''''"
8. Hook the unit to a regulated propane source. Gas supply lines of either
: ~lack pipe, aluminum tubing or copper tubing in%ernally lined which meet.
the requirements of regulatory agencies may be use,~.... K/uockout plu¢ls
:.'~ provided on both sides and at the rear of the cas~, . Knock,out the phv~,
%' push the fuel tubing thrc, u. qh a.'.d install the slit urom~et in the hole.
/ 9~ Check for ieak~ t.:"~.'ou~.~%..:ut
1.~ Locate unit where desired.
, 2. Re~ove back, ~ark through two holes in base.
3. O~e~ front door, mark through two holes in base.
T~ INSTALL
A super-heated flame converts human waste into essentially odorless, lvaPor which
ia e~hausted by natural draft through a. flue. ' . ' i
A i LITT~ JOHN needs ~s a fuel suFply (propane or natural gas), ~,~9
wall vertical e~aust for installation. It requires no electriC~l~w~r~]'~,
water supply and no special fireproof material around 'it. ".~.i.~
LITTLE JOHN starts a high speed burning cycle each.ltime.lthe seatL,lid is
Tha ave~.age burn time is 15 minutes. Allow 5 minute,:'¢~oling.., , ..:.L~me',~, ~etw~.
an~ lower the door to read instructions and installatio~ notes.. ' '~
INST~TION INSTRUCTIONS ~,, ~..: '; ' '
~.~n'and Stationary Installations -- -', .......
~..~t~'L~"~O~ re~i~ea inlet air for proper co~ustion.: ~i~ 'i~l;~a~
~'~','~~~::~rough ~he back of the case. ~o holes of.~' ~nch"' d~'m~er;'~""~':"~'~nim~
installed ~ith the sides:,. ~.::~
b~~or bott~ touching comestible construction, but should have enoug~
s~: ~ qllow air into these holes. If the back is mounted flush against ~. ':~
wa11:~ provision m~st be made for inlet air. In this event, two ~.
h°l~y be made in the lower part of the front door' "
:
' FO~ C~r ~d Travel Trailer Installations -- .
nle~ ~x should c~e from outside. Room air should not be used. A'
~e~]'~l, part %0102014 should be used. This rear Pan~l has %
Zr~ l~. In order to locate ~e hole, push the rear .of Li~ JOH~ a~
~ ~e wa~l as ~ssible. ~en it xs sltuated' properl%"s~de to',.s%ag,~ mark~aroun4:~
~e Chute on the wall. ~move the LITTLE JOHN and cut a hol&' i~ 6h~ ~e~
wall as ~rked. ~t LITTLE JOHN flush withthe wall. ~ if the chut~ U'r~r~de's"
o~er one-half inch past outside camper wall, cut off tO 'within'o~e-h~lf~i~ch~'.'
I,s~ll outside vent cap with opening facing down. ' . ',.,.
LITTLE JOHN: the fully automatic combustion toilet, is designed, to. provide a' .~
reliable and convenient sewage disposal unit. ~ ,:. ,.
TO LIGHT
1. Open the front door.
2. Turn gas dial to OFF.
Wait 5 minutes to allow
unburned sas, to vent.
Remember propane gas
is heavier than air and
will not vent upward
. -- naturally.
· clockwise to PILOT
Press dial in and
light pilot. Hold
for 60 seconds and
release.
NOTEs If pilot fails
to Stay lit, start
inst~uctions at
numb~ 2 above.
iiI &o Turn dial counter-
clockwise to ON
5. Close the front door.
NOTEI Main burners
will ignite each
time the seat lid is
low,ed,
_TO SBtrr vo~
turn clockwise to
OFF.
Close gas valve at
Propane t~, if no
other appliances are
beir~ used.
nay'
~OB'I~OL VALVE
SIDE VIEW OF BI~I~NERS & COFrROLS
lnttiate., an extra burn. cycle.
.~tloq. ash tray to cool 5 to 10 minutes
'out tray and dump.
~t tray carefully in tuide rails, ush all the way ~ ~e r~r..
'~ F~el ~y be cleaned with a ~ood co~ercial cleaner ~d ~t~,
'd~ ~it, initiate and extra b~n cycle.
D lliF/t5 ION S:
'.~ F~EL s
· ~ ~ ""~ INPUT PRESSURE:
INPUT CONNECTION
FLUE CONNECTION:
¢ · ~'TYPE:
LITTLE JOHN MODEL 101 SPECIFICATIONS
14-1/2" wide x 21" deep x 16'1/2" high
55 pounds
Propane or Natural Gas
11" W.C. Propane ~ 6" W.C. Natural GaS
3/8" Aluminum Tube SAE 45 Degree Flare
3" and 5" double wall vent
· 1',600 Degrees F. ': ~i.!
Singl. port inshot, 2 buyers
AGA a roved control valve with saret?] shut-off
170 degrees ambzent safety.swx~cn
Seat positiOn safety switc%i,i. ~. .. ..;.
~ss than %1 ringlem .-~, ~ ~ ~.~ ,
3 C~lete Cycles per ho~'.': . ' .:!~' ~: .'
Co~ustion cheer: 1/8 bushel [~.. '.~.' .
Ash tray: 21 fluid oz. to top .of fins -
is hours pi~ot '~i~ht e~ive;~= ~o:0~ .b~c~.
1 unit for each 10 to 16 persons ~',
SEAT LID
STE FUNNEL,,
(,OMBUSTION cHAMBER
~BUCKET LINKAGE
..,HAMBER BACK
gXHAUST FLUE
.]
IXCLU$10N NOTE: It Is the owners'
responsibility to determine tho
existence of any easements, covenants,
er restrictions which do not appear
'bfl the recorded subdivision plat.
SURVEY CERTIFICATION: I hereby certify that I have surveyed the property shown and de
scribed hereon end that the Irnprovementt situated thereon ara within the property lines and nc
encroechmant~ exist other then noted.
ENGINEERB · I=I. ANNER~ · ~URVEYOR~
440 WEST BENSON BLVD.
ANCHORAGE, ALASKA 99503 562-5291
PLEASE NOTE: It is the contract I
-or's responsibility to check topi
of foundation In relation to
finish grade end building set-
backs In relation to lot lines
and easements.
LEGAL DESCRIPTION:
LEGEND: SET FOUND
5/8" REBAR ~ 0
HUB & TACK r-i ~
MONUMENT t~ (~)
AL-CAP ~ e
PK NAIL X
IRON PIPE (~
r'--'~ - E LEVS, o DATUM
ASSUMED
Municipality of Anchorage
Dept. of Health and Human Services
P.O. Box 196650
Anchorage, AK
99519-6650
Attn. John Smith
Program Manager', On-site Services
Dear Mr. Smith:
Pursuant to appropriate permits being issued to the
landowner of Lot 6, Block 4, Blueberry Hills Subdivision,
Sanitary Pumpers Inc. of Chugiak is willing and able to service
the permitted facilities.
It is understood that the servicable facility shall consist
of a polyurathane vault-style privy, as described in the
"Proposed Facilities" enclosure. It is further understood that
facility maintenance must be conducted to obviate winter service
and prevent overflow/spillage during periods of potentially
limited access.
P.O. Box 1572
Anchorage, AK
99510
Dan Van Boven
Sanitary Pumpers Inc.
HC 78 Box 2691
Chugiak, AK
99567
SANITARY PUMPERS
HC 78 BOX 2691
CHUGIAK, AK 99567
$94-2408
Assemblyman Campbell
P.O. ~o:.: 196ff, 5C
Dear Mr. CampbeLl
Enclosed are the ie~-ters E>:chan{:ied with -the Heaith Dept. , On-Site
Servioes. Developments ~nce include -~ne establishment of yea~--cound
access te 'the !c:t. '.'although, despite m.>. neiqhbo:r and i payi[ng road-
ke~c~Ang 'n~. c~pen ' ~i._ '4e w zn that ha"ti!e), and On-Site Services has
specifics ,'mst be included in the contract.?
Fo~' your. info~mation, my ~ cur'rent .z'c, ssible waste-disposal options
- ~e_Lc,~. This would sezvice e singie-oc, oupent one-::-oom cable
on a 6. 17 acre lot near Mile High F~s.
i. 55 gallon plastic vault privy. Specs of 'the drum are derived
from 'the DOT number stamped on it. DOT ~2SL 66 is 100% polyurethane,
inches, net tapco, is 5S gallons, gross capac, is 58 gallons (4~{:FR·
Glycol (enti~reeze). 490F~ 172. lOl appeePemtly lists o~heP commodieies
t. his container is sui%abie to transpoz%. An encapsulating 20 gauge
steel open head {r'eCher then bung-heed) barrel is available lecaily ii
deemed neooesery. (All these details the Health Dept. is requiring
przor to approval of t. he specific drum used. )
Al'terna'tively, 'to increase cac, ecity in the future, e Bondico 95
gallon po.ly-over~ack S;aivage Drum, constructed of 100% polyethylene,
may be ordered out c,i Wisconsin.
2, P:.r'opane-:fir. ed iacineration 'Loller, Little John available tocml~,/
has 3-5 uses per' firing w.hic:h renders wastes into ashes.
?Imy C~e uneccept.-h' %o ' ' . ....
Health Dep't. clue to srnaii si~,~ er etc.
get spec sheet As, AF.
3. Rent-A-Can portable toilet. Capac. varies by model/'year: 40-6,0
gaiio£,s <7-10 gallons of saline solution are added 'Lc, tank once
installed). Weight of unit: 180-220 lbs.
4. Shallow pit Earth privy. I have 7-8 foot soil depth near the cabin-
site. i could construct a 15 or so cubic foot capac, pit and still
maintain the 6 foot depth to bedrock below the hole. Unfortunately,
verifying this 6-£t. depth at this time of year would be rather
troublesome.
I hope this 'provides the information you need to help straighten out
the snags I keep running_into enroute to obtaininq a Land-Use Permit.
Thank vou~-cs~-~c, ur. ~e and asses%anne' "
oincer'el%, q ) / / .', /.
picnics, golf courses,
'3
'£
...... . . :.~ ~o'lu'r sozr'rnl>3,..[ {4[.1(').['
I ..
~"p~)%oI s*'~ p'[y :luau: a~I:l au.-}::1 H,".>'ec.~ o1':;.~o (m'~':.iK/t",c~ [);3~,:,:~; :.~1%'~i; ~ r'r'.;,:~:,'-g;: [il[(')f'
Ou
%~ ~)p'rAo.x.:."~, 0:1. ][)at.151:s ;~[), ' S I ['. ' .io'l l':,:;. :..~,.~'t ::, :; t,qti;,::,:>. 0 [ 2~'i2tUO:; ri E'. ,{ '[ '[. F[:~ ;:',:: &, : I]}[0£'
H() Z :~ VH':[ () Z !'; :£
WE IGHT:
FUEl,:
INPUT PRESSUI?I']:
INPUT CONNECTION:
FLUE CONNECTION:
HEAT INPUT:
FLUTE TE14PE~TURE:
BU~'~ER TYPE:
BURNER CONTllOLS:
BUPd] CYCLE:
SMOKE OUTPUT:
CAPACITIES:
I,I'J. TLE JO'I[l MODEL i01 SPECIFICATIONS
14-1/2" wide x 21" deep x 16-1/2" high
55 pounds
Propane or Natural Gas
11" W.C. Propane ~ 6" W.C. Natural Gas
3/8" Aluminum Tube ~.,At~ 45 Degree Flare
3" and 5" doubl~ wall vent
] 5,180 BTU,/H.~.
1,600 Degrees F.
Single port inshot, 2 burners
AGA approved control valve with safety shut-off switch
170 degrees ambient safety switch :
Seat position safety switch .
15 minutes average, 5 minu~es cool. in~ period
Less than ~1 ringleman ~
3 Complete Cycles per hour
Con~ustion chamber: 1/8 bushel
Ash tray: 21 fluid oz. to top of fins ~:
5 Gallon LPG ta~ - 105 burn cycles nmxim~
(5 hours pilot 'light equivelant to one burn cycle)
1 unit for each 10 to 16 persons
I1
~-- SEAT LID
.... E A r
MB LJ,STION CHAMBER
BUCKEI' LIN I";AG E
C H A M B E R [:'~ A C K
£XHAUST FLUE
S T E F U N N E L
$ ULATION
U C K E T
.... -q:~ I[.. O TCHIMNEY
........... FRONT DOOR
8 U RI',JE F~MANIFOLD
JRNER
.ASH TRAY .. , ,,
COMBINATIOI',I VALVE,'.
HERRY SWITCH
..T ~ I','~ ER' "5 W l T C t4
INLET TUBING
KLI ×OKI SWITCH
TO LIGHT
1. Open the front door,
2, Turn gas dial to OFF.
Wait 5 minutes to allow
unburned gas, to vent.
Remember propane g~ls
is heavier than air and
will not vent upward
naturally.
,3. Turn dial counter-
clockwise to PILOT
Press dial in and
light pilot. Hold
for 6o seconds and
release~
NOTE~ If pilot fails
to stay lit, start
"" inst~uctions at
ntunber 2 above,
4. Turn dial counter-
clockwise to ON
5. Close th~. front door,
NO'FF,~ blain burners
will ignite each
time the seat lid is
lowered.
TO SHUT DOWN
Press dial in and
turn clockwise to
OFF.
Close gas valve at
Propane tank, if no
other appliances are
being used.
LIGHT PII,O'I
H ~ £
'fRAY
~,ONTROL VAI,VE
SiDE VIEW OF BI)RNI~{S & CONTROLS
TO CLEAN ASH 1]~AY
1. Initiate an extra burn cycle.
2. Allow ash tray to cool 5 to 10 minutes.
~3. ~ull 'out tray and dump°
4; Insert tray carefully in guide rails, push all the way to the rear.
NOTE! Funnel may be cleaned with a good co~muercial cleaner and water.
To dry unit, initiate and extra burn cycle.
Municipality of Anchorage
Department of Health and Human Services
825 "L" Street
Tom Fink,
Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650
December 4, 1990
David F. G. Wolfe
Box 1572
Anchorage, Alaska 99510-1572
Re: Lot 6, Block 4, Blueberry Hills Subdivision
Dear Mr. Wolfe:
Please be advised that based on our site inspection of the
subject lot and our interpretation of available surface and
subsurface soils information, it appears that the physical
characteristics of the lot will preclude its development using
an on-site well or conventional wastewater disposal system.
Specific physical characteristics which limit the ability to
develop this lot include, but may not be limited to:
Steep slopes - municipal and state regulations prohibit the
installation of an on-site wastewater disposal system on
slopes greater than 25%. Slopes on the subject lot appear
to exceed 35% in all locations (AMC 15.65.060.A.2.a,
18AAC72.025.4.E).
Proximity to bedrock - municipal and state regulations
require that there be a minimum 6 feet vertical separation
between the bottom of a wastewater disposal system or an
earth privy and bedrock. Available information indicates
that there is insufficient depth to bedrock to accommodate
either a wastewater drainfield or an earth privy (AMC
15.65.060.A.2.c, AMC 15.65.090.C.2, 18AAC72.025.4.D).
Access - year-round access is not available to the lot.
Year-round access is required to ensure that the wastewater
system can be serviced by a pump truck (AMC 15.65.050.G).
Providing that you have no intention of installing an on site
well or installing plumbing within your proposed dwelling and
providing that you establish year-round access to the lot, it
may be possible to construct a vault privy.
Kids Are Our Future
David F.G. Wolfe
December 4, 1990
Page Two
Installation and use of a vault privy requires that the privy
pit be lined or constructed with an impervious material such as
concrete, steel or plastic. The vault privy must have a minimum
capacity of 50 cubic feet. Year-round access must be available
to the vault privy so that it can be serviced by a permitted
pumping contractor. A copy of the pumping/maintenance contract
must be provided to this office.
As a variation to the vault privy concept, this office will
allow the use of a portable self contained "rent-a-can" type
toilet. The toilet should be located no further than 100 feet
from your proposed dwelling and year-round access must be
provided so that it can be serviced by a permitted pumping
contractor. A copy of the pumping/maintenance contract must be
provided to this office.
If you have any questions or if you wish to pursue obtaining a
permit for the installation of a vault privy or self contained
toilet, please contact our office at 343-4744.
Sincerely, ~ ~
~rogram Manager, On-site Services
cc: Dave Brennen, Code Enforcement Manager, Building Safety
Municipality of Anchorage
Dept. of Health & Human Services
825 L Street
Anchorage, AK
22 October, 1990
Dear On-Site services reviewer;
Pursuent to my conversations with Mr.
NOIJ..~gJ.Oltd 'IVJ. N:IWNO~llAN:I
~' H.I.'IYgH dO '.LdgC]
I1E)VtlO~¥ :10 AJ.l'lVdl:)lNi"l~
Roth in May and Mr.
Robinson in October, I have prepared a wastewater and sewage-
disposal plan for Lot 6, Block 4, Blueberry Hills Subdivision in
order to obtain a Land-Use Permit.
The following description of the plan should meet with your
approval as we have discussed.
Expected usage of facilities is 80-90% of winter months by
one adult; less during summer months.
There is no well on the lot, so all fresh water will be
imported city water. Minimal gray-water that is created will be
collected and disposed of in household drains in town that are
connected to sewer-line or septic systems.
A septic system is not practical at this time, so sewage
will be collected in a vault-style privy. The vault will be a
servicable 55-60 gal. plastic military-surplus barrel.
Observations by myself, an engineer from S&S Engineering,
and surveyors with LandTec Inc. have revealed no surface water~
no groundwater above bedrock~ and no natural water channelling or
collection zones on the lot.
The building site is 100 feet or more from any lot line, and
over 700 feet upslope of any other developments.
Should you need further details~ please contact me as soon
as possible as noted below.
David Wolfe
P.O. Box 1572
Anchorage~ AK
99510-1572
272-7698
'"'~1,~
Municipality of Anchorage
Dept. of Health and Human Services
Division of On-Site Services
825 L Street
Anchorage, AK
Attn. Mr. John Smith
28 Nov., 1990
Dear Mr. Smith:
In a letter to your office dated 22 October, 1990, I
outlined a sewage and waste-water disposal plan for Lot 6, Block
4, Blueberry Hills Subdivision. The plan therein detailed had
received verbal approval from Mr. Robinson of your office, and
earlier conversations with Mr. Roth of your office indicated no
problems with such a system.
Within a week of my initiating formal contact with your
office, via the letter, a "complaint" was lodged against me with
the Division of Building Safety. I now have less than 30 days to
devise a system that meets municipal regulations and to get my
Land Use Permit approved.
With this letter, therefore, I am requesting a response, in
writing, to the waste-water and sewage disposal plan outlined in
my 22 Oct. letter (copy enclosed). If you have problems with
this plan, please detail alternative options available to me at
this time of year. Please also note Regulation or Municipal Code
citations involved in any problems you may have with the plan,
and detail those problems.
Your timely response is appreciated.
/~ David ~.G. Wolfe
Box 1572
Anchorage, AK 99510-1572
Municipality of Anchorage
Dept. of Health & Human Services
825 L Street
Anchorage, AK
22 October, 1990
Dear On-Site services reviewer;
Pursuent to my conversations with Mr. Roth in May and Mr.
Robinson in October, I have prepared a wastewater and sewage-
disposal plan for Lot 6, Block 4, Blueberry Hills Subdivision in
order to obtain a Land-Use Permit.
The following description of the plan should meet with your
approval as we have discussed.
Expected usage of facilities is 80-90% of winter months by
one adult; less during summer months.
There is no well on the lot, so all fresh water will be
imported city water. Minimal gray-water that is created will be
collected and disposed of in household drains in town that are
connected to sewer-line or septic systems.
A septic system is not practical at this time, so sewage
will be collected in a vault-style privy. The vault will be a
servicable 55-60 gal. plastic military-surplus barrel.
Observations by myself, an engineer from S&S Engineering,
and surveyors with LandTec Inc. have revealed no surface water,
no groundwater above bedrock, and no natural water channelling or
collection zones on the lot.
The building site is 100 feet or more from any lot line, and
over 700 feet upslope of any other developments.
Should you need further details, please contact me as soon
as possible as noted below.
David Wolfe
P.O. Box 1572
Anchorage, AK
99510-1572
272-7698
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RECEIVED
SEP 9 1991
Municipality of Anchorage
Dept. Health & Human Services
Part I
Postal Customer:
The sender of the article described below has made an inquiry regarding delivery of the item. The article was not located at the mailing
office. Therefore, we are contacting you to determine if the article has been delivered. Please indicate below if the article has been
received. Return the form in the enclosed PREADDRESSED ENVELOPE WHICH REQUIRES NO POSTAGE. Your response will
assist the Postal Service in providing improved service. PLEASE RETURN BOTH PARTS I AND II-A.
~TANK YOU
The A~icle Was: Unknown Date of Reply Si~9~ ~~2)~
[] Received (Date/(known/ Feb 28, 1992 Laura J. Montgomery for J. Sm~th~
[] Not Received [] Refused
Remarks Wolf but no evidence it was senti' ')~-'-
This office has rec'd a letter from Mr.
certified mail. It is attached to his permit. This office received it
on Sept 9, 1991 and he is welcome to come down and review his file.
PS Form 1510, January 1989
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U.S, Postal Service
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a. Name'"-=~ , ! . ?,,.,~,,,~ a. Nam~
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a. Date b. Time ~ AM
~ rHour) ~ PM ~ Other (Specify) ~ Other (Spec/fy)
~ Special Handling ~ Special Delivery ~ Return Receipt for
No. merchandise
10. Place of Meiling~ Name And/Or Address of Location Checked
:~ontract Statio.~ / city A%~ Stat. o~ Loca~io. Chec~e~ Tz~P +4 ~or Locatio.
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~ Hesidence or Business'
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1 1. Contents Of Article (Descr/be in detail, size, co/or, brand name, serial no., check ~o., and amount, etc.} 1 2. Value
PS form 1510, January 1989 SEND TO REGIONAL CHIEF INSPECTOR