HomeMy WebLinkAboutWALTER G PIPPEL ADDITION BLK 9 LT 7
EHA'Form 2573 ~/ ~k._ Form Approved
Rev. July 1958 FEDERAL HOUSING ADMINISTRATION ,/ Budget Bureau NO, 63-R296,8
I-IE~LTI'I AUTHORITY APPROV~.L
INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM
INSURING OFFICE
Fede~l ltouoing Adm:inistra%ion
MORTGAGOR OR sPoNSOR
~e~ ~.Io~
SUBDIVISION NAME / .
LIVING UNITS ,BEDRO OM5 BATHS
a . su *' '.
PART I.--TO BE COMPLETED BY FHA
BASEMENT
Anehorage~ /~laska
PROPERTY ADDRESS
[] Pu, bl~z s,,y~,tem
SBWAGE;DIS~OSAL BY:
[~ Pfiblic ~ystem
SERIAL NO.
~-008570
[~Yes [] No
JJ'~"] New installation
]Community system
~] Community system
BLOCK NO.
9 LO,NO.
Can attic or other area be made Into
additional bedrooms?
(if Yes, how many~)
SYSTEM DESIGNED FOR
[~ Individual NO. OF 8DRM$, GARBAGE DISPOSAL
[] Individual 3 [] Yes [] No
PART II.~TO BE COMPLETED BY HEALTH DEPARTMENT
HEALTH DEPARTMENT INSPECTOR'S SKETCH
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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-
tem 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 / SIGNATUREt] ~)~/~ ~ ~---~ TITLE
PART Ill.--FOR USE OF F~A ~FFICE
TO THE CHIEF UNDERWRITER:
SIGNATURE
CHIEF ARCHITECT
DEPUTY FOR CHIEF ARCHITECT
DATE
HEALTH AU~ORITY APPROVAL
INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM
FHA Form 2573
Rev. Suly 1958
REPORT OF INSPECTION--INDI¥1DUAL SEWAGE-DISPOSAL SYSTEM
PRIMARY TREATMENT consists of [] Septic tank. [] Cesspool.
Septic Tank:
Distance from well,._~___.feet.
'lotal liquid capacity, t}O0
Inside length, --~ feet.
Cesspool:
Distance from: Well, feet; foundation
Inside diameter, feet. Depth,
SECONDARY TREATMENT consists of [] 'File disposal field.
Materinl QQ)q~°n~'7~'7 Number et co,part, :nts~. ,.
gallons. Capacity inlet compartment, ~- gallons.
Inside width, '--- feet. Liquid depth, ----- feet.
Tile Disposal Field:
Distance from: Well,
Total length of tile lines,
Trench width,
Length of each line,
Type of filter material: [] Gravel.
feet; nearest lot line at [] front, [] side, [] rear,.
feet. Liquid capacity, gallons. Lining material
[] Seepage pits, Other
feet.
feet; foundation, feet; nearest lot line at [] front, [] side, [] rear,.
feet, Number of lines, Distance between lines,
inches. Total effective absorption area in bottom of trenches,
feet. Depth, top of tile to finish grade,
[] Broken stone. Other
feet.
square feet.
.inches.
inches.
Depth of filter material beneath til% inches.
Seepage Plts~
Number of pits 1 Outside diameter, ~ .feet. Depth,
Distance from: Well, '100 feet; building foundation, 20
Inspection made byte] State. [] County. [] Local Health Authority.
Inspected by
Date of inspection ~o't/'olllbe]~ /51, ].960 , 19
Depth of filter material over tile,
6 .feet. Lining material log
feet; nearest lot line at [] front, [] side, [~ rear,
Bruce D. Adam~3
Regional Sanitarian
20 feet.
REPORT OF INSPECTION--INDIVIDUAL 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
Properties in neighborhood [~are [] are not being developed with both individual water-supply and sewage-disposal
Lot size: 102 .feet wide 13~ feet deep. Dwelling set back from front property line 2~ feet.
Individual water supply from: ~ Drilled well. [] Driven well. [] Dug well, [] Bored well.
Distance of well from:
Building foundation,
cast iron sewer,~_~O.
seepage p~t,
Well construction:
Diameter~
60
feet; tile sewer,
-feet; cesspool,
feet; nearest lot line at [] front, [] side, [] rear,
feet; septic tank. ~5 feet; disposal field~
~- feet; other sources of possible pollution,. Ilon~ feet.
systems.
Approximate depth to pumping level of water in well, .~0 feet. Approximate yield,. 6
Sealed watertight to depth of 60 feet.
Exterior space around casing sealed with: [] Cement grout. [] Puddled clay. [] Ordinary backfill.
Well cover: [] Concrete. [] Wood. [5~Metal. Openings in well cover watertight: [~l Yes. [] No.
Pump~ [] Shallow well. [~Deep well. Length of drop pipe,----- feet. Pump capacity,. ~
Located in: [] Basement. [] Pumproom off basement. [] Pumphouse above ground. [] Pump pit.
Pumproom properly drained:~ Yes. [] No. Pump mounting watertight: ~] Yes. [] No.
Type of storage: [] Pressure. [] Gravity. Capacity, 15~ gallons.
Has bacteriological examination of water been made? [] Yes. [] No. If answer is "yes," give date Dooernbo-o 'l 9
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 Brace Do Adams
Date of inspection Novel~ber ~ , 19 60 Regional SanitariaB
feet,
feet;
inches. Total depth, 60 feet. Type of casing, .q~',oo.] Depth of casing, 60 feet.
gallons per minute.
gallons per minute.
, x960
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