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Home My WebLink AboutCAMPBELL HEIGHTS BLK 3 LT 14II GF'"'~TER ANCHORAGE AREA BORO"'~,H ~ ~ HEALTH DEPARTMENT ~ 327 EAGLE ~1. ANCHORAGE, AtAS~ 99501 279-251 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: MAILING ~z~ ADDRESS ~'~'~' -'~-~-. DISTANCE FROM WELl ~'~"'~ / -/- MATERIAL .,~'~"~'~"'~' NUMBER OF / ~OMPARTMENTS LIQUID CAPACITY /~ ~ GALLONS. INSIDE LENGTH ~NSIDE WIDTH. ~ DEPlH SEEPAGE SYSTEM: SEEPAGE PiT: NUMBER OF FITS ~ OUTSIDE DIAMETER. ~ OR WIDTH -- LINING MATERIAl ~. ~ ~-..1'- DISTANCE FROM WEII_~_ _/~/'~"/'~ NEAREST LOT LINF ~" d~.ff~~r~, . TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) - ., LENGTH , DEPTH ~ / , BUILDING FOUNDATION~ ~, ,SQ. FT. TILE DRAIN FIELD: ~ ~'~ TOTAL LENGTH DISTANCE FROM WELL / , FOUNDATION J , NEAREST LOT LINE , OF LINES__ o DEPIH: lop OF TILE TO FINISH GRADE DEPIH OF FILTER MATERIAL BENEATH TILE__IN. ABOVE TILE WELL: TYPF~.~../,~i/, DEPTH ~'/ · DISTANCE FROM ~ / WATER , BUILDING FOUNDATION / SAMPLE .~ , NEAREST NEAR[ST SEPilC SEEPAGE ~ / OTHER LOT LINE ~ ~ , SEWER LINE / ..TANK ~O ~ , SYSTEM _//~ , CESSPOOL , SOURCES DIAGRAM OF SYSTEM DISTANCES: GREATEI'"' kNCHORAGE AREA ROUGH IIEALTil DEPARTMENT 327 Eagle St. Anchorage, Alaska 99501 279-2511 SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT ! MAILING ADDRESS , "'[ · ONE NO...~.___,~ RESIDENCE ADDRESS ~ LOCATION OF INST~TIO~"~ '.f ' r / APPLICATION TO INSTALL: SE~IC TANK~, SEEPAGE PiT _ , DRAIN FIELD , OTHER FINANCED THROUGH ~{~ . TO BE INSTALLED BY ~~- BELOW TO ~E FILLED OUT BY HEALTH DEPARTMEN~ THIS IS / . __AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the above described system i.s in accordance with ~aid code. ,MUnicipality· of Anchorage 3000 ARCTIC BOULEVARD ANCHORAGE, ALASKA 99503 · (907) 277-7622 GEORGE M. SULLIVAN, MAYOR December 20, 1978 DEPARTMENT OF ENTERPRISE ACTIVITIES Sewer & Wafer Utility TO WHOrl IT MAY CONCERN: Lot 14, Block 3, of Campbell Heights Subdivision is in Campbell Heights South Lateral Sanitary Sewer Improvement District No. 91. This L.I.D. was approved by the Assembly on 11-22-77, A.O. No. 77-375. Proposed--7- completion of this L.I.D. will be during the summer of 1979. The Anchorage Sewer Utility in no way guarantees that this L;I.D. will be constructed. From time to time problems are encountered in planning, design and financing that would delay or even cancel projects approved for construction. If you have any other questions, please feel free to contact this office. ~Vt~ ~ineer Anchorage Water & Sewer MUNICIPALITY OF ANCHORAGE "EP' ~' '"'~'~" ~, DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION~/x~ ', ENVIRONMENTAL ENGINEERING DIVISION ~0 N 1 5 1.79 DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be proc~ed. Fteaee allow te~ (10) d~vs fo~ preempting, 1. PROPERTY OWNER MAILING ADDRESS PROPERTY RESIDENT (If different from above) PHONE MAILING ADDRESS $.go7 ,. 3. LENDING INSTITUTION MAILING ADDRESS MAILING ADDRESS STREET LOCATION TYPE OF RESIDENCE NUMBER OF BEDROOMS I'"1 One ,[~ Four J~ SINGLE FAMILY r-I Two I--i Five ~--I MULTIPLE FAMILY D Three [-I Six [] Other 7. WATER SUPPLY J~ INDIVIDUAL' * ATTACH WELL LOG. A well log is required for all wells drilled [] COMMUNITY since June 1975. For wells drilled prior to that date, give well [] PUBLIC UTI LITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM ~ INDIVIDUAL/ON-SITE** **If individual/on-site, give installation date J ¢~/ . If system is over two (2) years old an adequacy test is required r--I PUBLIC UTI LITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED, 72~)10(3/78) r THIS SIDE FOR OFFICIAL USE ONLY . DATE RECEIVED . INSPECTION APPOINTMENTS TIME I TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE *NUMBER OF BEDROOMS ['-1 SINGLE I~AMILY I-] ONE t-'1 THRI~E I'-I FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR I-'1 SIX WATER SUPPLY PERMIT NUMBER ~ · * ' 2. [] INDIVIDUAL DEPTH OF WELL - ..' .... [] COMMUNITY DATE DRILLED ' [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER i'-IINDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER []SepficTank or [--IHoldingTank Size: If Tank is homemade SOILS RATING ' give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA · MATERIAL 4. DISTANCES Septic/HoIchng Tank Absorption Area ISewer Line ~ Nearest Lot Line WELLTO: I I Absorption Area to nearest Lot Line 5. COMMENTS [] APPROVED FOR . BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY (Title) LEGAL DESCRIPTION 72-010 (Rev. 3/78} Ju Jerry Brisk~ 2140 East Dlmond Boulevard Anchorage, Alaska 99502 Subject: Lot 14 Block 3 Campbell }{eights Subdivision The existing sewage system is inadequate. A replacement system consisting of a 2,000 gallon holding tank is required. The holding tank requires routine pumping. There is a strong possibility of a public sewer line being constructed the summer of 1979. The installation of the public sewer line would make the installation of a holding tank meaningless. Therefore, the potiential buyer should be aware of a proposed sewer line and in the event the sewer line is not installed, routine pumping will be required on the holding tank until a public sewer line is available in future years. To gain a conditional department approval monies should be escrowed for: (1) (2) Installation of a 2,000 gallon holding tank by July 30, 1979. Funds to pump the existing system ~s needed until a holding tank is installed. (Be advised that pumping of the new holding tank will be the financial responsibility of the new owner if a public sewer line is not available to negate the use of the tank.) If there are any further quesitions, please contact this office at 264-4720. Sincerely, Les N. Buchholz, R.S. Senior Environmental Specialist d,d LNB/ljw cc: First National Bank of Anchorage Post Offi6e Box 720 99510 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIO~ic/PALr/~t.:O 825 L St feet · An~'tor~, Al~ka 9950 ! DEPT. ENVIRONMENTAL ENGINEERING DIVISION Tele~e DIRECTIONS: Complete ,11 pa.s on pa~ 1. Inc~.~ ~ will n~ ~ ~ ~ MI~ t~ ~~ 1. PROPERTY OWNER PHONE MAILING ADDRESS PROPERTY RESIDENT (If different from abow) } PHONE 2. BUYER J PHONE 3. LENDING INSTITUTION ] PHONE MAILING ADDRESS 4, REALTOR/AGENT PHONE MAILING ADDRESS 5. LEGAL DESCRII~rlON ' STREET LOCATION ~ SINGLE FAMILY ;--I MULTIPLE FAMILY 7. WATER SUPPLY ~ INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY ~ 8. SEWAGE DISPOSAL SYSTEM [] INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY NUMBER OF BEDROOMS I-'1 One f--I Four [] Two [~ Five [] Three r--I Six [] Other * ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) **If individual/on-site, give iristallation date If system is over two (2) years old an adequacy test is required by this De~rtment. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE 'PROCESSING CAN BE INITIATED. 72~10(3178) l.- , THIS SIDE FOR OFFICIAL USE ONLY .. , DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TiME DATE DATE DATE INSPECTOR - INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE ' ' NUMBER OF BEDROOMS I--I SINGLE FAMILY [] ONE [] THREE [] *~FIVE ' [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX 2. WATER SUPPLY ' PERMIT NUMBER . I'-] INDIVIDUAL · DEPTH OF WELL · [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMSER i'-IINDIVIDUAL/ON -SITE ~ DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER I--ISeptlc Tank or []Hold[ngTank Size: If Tank is homemade SOILS RATING , ,'. ,., . · * ' give dimensions: TYPE OF TANK MANUFACTURER ·. , ',. '. TOTAL ABSORPTION AR EA MATERIAL 4. DISTANCESwELL TO: Septlc/H°iding Tank IAbs°rpti°n Area ISewer Line Absorption Area tO nearest Lot Line 5. COMMENTS [~oPPROVE D FOR BEDROOMS. NDITIONAL APPROVAL (letter mu*st accompany c~itificate) I"-I DISAPPROVED DATE BY (Tit~e) LEGAL DESCRIPTION 72-010 (Rev. 3/78) 5905 OLD SEWARD HIGHWAY ANCH_ORAGE. ALASKA $9502 December 29, 2978 ADC No. 78122 Mr. LarrYld~cGranahan 3907 E. 67th Avenue Anchorage, Alaska 99507 Res Adequacy Test' for Existing Septic System for Lot 14, Block 3, Campbell Heights Subdivision. Dear Mr. NcGranahans At your request, we have performed an Adequacy Test on your existing septic system for your 5-bedroom residence at the above-referenced location. Per the G.A.A.B.~s Inspection Report On-Site Sewage Disposal System, dated August 24, 1970, your septic system consists of a lO00-gallon steel septic tank and 2 log-crib seepage pits of unknown dimension. The water was supplied by the cesspool p~mper you arranged for, TJ's ~umping. After p~mping the septic tank and seepage pits, approximately 1700 gallons was added to the system through Seepage Pit 1, the pit nearer to the septic tank. The p~mp truck was not equipped with a meter, and thequantity of water is an estimate by the ptnmper, Mr. Tim Buckley, after unloading the remainder of his load of water at a dump station. Since the initial depth of wastewater in Seepage Pit I was 5.6 feet (see attached Summary of Data) and the depth of the pit is 7,8 feet, it was necessary to pump the seepage pit prior to adding water for the test. Initial depth of liquid in the septic Sank was not measured, however, pumping the septic tank lowered the level in Seepage Pit 1 to 3.9 feet, a drop of 1.7 feet. Pumping of Seepage Pit 1 lowered the level to 3.4 feet, at which pSint the hose began sucking rocks and debriis. The initial level in Seepage Pit 2 was 5.8 feet with the total pit depth measured at 9.1 feet. The stand pipe for Pit 2 was not uncovered until after the septic tank was pumped. The attempt to pump the second pit only lowered the level to 5.4 feet, because the stand pipe or top of the pit was clogged with debriis, and the pumper was unable to extend the hose any deeper. Nr. ~cGranahan Dec. 29, 1978 Page -2- After adding approximately 1700 gallons of water to Seepage Pit 1, the level rose approximately 1.4 feet in beth seepage pits (see Summary of Data)~ The water level in the septic tank rose from 3.4 feet prior to addition of water to 6.1 feer afterwards. Water could be heard running into the septic tank immediately from the onset of adding water to Seepage Pit 1. After a period of 4 hours, the levels in the pits and septic tank were measured again and found to have raised an average of 0.6 feet. At theend of the 24-hoursperiod, the levels had not changed appreciably. Because the water level in Seepage Pit 1 dropped when the septic tank was pumped, coupled with the fact that water immediately began running back into the septic tank when adding water to the seepage pit, indicates that the system ~ing properly. Further, the fact that the seepage bits and the septic tank increased, the level in Pit 1 returned to its initial static level, during a 4~hour period of minimal useage, indicates that the problem may be related to a high water table. Information is not available from this test to determine the depth of the groundwater, but it appears that it could be as shallow as 5 feet. To determine actual groundwater depth would require that a test hole or test pit be dug. If you have any questions regarding this adequacy test, please contact this office at your convenience. Very truly yours, ALASKA DEVELOPMENT CONSULTANTS SUMMARY OF DATA Time Depth in Pit 1 9,o5 5.6' Depth in Pit 2 Depth in Septic Tank 9'30 3.9' 9,45 10,00 3.9' 12,55 3.4' 5.8' 1,00 - 1,42 1,25 4.1' 1,30 4.4' 11~4 4.8' 1:36 1:42 4.8' 1700 gallons added to Pit I 6.1' 3.8' 6.3' 6.1' 5,50 5.6' 1,42 5.6' 7.2' 6.6' 7.4' 6.6' Remarks Pit 2 standpipe not located~ static level Pit 1. Septic tank only pumped. Initial level pit 2. Pit 1 partially pumped. 2 hrs after Pit 1 pumped~ Pit 2 partly pumped. Stopped adding water to Pit I due to rise in Septic Tank. Begin 24-hr period. End Test. Dec. 28, 1978. January 2, 197B }~tche11 C. Mc Granahan 3907 East 67th Avenue Anchorage, Alaska 99~02 SubJect~ Lot 14 Block 3 Campbell Heights Subdivision The existing sewage system is inadequate. A replacement system consisting of a 2,000 gallon holding tank is required. ~e holding tank requires routine pumping. There is a strong possibility of a public sewer line being con- structed the summer of 1979. The installation of the public sewer line would make the installation of a holding tank meaningless. Therefore, the potiential buyer should be aware of a proposed sewer line and in the event the sewer line is not installed, routine pumping will he required on the holding tank until a public sewer line is available in future years. To gain a conditional department approval monies should be escrowed £or~ (1) Installation of a 2,000 gallon holding tank by June 1, 1979. (2) Funds to pump the existing system as needed until a holding tank is installed. (Be advised that pumping of the new holding tank will be the financial responsibility of the new owner if a public sewer line is not available to negate the use of the tank.) If there ere any further questions, please contact this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist cc~ First ];ational D~nk of Anchorage Post Office Box ?20 99510 Attention~ Trish ~alick GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR Date Received August 23, 1976 Time of Inspection O.'~ ~nTi Conv. l. Approval requested by: Alaska Bank of Commerce Mailing Address: Pouch 7012 99510 Phone: 279-5641 x 341 2. Property Ovmer: Carl H. & Glades Dewees e Mailing Address: C . Legal Description. Location: 3907 East 67th Avenue Lot 14 Block 3 Campbell Heights Subdivision 3907 East 67th Avenue 5. Type of facility to be inspected Sini~le Family 6. Well Data: No. of bedrooms A. Type C. Construction Individual B. Depth D. Bacterial Analysis 71 feet' 7. Sewage Disposal System: On-site system A. Installed 1970 B. Installer C. Septic Tank: 1. Size 2. Manufacturer D. Seepage Pit: 1. Absorption Area 2. Material E. Disposal Field: Total length of lines ge Distances: A. Well to: Septic tank Absorption area , Sewer Lines Nearest lot line , Other contamination B. Foundation to septic tank , Absorption area C. Absorption area to nearest lot line EQ-034 {1/74) Page 1 of two pages MUNICIPALITY OF ANCHORAGE DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 'C' Street, Anchorage, Alaska 99503 - 274-4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES MUNICIPALITY OF AN~HOP~,GE DEPT. OF HEALTH ENVIRONMENTAL Pi~OTECrlON AUG 2 3 1976 RECEIVED 1. Type of Inspection: CMRO VA 2. Property Owner: Cnrl ~. & Clad.rs Dew~ Mailing Address: ~qo7 £ast 67th Avenue 3. Name of Buyer: Hl f-rhpll 1.. & Doris C. H~O~pahan Mailing Address: 1~J77 "c." Rtreet 4. Name of Lending Institution: Ala~n Rank ~f Corm~e~ce Mailing Address: pn,~h 7012: Anchorage. A~ 99510 5. Name of Realtor or Agent: Mailing Address: ?~R Nnrthe~n t~_ht~ RlYd. Anch, FHA Day Phone Day Phone Phone ~award H. Bnyd - P[gneer Realty, Inc. CONV 344-2686 274-9551 279-5641 ex. 341 Phon~77-4541 6. Legal De~ription: Lot 14 Block 3 Campbell Heights Subdivision Location: 3907 East 67th Avenue~ Anchorage, A~ 7. Type of Facility to be inspected: 8. Water Supply Type of Supply: Public Utility If Individual, number of dwellings presently Served If Individual, depth of well 71 feet 9. Sewage Disposal System Type of System: Public Utility If Individual, date of installation 1970 No. Bdrms. 5 Individual X one X Single Family l~ellin~ Individual (on-site) EQ-037 (1/74) Page 2 of two Pages - R~'~t for Approval of Indtvtdual'{~'~r & Water Facilities Legal Descrtption~...` ~ 1.4, ~Oc? .3 Came>bell liei~hts Subclivision Approv ~ts~pproved . * ~ Date ~- proval,Valtd ~or ~ne year frem date signed - ~reater Anchorage Area Borough, Department of Enviro~en~l Quality certify, that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED EQ-034 (1/74) Date REQUEST £OR APPROVAL OF INDIVIDUAl, S£VAGE AHD VAT'ER FACILITIES d, Dl~t~nce f~ ~ell ~o closes~ ex~sth[ or p~posed: 5, P~perty Llne~ ho~es~ ba~, ~ainage d~tch, e~c. 7. Septic ~k capacity i~ c. Nan of septic t~k m~ufact~~. 1. If "home mede" show dis{rem on revers~ side cf this house ~q~_ f. Percolation Test perfo~d by, , .~he f~ Info.etlon: p~pe~ lines, ,well l~a~ion, house locati~, ~ic tank l~a~l~, dls~aal a~a locatl~, locati~ of percolation ~ dl~cti~ of ~und slope. ~. S!~alm of Appllc~t ~ate SiFned ~0 BE FILLED OUT BY HEA4TH D£PA~E~T PERSONNEL ~e abo~ described s~lt&ry faoilities ..... ?61~owinF cond~t~ms: Conditions: ,,, are he.by approved, s~bJect to the The abo~ described s~itary facilities are disapp~ved for the foll~ing Signature of a.~i~il~ :~' ".' .;. ~ate ~:' -M' ,'~..1 '-Approval la valid for one year following the date of approval. =- CPJ:c~ FHA Form 2573, ~ FEDERAL HOUSING ADMINISTRATION ~ F~m A~,o~od · *'" · ~- HEALTH AUTHORITY APPROVAL · INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM PART L--TO BE COMPLETED BY FHA INSURING OFFICE AnchorageR Alaska MORTGAGOR OR SPONSOR Henr/ David ~alker MORTGAGEE SERIAL NO. ]ll-Ol1316 PROPERF~ ADDRESS 3907 East 67th Avenue SUBDIVISION I~&ME Camobell ~eig, hts []¥. I--]No WATER SUPPLY BT* [] Public system [] Community system J BLOCK NO. LOT NO, (If Ye,, how man~) SYSTEM DESIGNED FOR ~ Individual ~. OF DE~. GAraGE DISPOS~ SEWAGE DISPOSAL [] Public system ['--~ Cornrnunity system PART II.--TO BE COMPLETED BY HEALTH DEPARTMENT HEALTH D~PARTMENI' 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 [] State [] County [] Local Department of Health that this individual sewage-disposal tern with proper maintenance: [~ Can be expected to function satisfactorily, and [] Cannot be expected to function satisfactorily is not likely to create an insanitary condition/~ )/ Ins~ ~horlty, Til~ Dispo, PART Ill.--FOR USE Of FHA OFFICE Distance ?,RWRITIR: To~l bn~h ~e foregoing and the ~ninent FHA ~mpli~ce lns~ion Re~n, and recommend that 'the ~:.supp y system ~ Trench ~n~h of ~ch lin , considered ~ Acc~mble ~ Not Acceptable Ty~ ~ tikes ~te~.considered ~ Accep~ble' ~ Not A~ep~ble. ~h of filter match Numar of plt~ URE Di~nce flora: Well,· ~ Ins~Olon maria b~ ~, ~ ~ ~I cHIEF ARCHtTECT ~'I DEPU[Y FOR CHIEF ARCHIT~C~ Date of insl~x-iion HEALTH AUTHORITY APPROVAL ':VIDUAL· WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FHA Form 2573 R~*. July 1958 REPORT OF INSPECTION--INDIVIDUAL WATER-SUPPLY SYSTEM Distance to nearest public water main. feet. Size of main. inches. Individual wells 1-1 are I-1 are not customary in neighborhood. Give most recent record of £ailute of wells in immediate v~clnity to ~urnith adtNuate supply of water Properties in neighborhood I'-I are [] are no~ being developed with both individual water.supply smd sewage4ispusal systems. Lot size: feet wide feet deep. Dwelling se~ back from front property line. feet. Individual water supply from: I-I Drilled well. I'-I Driven well. n Dug well. [] Bored well. Distance of well from: Building foundation, feet; nearest lot line at [] front, Fl side. I-I rear. ,feet; septic tank. feet; disposal field. feet; othe~ sources of possible pollution, feet. Diameter, inches. Total depth, feet. Type of casing, Approximate depth to pumping level of water in well feet. Approximate yield., Sealed watertight to depth of feet. Exterior space around casing sealed with: [] Cement grout. ["1 Puddled clay. [] Ordinary backfill. ~rcll cover: [] Concrete. f-I Wood. I-I l~4etal. Openings in well cover watertight: [] Yes. [] No. I~mp: l-I Shallow well. [] Deep well. Length of drop pipe, feet. Pump capacity,. Located in: [-I Basement. f-I Pumproom off basement. [] Pumphouse above ground. [] Pump pit. Pumproom pwpesly drained: n Yes. [] No. Pump mounting watertight: n Yes. '[] Iqo. Type of storage: [] Pressure. [] Gravity'. Capadty. gallons, Has bacteriological examination of water been made? [] Yes. ['1 No. If answer is "yes.;" give date Quality of water [-] is [] is not satisfactory for human consumption. · Installation ~-1 does f-I 'does not comply with approved exhibits, if any. Inspection made by: [] State· [] County. I"1 local Health Authority. Inspected by , Oa!e of i~lspection , 19 Depth of casing, gallons per minute. gallons pet minute. 19 follo~in2 Cesctibed ~to~erty-- Improvement~ situole~ ~hsr~n crc ~Jfh~n tho tho property lyipg ndjcceet thereto, that no ROBERT W. BURNS REGISTERED LAND SURVEYOR