HomeMy WebLinkAboutCREEKSIDE PARK #3 LT 22icl
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FlffA Form 2573 ~ ?' Form Approved
~Re~. July 1958 ~ FEDERAL HOUSING ADMINISTRATION~' Budget Bureau No. 63-R296.8
' . . HEALTH AUTHORITY APPROVAL
· INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM
PART I.--TO BE COMPLETED BY FHA
INSURING OFFICE MORTGAGEE SERIAL NO.
MORTGAGOR bR ~P~S~ --t ' PROPERTY ADDRESS
SUBDIVISION NAME ~ ~
BLOCK NO. [ LOT NO.
Can ~Jc ~ o~er a~a be made into
TOTAL NUMBER: BASEMENT New installation ad~flonal b~moms?
LIVING UNITS SEDROOMS 8ATHS
(If Yes, how many~)
WA~R SUPPLY BY; SYSTEM D~IGNED FOR
~ ~blic system ~ ~mm~i~ system , ~ Individual I,d.
SEWAGE DISPOSAL BY:
~ ~blic system ~ ~mmunity system ~ Individual ~ ~ Yes ~ No
PART fl.--TO BE COMPLETED BY HEALTH DEPARTMENT
HE' ~LTH JEPARTMENT INSPE~OR'S SKETCH J
Jill III
~ Jill III
i111 III
· I I I I I
~ '~11 III
II 111
1 I ~ I I ~l~ m
~llll Ill d
llll ~ Ill
!1 I I Nil I I E '~
!1 I I [I I I ~ ~ ~ ~_
nil III -, i h
II k & III
I I ' ' I I I d Jtd I
Il ~ VII I
II - III
eopinion of ~e ~ State ~ Coun~ J J Local Department of Heal~ that this individual water-supply system
~is not satisfactory as a domestic water supply for the subject properW.
It is the opinion of the ~ State ~ County ~ Local Department of Health that this individual
sewage-disposal
sys-
tem with proper maintenance:
Can ~ expe~ed to function satisfactorily, and ~ Cannot be expected to function satisfactorily
is not likely to create an insanit~ condition
DATE SIGNA~RE TITLE
UJe of the obove 9~d for Heolth Depnrtment Inipector'i ~ketch os well oi vie of the b~{k of thii form iJ ot the option of the
I have review~ ~e foregoing ~d the pe~inent FHA Compli~ce Ins~ion Repo~, and recommend that 'the
Individual water-supply system ~ considered ~ Accep~ble ~ Not Accep~ble
~mge dis~sal ~ considered ~ Acceptable ~ Not Acceptable.
DATE
SIGNATURE
~ CHIEF ARCHITECT
DEPU~ FOR CHIEF
ARCHITECT
HEALTH AUTHORITY APPROVAL
INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM
FHA Form 2573
Rev. July 19,58
REPORT OF INSPECTION--INDIVIDUAL SEWAGE-DISPOSAL ~sTEM'"':z'*t'c':i
PRIMARY TREATMENT consists of ~ ~pfic ~nk. ~ ~ss~l.
h~ Tan~ ~
Total liquid ca~c~,; ~¢¢ ,-g~lons..~ ,, Capaci~ inlet comp~ment,m ~ ~ /O ~ ~ g~lons.
~side 1~, ~ '~ f~t. Inside wide, ~ * ~ f~t. L~uid ~h, ~ w ~$ feet.
Ce~h
Dis~nce from: W~L - f~; fo~dat~n, , ~ n~ 1~ ~ ~ ~ ~nt; ~~.
Inside d~ter, f~t. Depth, f~. Liquid capaciw, gallons. Lining material
~CONDARY TREAT~NT consists of ~ Tile dis~sal field. ~ S~page pi~. Other
Tib Disposal Field:
Total len~h of tile lines ~t. Numar of lines Di,tance b~een lines .f~.
Trench width, inches. Tot~ e~five abso~tion a~a in bottom of trenches, ~qmre f~.
~n~h of tach line, f~t. Depth, top of tile m finbh grade, inches.
Ty~ of ~r material: ~ Gravel. ~ Broken stone. ~er.
~pth of filter marerial ~neath tile,~ inches. Depth of filter material over tile. inches.
Numar of pi~ /, ~tsid~~ ~ feet. ~h, ~ f~c Lining marefi~ ~
Distance bom: ~e;l, ~/~fe~; bfiil~ing fo~dation, ~ ' f~ de~ l~t l;fi~ arb ' ~f~.
bOng ~ side; ~ rear,.
Inspection made bi- [] State. [] C_~unty. [] Local Health Authority.
Date of inspection /'// /, 1.9~ '~ Inspected by
(TITLE)
REPORT OF INSPECTION--INDIVIDUAL WATER-SUPPLY SYSTEM
Distance to nearest public water main, feet. Size of main, inches.
Individual wells ~ are [] are not L~ustoma~ in neighborhood.
Give most recent record of failure of wells in immediate vicinity to furnish adequate supply of water
Propertiesa~ghborhood ~ are []_are not being developed with both individual water-supply and sewage-disposal systems.
Lot 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.
Distance of well from:
Building foundation. J~--~ feet; nearest lot line at [] front, ~ side, [] rear, ~ ~
cast iron sewer. ~ ,,.feet; tile sewer, feet; septic-tank,~feet;~ disp~asal-..field,
seepage pit, ;Sa/aO&~ feet; cesspool,, feet; other sources of possible pollution, ~ ·feet.
Wall construction:
Diameter, ~ .inches. Total depth, ~'/ ~ feet. Type of casing, '~15e~¢ /
Approximate depth to pumping level of water in well,, feet. Approximate yield,
Sealed watertight to depth of // 7 feet.
Exterior space around casing sealed with: [] Cement grout. [] Puddled clay. ~ Ordinary backfill.
Well cover: [] Concrete. [] Wood. I~ Metal. Openings in well cover watertight: ~ Yes. [] No.
Pump: [] Shallow well. ]~ Deep well. Length of drop pipe, feet. Pump capacity,
Locat~ in: [] Basement. [] Pumproom off basement. [] Pumphouse above ground. [] Pump pit.
Pum¢oom properly drained: [] Yes. [] No. Pump mounting watertight: [] Yesi ?~d
TyPe or storage: ~ Pressure. [] Gravity. Capacity, ~'~,~ gallons. ~1~ ~, ~,
feet,
Depth of casing, // ~' feet.
gallons per minute.
/a , , /,' ,.
gallons per minute.
Has bacteriological examination of water been made? [] Yes. ~ No. If answer is "yes," give date 19
Quality of water [] is [] is not satisfactory for human consumption.
Inspection made by: [] State. [] County. [] Local Health Authority.
Date of inspection ./// ~ ,. 19_~
(Tm~)
~' U. S. GOVERNMENT PRIHTING OFFICE: 1~57 O-F--4;17058 ,
HOME OFFICE
ANCHOI~AGI:'. ALASKA
I'. O. ~OX ~21
Test Location:
Test Date: ~
0I
Requested by:
Test Hole Log
15'
~3-1779
Percolation i~est
Lot 2~ Block
Test Hole Location
11 '1
approximate slope
lat. Filling:
Bottom of hole filled with of water and allowed
to drain out.
2nd. Filling:
Bottom of hole filled with
Percolation Rate: ~'~ min./in.
Remarks: . ~'! ~
of water and test run.
These results are only the visual soil conditions and theoretical
percolation rate on this date for this test hole.
By:
XO Xq~ireb 1.964
Hr. ebirl.ea Pnpp
OJ.d Harbor Rood
Anehoralo, Almoim
Dear Hr. Papp:
Apparently X vas S~ven some mLsLnforwaCXm resardLns Cb locacXou of
ImbXLe vicar ~n th~s area. T~,,refore, tim water ouppXy ce serve Loc
22, Creabide Pirk t3 SubdivioXou v~.ll be approved by ChLs deparCsmnc
pandits Cb uesit:Xv, results of baeterXolos~eal and deCerpmC Zeoto
to be performd on water oamplas Oaken from tb subject supply.
S~nterely,
DAVID R. L. DUNCiN, N.D.
DIIP: faa
ce: sp, rbm & HeLosu Co.
Deu~d S. Penner' S.S'~ ....
publLe supply.
mm mob0~ Bo moueim ef the ue~or e~le. Tkim lnformtiou wbowld kew
bern imeluded ms tbs ~rs ropor~.
SfjmJorely,
July 17, 1963
Loc 22
Creelmide Park ~3
Subdivts~ou - Hr. (:~haries
Dear
The percolation teac for Loc 22, Crbeka~de Park 8ubd~v~sLon ~3
l~d~eaCos chac chis lot will satisfactorily susCain che conventional
type private sevaSe d~sposa~ syscom eonw~sCin8 of an adequoC&ly sisod
sapcLe tank and an at x 8* x 6* los seepafe p~c surrounded by cwo
hoc of sood grade gravel co the cop of the los cribbin8.
Slnc~roly,
I~kVXI) R. L. DUIMA#,
DHP~roa
Santtartan