The URL can be used to link to this page

Home My WebLink AboutCREEKSIDE PARK #3 LT 30A?. ?"o? ,~o;/ GUSTAV V. IOHNSON ,o~. /~7 A:!C~ '.-~n ,",,. O ~, ALASKA T E.~T T~st Hole No. Maae By ~J. C 7 8 .,fo 0 TIME' TI~E ~ ,/ TIME ~' ........ DATE DATE DATE // INSPECT~ / X ~UNI~IPALI~ OF AN~O~GE MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & DEPARTMENT OF HEALTH & ENVl RONMENTAL PROTECTI~IEONMENT~ PROTE~ION 825 L Street - Anchorage, Alaska 99501 ENWRONMENTALSAN TAT ON O V S ON FEB 3 ? 1981 Telephone 264-4720 DIRECTIONS: Complete ail parts on page 1. Incomplete r~u~ will not be proc~d. Please allow ten (10) days for processing. 1. PROPERTY OWNER ~ PHONE I MAI LING ADDR ESS PROPERTY RESIDENT (If different from above) PHONE 2. BUYER PHONE MAI LIN G-A D DR ESS 3. LENDING INSTITUTION PHONE MAI LING ADDRESS 4. REALTOR/AGENT PHONE' MAI LING~ADDRESS / 5o LEGAL DESCRIPTION .To STREET LOCATION 6. TYPE OF RESIDENCE NUMBER OF~BEDROOMS [] One ~ Four ~ [] Two' [] Five SINGLE FAMILY [] MULTIPLE FAMILY [] Three [] Six [] Other 7. WATER SUPPLY INDIVIDUAL* [] COMMUNITY [] PUBLIC UTI LITY * 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.) 8. SEWAGE DISPOSAL SYSTEM [] INDIVIDUAL/ON-SITE** PUBLIC UTILITY YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY TYPE OF RESIDENCE [] SINGLE FAMILY [] MULTIPLE FAMILY [] ONE [] TWO NUMBER OF BEDROOMS [] THREE [] FIVE [] FOUR [] SlX [] OTHER 2. WATER SUPPLY [] INDIVIDUAL [] COMMUNITY [] PUBLIC UTILITY Connection Verified 3. SEWAGE DISPOSAL SYSTEM [] INDIVI DUAL/ON -SITE []PUBLIC UTILITY Connection Verified [--]Septic Tank or [~Holding Tank Size: If Tank is homemade give dimensions: PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED =ERMIT NUMBER DATE INSTALLED iNSTALLER SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: 3tion Area to nearest Lot Line COMMENTS Septic/Holding Tank IAbsorption Area [Sewer Line INearest Lot Line )ATE [];~PPROV ED FOR ~ BEDROOMS [~ CONDITIONAL APPROVAL (letter mus~accompany certificate) [] DISAPPROVED 72-010 (Rev. 6/79) CH,~EMIC.4L & GE~,~OGIC~,IL LABORATORIES ~ AL;ISK.4, INC.~ Drinking waier Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER WATER SYSTEM: , I.D, NO. W,ter I'/ _. , ;! ,-. ,hor. ,o. System Name v ~_ / .'~*~/ - ,, ~ - Mailing ~ress ~, ~ City SAMPLE DATE: Mo. Day Year SAMPLE TYPE: [] Routine [] Check Sample (for routine sample with lab ref. no. D Special Purpose ) [] Tmatod Water [] Untreated Water · TO.BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: J~] ~'atisfactory [] Unsatisfactory [] Sample too long in transit: sample should not be over 48 hours old at examination to indicate reliable results. Please send rrew sample. D~te Received Time Received Analytical Method: [] Fermentation Tube -I~ Membrane Filter SAMPLE NO. LOCATION 4I I Time Coilect~l Collecte~ By Lab Ref. No. Result* Analyst 1 I READ INSTRUCTIONS BEFORE COLLECTING SAMPLE 06-1220 (b) Rev. 1978 BACTERIOLOGICAL WATER ANALYSIS RECORD Date C Mlectici Source a.m. Date Recelvecl Time Received ~).m. Lab. No. I~esumpt lye 10mi 10mi 10mi 10mi 10mi 1.0mi 0.1mi 24 Hours 48 Hours Confirmatory 24 Hours 48 Hours EMB. Brot~ 24 hours: MultlDle Tulle Report: Membrane Filter: Direct Count Verification: L.TB Membrane Final Filter Result; ~ ,,, ., RePOct4d By Broth 48 hours: 10mi Tubes PoMtlw/Totll 10mi PMtlofls Collform/100ml BOB ~ol!formll00ml Tlme~ // ~r' ~,,,? ;:.D &,m. 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 264-4111 GEORGE M, SULLIVAN, MAYOR DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION March 2, 1981 James Jones 9109 Old Harbor Road Anchorage, Alaska 99504 Subject: Lot 30 Creekside Park Subdivision #3 Approval for you'r individual sewer and water facilities cannot be granted until the following items have been completed: (2) The water analysis report needs to be delivered to this office from the Chem Lab.. 5633 B Street, for our review. The top of the well casing needs to be sealed with a sanitary seal so that it is water tight. If there is one there, it needs to'be tightened. This will need to be reinspected by this office when it has been corrected. If there are any further questions, please call this office at 264-4720. Sincerely, Robert C. Pratt¢ R.S. Associate Specialist RCP/ljw CC: National Bank of Alaska Pouch 7-025 99510 Rick Jarvis % Dynamic Realty 501 West Northern Lights Boulevard 99503 ADH~H~I~-6-FI (e) This Form~ Must Out Uompletely. Be Filled INDIVIDUAL WATER SUPPLY ALASKA DEPARTMENT OF wII~4LTH Section o! Sanitation and En_rineering Please Look on Reverse of Sheet for Sample Colleetion Instruetlon~ ~ '8 /P~equest for Bacteriological Analysis / J .-~ 1'2 1/ ~,/., Lab. ~To ............. ~'~'":~d ..... :~ .......... , ,,,, , ,. . ....... ........ ...... Water ~mple co~ec~d from ~hen tap; ~ ~t~m ~p; ~ B~eme~ tap; ~ O~er (l~t)../~..~ .................................... ~ ......... ~ ....... ,-.-~ ..................... ~ ......... ~ ....... ~ ............ Addr~ prem~e where ~ce ~ l~a~d....~~ ........ ~~.-.~...~~~~..~. ~' (Name) (Bo~ ~. or street ad~e~) Please place an "X" ~ ~e box before t~ms w~ch b~t desc~be your ~ter supply: ~CE: Well ~ ~ Dug, ~ Drlvefl, ~ D~ed, ~ Bored ~ ~pr~g, ~ O~tem, ~ Other (Hst) ............................................................................................................... ~ Creek, ~ River, ~ ~ke, ~ Pond ................................................................ ................................................. DUG ~LL OR C~N CON~UC~ON: W~s- ~ Wood, ~ Concrete, ~ ~tal, ~ ~e, ~ Brick or Concrete Block Top -- ~ Wood, ~ Concrete, ~ Metal, ~ ~en Top LOCA~ON: ~ In b~ement, ~ B~ement ofIset, ~ Under ao~e, ~In yard O~er ...................................................................................................................................................................................... D~T~CE ~: B~ld~g sewer or o~er ~a~age pl~....~..ieet, Septic ~ .~.~feet, ~le field .............. feet, Seepage pit /~.~.1eet, ~esspool .............. feet, Pri~ .............. feet. Other ~sible souses of ~ntam~atlon (l~t) ............................................................................................................................................. ~~: Buffing sewer -- ~' Cast ffon, ~Wood, ~ T~e,~ ~bre pl~, ~ ~bestos cement ............... ........................................................................... ~~ ~R~ON: Does water become mu~aY or a~colOrea? ~ yes, ~o ~en? ....................................................................................................................................................... Dlame~r of well ...................... ......................... ~ ...... dep~ .......................................................... ieet Well c~ng mateflal ........................................ ~ameter .................. ~. deP~ ...... , ........................... Length of d~p pipe ............................................................................................................................... Water depth imm ~tWm...... ....................................................................................................... feet ~p location: ~ ~ well, ~ O/1se~ ~ basement,~n b~ement ~ ~ utffity r~m, ~ On top of well ~ O~er (~t) ........................................................................................................ PURPOSE OF EXAMINATION: Illness sus~cted? ~ yes, ~ho New source of supply?~ yes, ~ no ~pa'~irs to existing system.~ ~ yes, ~ no ~em~rk8: ................................................. , ....................................................................................................................................................... PLEBE DRAW A S~ ~ ~ SPA~E B~. ~IS SK~CH SHO~D SHOW ~CATION OF HOUSE, WA~ S~PLY SO~, SE~IG T~, 8E~R, DRA~ ~S OR O~ SOURCES OF PO~ON ~ DIST~C~ BE~ WA~ SUPPLY SO~E ~ ~ OF ~0~ _._. SAMPLES MUST BE SUBMITTED IN CONTAINEBs PROVIDED BY ~ ALASKA DEPAIt~ OF m~.4LTH INDIVIDUAL WATI/R SUPPLY .~LASKA DEPAR~ Ola' OFFICB FOR BACTERIOLOGICALspoaard. Ahok&~~~A' WATERee ANALYSIS examinadon has been complev~ , Rec. ords in this office indicate this Indiv~e Water Supply to be of ~---~//tiitact0ry Questionable Unsatisfactory samtary status. Analysis shows this SAMPLE to be Satisfactory Questionable Unsatisfactory. If an "Unsatisfactory" or "Questionable" status is indicated above, you should take immediate action as recommended below. 1. Boil or chemically treat your water supply to protect your family from water-borne diseases as outlined in en- clor~ leafier, "Drink It Pure." 2. Improve your springBSee bulletin H$1L6-2 3. Improve your dstem--See bulletin HSIL6-3 4. Improve your dug well--See bulletin HSE-6-4 5. Improve your driven well B See bulletin HSE-6-5 6. Improve your drilled well ~ See bulletin HSB-6-6 7. Relocate your well to a safe location in relationship to your sewage disposal system~See bulletin HSF,-15 8. Bottle broken in transit, please send new sample. 9. Sample too long in transit; sample should not be over 48 hours old at examination to indicate reliable results. Please send new sample. 10. Contact your nearest [] Local Health Department or [] Alaska Health Department, Sanitation office for bulletins, consultation, and assistance. 11. This is a surface water source and subject to pollution by man and animals. An approved water supply source should be developed. SANITARIAN'S REMARKS ACTION ON REQUF~T FOR BACTERIOL~I~ WATER ANALYSIS Your recent ~equest for an analysis of a sample fr°m t~~u~al~ Priva*e Wa~ply received '-- ~lt_ ~tll s,gt enmimion lzen Re~ords in this office indicate this Individnal Priv_~e Water Supply to be of Analysis shows this SAMPI-~. to b~ Satisfactor/ If an "Unsatisfactoqr" 1. ~,%~sfsc~ory Questionable Umatisfscto~'y .Questionable Umatisfacto~/. or "Questionable" status is indicated above, you should rake immediate action as recommclldcd b~ow. Boil or chemically treat your wat~ supply to protect your family from water-Ix)me diseases as outlined in en- clmed leaflet, "Drink It Pure." 2. Improve your spring--See bulletin HSE-6-2 3. Improve your cistemmSee bulletin HSE-6-3 4. Improve your dug well m See bulletin HSIL6-4 5. Improve your driven well--See bulletin HSE-6-5 6. Improve your drilled well m See bulletin HSE-6-6 7. Relocate your well to a safe location in relationship to your sewage disposal system--See bulletin HSIL15 8. Bottle broken in transit, please send new sample. 9. Sample too long in transit; sample should not be over 48 hours old at examination to indicate reliable results. Please send new sample. 10. Contact your neaxest [] Local Health Department or /-1 Alaska Health Department, Sanitation office for bulletins, consultation, and assistance. 11. This is a surface water source and subject to pollution by man and animals. An approved water supply source should be developed. SANITARIAN'S REMARIL.g Sigeat~~ Division o~ Public He'th l. aborstorie$ BACTERIOLOGICAL WATER ANALYSIS Lot 30 Creek Side Park Sub No. ~ a~pom m Mr. La~rence A. Schackle ~ /~36. $n~m,rd, Alaska Collec~ Jan 16. i.o~l. - Date Rec~ved Jan 18, 1961 Lacto~ Broth 10cc 10cc 10cc 10cc 10cc 1.0cc 0.1cc 24 hou~ mi~_aq, T ~ 48 hours EMB BGB Lactose Broth, 24 hfs 48 hfs Gram's s, ain Coliform Density (Most proba_h~e__lqp>.per 100cc. ) Reported by I.~ Date ~-/zo/~x Absen* x This %-lysiS indicates Colitorm Organisms to be: Pr'-~enr '~ Your r~cent request for an~ of a sample from the Individual Pdvate. W' .a~ SupI~ly WATER ANALYSIS Records in this office indicate this Individual Private Water Supply to be of Satisfactory Questionable Unsatisfactory Analysis shows this SAMPLE to be Satisfactory Questionable Unsatisfactory. If an "Unsatisfactory" or "Questionable" status is indicated above, you should take immediate action as recommended below. 1. Boil or chemically treat your water supply to protect your family from water-borne diseases as outlined in en- ck~ed leaflet, "Drink It Pure." 2. Improve your spring--See bulletin HSE-6-2 3. Improve your cistem~See bulletin HSF,-6-3 4. Improve your dug well ~ See bulletin HSE-64 5. Improve your driven well~ gee bulletin I-LiE-6-5 6. Improve your drilled well m See bulletin HSE-6-6 7. Relocate your well to a safe location in relationship to your sewage dispo6al system--See bulletin HSE-15 8. Bottle broken in transit, please send new sample. 9. Sample too long in transit; sample should not be over 48 hours old at examination to indicate reliable ia~ults. Please send new sample. 10. Contact your nearest [] Local Health Department or [] Alaska Health Department, Sanitation office for bulletins, consultation, and assistance. 11. This is a surface water source and subject to pollution by man and animals. An approved water supply murce should be developed. SANITARIAN'S REMARKS SUPPLY ~CTION ON ILEQUItST FOR BACTIiRIOLOGICAL Your recent request/or an amdy~ o/a sample from the lndiv/du~ Private Wat~ Supply mm~tiofi'~l~-e~ completed. WATER ANALYSIS Recoi~ in this office indicate rigs Individual Private Water Supply to be of Satisfactory Questionable Unsatidsc~or~ Analysis shows this SAMPLE to be Satisfactory. .Questionable .Umsatisfactoz7. If an "Unsatisfactory" or "Questionable" status is indicated above, you should take immediate action as recommended below. 1. Boil or chemically mt your water supply to protect your family from water-borne diseases as outlined in eh- eM leaflet, 'q~ink It Pure." 2. Impcove your spring--See bulletin HSIL6-2 3. hnptove lzmt cistern--See bulledn HSE-6-3 4. Iml~ave rout dUg well--See bulletin HSE-6-4 5. Impwve your driven weB,-See bolledn I-ISE-G-5 6. hnptove your drilled well--See bulletin H$IL6-6 7. Relocate your well to a sa/e location in tehtionship w your sewage clispo~al ~$~em-- See bulledn HSE-15 8. Bottle broken in transit, please send new sample. 9. Sample too long in transit; sample should not be over 48 hours old at e~mination w indicate reliable results. - Please send new sample. ' 10. Contact your nearest [] Local Health Department or .[-1 Alaska Health Department, Sanitation office for bullet~ consultation, and assistance, 11. This is a sm'face wate~ source and subject to pollution by man and animals. An apprqved ,Water supply SANITARIANS REMARKS Sig~e- EMB Lactose Broth, 24 hfs Coliform Density Reported by 1~pP This aaslysis indicates Coliform Organisms to be: lOcc lOcc 10cc lOccI 1,0ccI 0.1cc BGB 48 hfs Gtam's stain (Most 'probable Ho. pet 100cc. ) Ab~nt ~ ._ UTE sg~,' JUNEAU [] FAIRBANKS [] KETCHIKAN [] To: ANCHORAGE [] Accounting ...............................................Medical Social ........................................... Commissioner ........................................... Mental Health ............................................ Administration ............................................ Nursing .................................................... Health Ed .................................................. Prey. Med. Serv.. ................................... Laboratory .................................................. San. & Eng ........./~____.~___ .................... MCH-CC ........... ~-~;::- ................... Vi,a~ S,at~s.cs ......................................... Speech-Hear~.g __! ......... iL__:___~__~.'*.~,._~ /~_d___ ~" ~ ~Z~ ........ ~ ........... ~ ...... :.: ................... ~, .............. : ........ . ; ..... As requested Note and return Call me on this Note and file Comment Please reply For your information Prepare reply Initial and forward Signature More details Per eeewerlatiee I ITY NATIONAl, BANK OF ANI HORAI E FIFTH AVIrN Uir AND Ir AN I~ H 0 RAgir. ALABKA R.A. KI='NNARD August 12., 1960 Mr. Frederick P. Meader, Sanitarian Greater Anchorage Health District P. O. Box 968 Anchorage, Alaska Re: FHA #60-006533 Lot 30, Creekside Park Subdivision #3 Old Harbor Road Dear Mr. Meader: After receiving your letter of August Z, 1960, regarding the subject case, I immediately checked into the sewage disposal sys- tem of which Mr. Winey did not approve. As you will recall, I tele- phoned you regarding the fact that there was a sewage lift pump and thought it might be acceptable. In an effort to supply all the information that I think would be necessary to get the installation passed, I checked with the Alaska Plumbing and Heating, who installed the unit, and asked them to find out more about this particular unit and whether it has been accept- able in other areas. Enclosed is a letter received from the Pacific Pumping Company of Seattle, Washington, which points out that this unit has received full approval of city and state health and sanitary co~les and has been installed in many homes which were F.H.A. in- sured. l~r. Frederick P. August 12, 1960 Page ~2 Meader Your review of this case immediately will be very much appreciated, and if you will let us know your decision as soon as possible, we will then attempt to clear up the cesspool problem. Yours very truly, P~K:bh cc: l~r. A. J. Alter, Chief Alaska Department of Health Juneau, Alaska Executive Vice Presideut m~ ~'mrk 8ubdivi. m&on tS bed lenmlNm~,. ver~ tmu~ pmmm, TO FROM A1 Date 6/7/60 - 9:30 Abt FHA 60-006533(Petitt) Now City Nat'l Bank · ngela s :J55/cree , ae su . S3 Old Harbor Road Checked w£th Mr.Ganard's office, and on advice of secretary, contacted Mr. Ariola who actually put in system on above property. He will get key from bank and meet you and Cai at property on Thursday June 4, at 1:30 PM. House is at end of Old Harbor Road; big house on right hand side of road, last house on road. He will be in a grey panel Ford with Alaska Plumbing & Heating sign on it. CITY NATIONAl BANK OF ANCHORABE FIFTH AV~'N U~' AND £ lIT R I~' ~'T ANCHORAGI='. ALA~IKA May 26, 1960 Greater Anchorage Health District 1~. O. Box 968 Anchorage, Alaska Re: FHA Case #60-006533 Gentlemen: Enclosed please find three copies of FHA Form Z573. l~lease complete the enclosed forms and forward them directly to the Federal Housing Administration, P. O. Box 799, Anchorage, Alaska, for their use. Your cooperation will be greatly appreciated. Yours very truly, Director DGF:bh Enclo s~re s FHA Form 5573 : '""...,~' - ~:orm Appro~'ed Rev. Ju~y 1958 FEDERAL HOUSING ADMINISTRATION ~ Budget Bureau No. 63-R296A HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM PART I.--TO BE COMPLETED BY FHA INSURING OFFICE MORTGAGEE SERIAL NO. Aucboz&le, Aluh City NAtionAl B&uk of Aucho~&le 60-006533 MORTgAGe" OR S"ONSO" ".O"E.TY ADD.ESS O14 l~rbor lot 30, Creekoido Subd. f3 Anchor&jo, Al&ok& SUBDIVISION NAMF._~ . J BLOCK NO. LOT NO. [] Can attic or other area be made into TOTAL NUMBER: BASEMENT New installation additional bedrooms? LIVING UNITS BEDROOMS BATHS (If Yes, how many~) z I'ZlYes I--INa I'-Ives WATER SUPPLY BY: SYSTEM DESIGNED FOR [--] Public system ['-'] Community system ~ Individual .o. OF SEWAGE DISPOSAL BY: O Public system 0 Community system ~] Individual ['-'] Yes [--] No PART II.~TO BE COMPLETED BY HEALTH DEPARTMENT HEALTH DEPARTMENT INSPECTOR'S SKETCH I , , ~_ _~ ............ --~_ ~-__ --.~... ~ . ' ~... ~. --. ..... .~ -~ .-~ _~.. .....-~ ----' -~ ...... ~---~ ..---~-. .... .. .... --~ ~- -- It is the opinion of the D State N County __l~ 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 O County O Local Department of Health that this individual sewage-disposal 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 SIGNATURE ' ' TITLE NOTE: The health authority should complete the appropric~to opinion statement above and affix date, signature and title in the spaces provided. Use of the above grid for Health Deportment Inspector's sketch as well as use of the back of this form is at the option of the health authority. PART Ill.--FOR USE OF FHA OFFICE TO THE CHIEF UNDERWRITER: I have reviewed the foregoing and the pertinent FHA Compliance Inspection Report, and recommend that 'the Individual water-supply system be considered [-~ Acceptable [~] Not Acceptable Sewage disposal be considered ~ Acceptable 0 Not Acceptable. DATE SIGNATURE [-'] C.IEF ARCHITECT /~_._ O DEPUTY FOR CHIEF ARCHITECT HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FHA Form 2573 Rev. July 1958 FHA Form 2573 · : '- ~orm Appro~,ed Rev. Jul), 19S8 ~ 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. Auchor&je, AtHki City NiUoul Ba~ of Aueborlle 60-006533 MORTGAGOR OR S~NSOR PROPER~ ADDRESS O~d ~&~bo~ ~ot 30, Creekel~ Subd. SUBDIVISION NAM~ -- J BLOCK NO. J LOT NO. TGTAL BASEmEnT ~ ~w ~flStGl]~fi~ Can ~ic ~ ~ a~a bo made in~ LI~I~G ~HITS SEDRO~S B*THS additional b~oms? (If Yes, ~ow I ~ l/Z ~ Yes ~ No ~Yes ~ No WA~R SGSF~Y BY: ~blic system ~mmuni~ system Individual NO. o~ ~D~s. GARBAGE mSPOSAL SEWAGE DIS~SAL BY: ~ ~blic sy,,cm ~ ~mmuni,y s~s,em ~ Individual ~ Yes ~ No PART II.~TO BE COMPLETED BY HEALTH DEPARTMENT HEALTH DEPART~E~ INSPE~OR'S SKETCH III Ill [11 III III III III III Ill III : III III III i : I11 I I ~ III III : ' III ii , I I I I I I I I I J ~ ~111 III : III , ~ III III ~ II1' 11 Ill , i ~ iii iii , ii 111 iii : ~ , III : III III Iii III : IIII, I III Iit , IIII : III :111 III III III III III III ~ III III III III Jill III III III III , III III III III I I III I I III, III i I I i ; I I ~ I : IIii ~ is ~ is ~ot satisfactory as a domestic wa~er supply for the suNec~ properS. tern with proper maintenance: DA~ SIGNATURE · ' ~ TITLE NOTE: The health =u~ should ~omplete the apprepr~ate opinion statement above and a~x d~e, signature and title in the spaces provided. Use of the above gffd for Health Department Inspec~r's sketch as well as uso of tho back of this form is at tho ~flon of ~ heal~ au~o~. PART III.--~ USE OF FHA OFFICE TO T~ CHIEF UNMRWRI~R: I have reviewed ~e foregoing and the ~inent FHA Compli~ce Ins~ion Repo~, and recomend that 'the Individual water-suppl~ sTstcm ~ considered ~ Accep~ble ~ Not Accep~ble ~wage dis~sM ~ considered ~ Acceptable ~ Not Acceptable. DATE SIGNATURE ~ CH'EF ARCHITECT /~ ~ ~ DEPU~F~CHIEFARCHITECT I I IIi I II II II III II III Ill 111 Ill III Ill Ill III III III III III III Ill ilI Ill III I III III III III III I I I I I1 I III III III Iii Il Ill III III III III III III I Ill III itl III III III III III III Ill III III I I I I I I I I I III III III lit Ill III II III Ill III Ill III III III Iii ,,[ Ill Ill III Iit III III III III Ill III III III III III III III III III Ill Ill Ill III III III Ill III Ill Ill III III III III III III III III TH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FHA Form 2S73 Rev. July 1958 FHA Form ~573 ~ ~ , 'Form ApproVed Rev. 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. Anchorage, Alaska City National Bank of Anchorage 60-006533 MO,TGAOOR ORS~ONSOR e,OeeRr~ ADORESS Old Harbor Road lot 30, Creekside Subd. ~3 Anchorage, Alaska Creekside/S~division No. 3 30 TOTAL NUMAR: BASEMENT New inst~lation additional b~moms? LIVING UNITS BEDROOMS BATHS (If Yes, how man~) ~WA~R SUP~Y BY:~ SYSTEM DESIGNED FOR ~ Public system ~ ~mm~i~ system ~ Individual Ho. oF BDRM$. GARAGE DISPOSAL SEWAGE DIS~SAL BY: ~ ~blic-system ~ ~mmunity system ~ Individual ~ Yes ~ No PART fl.--TO BE COMPLETED BY HEALTH DEPARTMENT HEALTH DEPART~ INSPE~OR'S SKETCH ~---~ ' ~ ' -~ - __ 2 ~_= ~- _- ...... m ~, ~ It is the opinion of ~e ~ State ~ Coun~ ~ ~ Department of Health that ~is individual water-supply system that this individual sewage-disposal sys- tem with proper maintenance: ~ Can ~ expe~ed to function satisfactorily, ~d ~ ~nnot be exacted to run.ion safisfa~orily is not likdy to create an insanit~ condition DA~ SIGNATURE TITLE NOTE: The he~l~ ~u~d~ should {omplete the apprapri~te oplni~n statement above and affix d~te, slgnature and ti~e in ~ ~ ef ~e abe~e g~d f~r Health ~p~rtment Inspector's sketch as well as use of the ba~k ~f this farm is at the opM~n ~f ~e PART III.--~ USE ~F FHA OFFICE TO THE ~HIEF UN~R~RI~R~ I have review~ ~e foregoing ~d the ~inent FHA Compli~ce Ins~ion Repo~, and reco~end that 'the Individual watcr-mpply system ~ considered ~ Accepmbk ~ Not Acceptable ~wage dis~sal ~ considered ~ Acceptable ~ Not Acceptable. DEPU~ F~ CHIEF ARCH~TE~ HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FHA Form 2573 Rev. July t958 FHA~ho;m 2a~73 ~,- Form Approved Rev. 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. CI~[ NATIOK~ BANK OF ANCHORAGE 60-006~3 ANCHORAGE MORTGAGOR OR SPONSOR PROPERTY ADDRESS PETTITs Gilbert W. and Anti~ette F~ Old Harbor TOTAL NUMBER: Can attic or other area be made into [~ New installation additional bedrooms? BASEMENT LIVtHG UNITS. BEDROOMS BATHSL-.--J (if Yes, how many~.) I ~ 'l,l~ [Ir1 Yes [~$o ~]Yes [-~$o WATER SUPPLY BY:__ ~ SYSTEM DESIGNED FOR [~] Public system !1 Community system III Individual ,o. OF gDIt,S.OARBAG, DISPOSAL SEWAGE DISPOSAL BY: ~]'Public system I~ Community system ,[~ Individual ~ [--] Yes [~ No PART II.--TO BE COMPLETED BY HEALTH DEPARTMENT HEALTH DEPARTMENT INSPECTOR'S SKETCH ---:---! _ :. , - ~ ~ ' ____2 .... ....... ~ ~ ~ --- , ~ ...... ~ ~ ..... ~ ..... ..... -~ ----~ ~--, , ~ - ~ ~ -- ? __ _ ~___7_ --~ .......... ...... i It is the opinion of the N State [--1 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 SIGNATURE TITLE NOTE: The health authority should complete the appropriate opinion statement above and afflx date, signature and title in the spaces provided. Inspector's sketch as well as use of the back of this form is at the Ol~tion of the Use of the above grid for Health Department health authority. -; , ~, PART Ill.--FOR USE OF FHA OFFICE ' TO THE CHIEF UNDERWRITER: I have reviewed the foregoing and the pertinent FHA Compliance Inspection Report, and recommend that'the Individual water-supply system be considered ~'1 Acceptable [~ Not Acceptable Sewage disposal be considered U Acceptable [~] Not Acceptable. ~^TE .,o.^.u. i-] c.,~.~c.,,~c. /77 HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FHA Form 257~ Rev. July 1958 ' Form Approved FHA~°~'m'2~3 ' ~ FEDERAL HOUSING ADMINISTRATION ~ Budget Bureau No. 63-K296.8 Rev. July 1958 , HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM PART I.--TO BE COMPLETED BY FHA INSURING OFFICE MORTGAGEE SERIAL NO. AZKIIOI~le Azaa~ CZ~ ~~ ~ 0~ ~~Z MORTGAGOR OR ~N~OR '~O~ ADDRESS SuuD~ws~o~ N~ I~K NO. tO~O. Can ~ ~ o~ oma ~ m~e In~ T~AL NUMAR: B~EMENT ~ ~W ~fiSC~fiG~ a~flonal b~? LIVING UN~S SED~OMS BA~S (If Yes, how many~) WA~R SU~Y BY: SYS~ DESI~ F~ ~ ~blic system ~ ~uni~ system ~ Individual .o. o~ ,u,~. ~.uu, ~WAGE DISKSAL BY: PART II.--TO BE COMPLIED BY HEALTH DEPARTMENT HEALTH DEPART~ INSPE~OR'S SKETCH ~---:---: ~ ~ ---~-~~ - , ..... .... ~__ _~ ~ ~- -~ .... , ~ ....... ----~ , ~:::~ ~ .... _ ~ ~ - ~_,__ ~ ....... ..... ~ ~ ~ .... ~ ~ ~ .... ~-- ........ _,.__ It is ~e opinion of ~e ~ State ~ Coun~ ~ ~c~ Department of Health that this individual water-supply system ~ is ~ is not satisfactory as a domestic water supply for the subject proart. It is the opinion of the ~ State ~ County ~ Local Department of Health that this individual sewage-disposal sys- tem with proper maintenance: ~ C~ ~ e~e~ to ~nction satishct°rily, ~d ~ Onnot be expected to function ~atish~orily is not li~ely to c~ate ~ insanit~ condition ., spaces provided. Use of the above g~d for Health Department inspector's sketch as well as use of the back of this form is at the o~tion of heal~ au~ori~. PART III.~FOR USE OF FHA OFFICE ' TO THE CHIEF UN~RWRI~R: I have r~iew~ ~e foregoing and the ~inent FHA Compli~ce Ins~ion Repo~, and recommend that'~e Individu~ water-supply system ~ comidered ~ Acceptable ~ Not Acceptable ~w~ge ai,~,~ ~ con,ia.ea ~ a~ep=~le ~ $o~ ,¢~ep=~l~. DEPU~ F~ CHfEF ARCHI~ HEALTH AUTHORITY APPROVAL iNDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FHA Form 257,~ Rev. July 1958 FHA~Iro~'m '2~3 · ,~,Y Form ApprOved ~ FEDERAL HOUSING ADMINISTRATION ,~/ Budget Bureau No. 63-R296.8 Rev. July 1958 ~' ' HEALTH AUTHORITY APPROVAL iNDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM PART I.--TO BE COMPLETED BY FHA INSURING OFFICE MORTGAGEE SERIAL NO. MORTGA~ OR Can ~c ~ o~ ama be made in~ TOTAL NUMAR: BASEMENT ~ ~W ~SCa~afiOfi a~l b~? LIYlflG UNITS SED~OMS BATHS (lf Yes, how m~) WA~R SU~LY BY: SYS~M ~GN~ '~ ~blic system ~ ~ufliw system ~ Individual No. OF BDRMS. GARAGE DISPOSAL ~AG~ DI~SAL BY: II' iic S So PART fl.--TO BE COMPLIED BY HEALTH DEPARTMENT HE~L~ DEP*RT~E~ INSPE~OR'S SKETCH ] IIII III I I ' ~ : , II1~ '., I~1 I t Ill ~ III I III III : ~lll u , iii ' , lib III ~ I~ I ,' Ill Ill III ; III ~ III III i i Iii III ~ : , I ~ , I III ~ ~ III , , ' ~ III I ~ Ill ' III ~ ill Ill Ill III ~ I III ~ ~ III ' I11 : I I I : ; I II III ;Ill i ~ ~ III , II1: I , t Ill ; II t ; lit III , ; I Ill III ' I III III ~ ' III t III ' Iii III : III, III III , ' ,Ill Ill ; i, III III ' '" '" : I" : ' : Ill ; II , i , , III I: : III L L: , ' I III I i III I I L , L III, I III I I i I ~ C~ ~ expe~ to ~nction satisfactorily, ~d ~ ~nnot be expected to function satisfa~orily is not likely to c~ate m insanit~ condition ",. ', DATE SIGNA~RE TffLE NOTE: The heal~ authori~ should complete the appro~ria~ o~inion statement above and a~x date, signature and title in spaces provided. Use of the above gdd for Health Depa~ment Inspector's sketch as well as use of the back of this form is at the o~tion of hea~ au~orl~. . . PART III.~FOR USE OF FHA OFFICE ' TO THE CHIEF UN~RWRI~R: ~ h~ve ~i~ ~e EoreKo~nK 3nd the ~inenc FHA CompH~cc Zns~{on ~cpo~, ~nd ~ccommend Individu~ water-supply system ~ consisted ~ Acceptable ~ Not Acceptable ~w~ge ms~s~ ~ considered ~ Acceptable ~ Not Acceptable. D~PU~ FOR CHIEF ARCHITE~ III III Ill Ill III III III Ill Ill III III III III III II1 III III III III III III III III III III ill Ill III Ill III III III III I11 I I I I II Ill III III III Ill Ill I[[ [[[ I[I ill II[ ][I Iii I~l Ill Ill Ill Ill Ill Iii Iii Ill I[[ [[I Ill II! III II |11 Ill Ill Ill III Ill HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM ~rm Rev. July 1958