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HomeMy WebLinkAboutSAMPSON ESTATES BLK 3 LT 1(: I CNP %Y \ Fn ki /j 10* las) IW s N N -W tawol Municipality of Anchorage Page 1 of z DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 0 Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: .5w 54 Wz8 PID Number: 051-81-1.2 Name: Wastewater System: W New ❑ Upgrade M PSI & M Contracting AddrePs. 0. Box 670485, Chugiak 99567 ABSORPTION FIELD PhonFj8 8-12 36 No. of Bedrooms: ❑ Deep Trench ❑ Shallow Trench CR Bed ❑ Mound ❑ Other LEGAL DESCRIPTION Soil Rating: Total Depth from original grade: varies 2-.0-3.5'1 0.8 GPD/Sq. Ft. Qq Lot: Bloc Subd. Stna.te s 1 `§ Sampson Depth to Pipe bottom from original grrade: varies 1.5-3.0 Gravel de th beneath pipe �.5' Ft. Ft Township: Range: 1W Section: 7 Fill added above original grade: 2.5-3.0' Gravel length: 32' Ft. 15N varies Ft. WELL ®-New ❑Upgrade Gravel width: 24 Number of lines: 4 Distance between linFS 6,6,5 Ft. Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: 768 Pipe material: D30341 P810 Private 176 Ft. 176 Ft. so. Ft. Driller: Date Drilled: Static Water Level: Installer: Date installed: Sullivan 4 123 Ft. m M& M Contr. 5-12-94 Yield:Pump Set at: Casing Height Above Ground: TANK 40 GPM Unk Ft. 2 411 Ft. SEPARATION DISTANCES eptic ❑ Holding ❑ S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: An ch. Tank Capacitty �iin��gall ons:JAE From Tank Field Station Tank Sewer Lines Material: Number of Compartments: Welt' 122 120 +100 Steel 2 SurfacWater +100 +100 +100 LIFT STATION Water Lot Size in gallons: Manufacturer: Line 28 10 +20' "Pump on" level at: "Pump off" level at: High water alarm at: Foundation 6 20 Curtain Pump Make & Model Electrical Inspections performed by: Drain 1 +50 +50 BENCH MARK Remarks: System installed per approved Location and Description: desicrn. Final grading to be npr- Firat formed no later than 6-15-94. Assumed Elevation: l oo.a ENGINEER'S SEAL �,aao'�DpC3 ®F At ©QO A;����oo,00e°°e°oq��Dd DO � ...,�,Boo Oo 1.0"a nado�V Inspections performed by: Dates2nsdt 5/5/94 en Du us an7o a voa 00000 le Kermeth M. Duf o �� �n'a1 5/12/94 . % CE 71 1 6 8 � Department of Health:ataaaaaa W Hu ra-Services approval / G 4ZZ3 ` �w Reviewed and approved by: , Date: 72-013 (Rev. 9/91) MOA 25 AS -BUILT WASTEWATER ABSORPTION SYSTEM PERMIT # SW940028 LOT 1 BLOCK 3, SAMPSON ESTATES PID # 051-81-127 aiV as ys °� c.o. G n G C SCALE 1" = 80' 1000 CAL SHPHIC A Q B � A 10.0 c�✓n B 60.0 w C 65.0 D M.0 � w FRAYS MUNE SELL N RR C. 0. a M. V. C. 0. m 28 LF 4" PERF {TYP) 9 � 3 A C.O. b OGA OS.. E PTIC TANK ° Oi HOUSE FOUNDATION NOT TOSCALE .49MI`I KENNETH DUFFUS CE 7116 '�OFESSIOX� 9 v see 8 FIRST FLOOR EL f00.0 ROUGH FINISHED A E ORIGINAL GRADE BOTTOM OF PIPE 4 BQ G 4. TANK BOTTOM OF FIELD 06. TEST HOLE EL 84.7 (BOTTOM) MM & M CONTRACTING, INC P❑ BOX 670485 CHUGIAK, AK, 99567 22041 PTARMIGAN DR EAGLE RIVER, AK, 99577 694-2359 DATE, 5-13-94 DRAWING # DRAWING NOT TO SCALE Kin by SULLI"N. WATER WELLS P.O. BOX 670272, CHUGIAK, ALASKA 99667 a TELEPHONE 688-2759 til OWNP R OF LAND &MMI, LEGAL DESCRIPTIONA22 �7- mi,kWDOWNFT GALS. PER MR DATE, - Started Ended KIND OF CASING PEM41't NUMBER Kjr4o.OF FORMATION: Ft, to--Vi—ft, vinin Frw 4) Ft. to---q-­Ft, . From­­ft- M ­Ft, From.—.E___..-Ft, toJl—Ft­4q6XP-ZA—�Ql.. Froin Ft- t0- Ft, Fromr'M /G t Y- IMOJ From --Ft. From,,;23— Ft. toz.is-- Ft. Ji"4lk4& Fruin 4 ig vc to From Ft. Frolp� t. st Ft. t) -u -b From.. Ft. to t. FromL4J- Ft. toi.14 Ft. 4 Front. _Ft. Ft. to r From to --Ft - — ---------- Fromll� - -t From Fri3in.—Ft. to-- -Ft, Froin......—Ft. frolil---Ft. MISCL, INFORMATION: vrolIl­-­ •N -E-vl� I v Eu From to_..:. "AY 1 pt�p4 11.9 From-..., Ft, 1�­ 4ngipality qt,6nchoip,- 9 uWff -&H u ffa—n- "Ge rvi ces rrom .--.,Ft. to-_.--- _ 't._.... —.-..._,_.—.,.. DRILLER'S o------ DRILLER'S NAME PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW940028 DATE ISSUED: 2/11/94 DESIGN ENGINEER:CONSTRUCTING ENGINEERS, INC. EXPIRATION DATE: 2/11/95 OWNER NAME:M M & M CONTRACTING INC OWNER ADDRESS: 0518112700088 PARCEL ID:05181127 LEGAL DESCRIPTION: SAMPSON ESTATES BLK 3 LT 1 LOT SIZE: 40467 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 OR 343-4681 AFTER BUSINESS HOURS 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: DATE; ISSUED BY: DATE: • WATER AND WASTEWATER ABSORPTION SYSTEM SITE PLAN DETAILS LOT 1 BLOCK 3 SAMPSON ESTATES SUB UNSUBDIVIDED ®��OFAL,q� ® � SAO HENRY H. iTILSON 0 T� 1732-E �4Q LOT AREA: 41,000 SF LESS PERIMETER. SETBACKS, BUILDING FOOTPRINT, WELL RADIUS: 21,500SF TOTAL AREA AVAILABLE FOR ABSORPTION SYSTEM: 19,500 SF PREPARED FOR: MM&M CONTRACTING, INC PO BOX 670485 CHUGIAK, AK, 99567 mm Z m n in aw G N G7 LL C[INSTRUCTING ENGINEERS °601 BUDDY WERNER DR HC83 BOX 192A MYRTLE DR ANCHDRAGE, AK, 99516 EAGLE RIVER AK, 99577 346-2000 694-9098 DATE, 1-12-94 DRAWING 4 SCALE: r = 100, 94-S1-0101 o MT 4'PERF (TYP) 6' (TYP) C❑ (TYP) 32' — ABSORPTION SYSTEM DESIGN DETAILS Z c z F - f A 5' MIN - 7 -Cl 1T50 GAL TA W - o z X'61� 3/4 r /' &/ _ %� / 7�8 in a a r r ~ _ 26' a W r w ° 0' D D IGINAL GRADE a o o ZQ FINSIHED GRADET oOR :11o _JW o FILTER FABRIC 0.5' I. j 0.5' 1T50 GAL TANK CONSTRUCTION NOTES 5' MAX 1. Bottom of Bed to be scarified prior to pLaci k. 2. Contractor to minimize use of mechanical equipment on excavated area. 3. Bed to be level including bottom of bed and distribution laterals. 4. Minimum 2' cover over pipes with 2" HD insulation, or 4' ground cover. 5. Finished installation to be top -soil and seeded by owner. ABSORPTION AREA CALCULATIONS: Minimum Required: 4 Bedrooms x 150gpd/bedroom = 600 gpd capacity Soils rating, proposed addition, 0.8 gpd/sf Minimum sizing: 600 gpd 0.8 gpd/sf = 750 sf absorption area Beck Design: Use 241W x 321L bed (minimum) ww/ 4 ea 4" Perf pipes on 6' centers, each 26' long. IMPACT ON ADJACENT LATS: There are no private wells within 100' of this proposed absorption system. The proposed absorption system has no adverse impact upon any adjacent lots as shown on attached site diagram. The lot is to be served by a private well on-site. HENRY H. SYILSON 4 1732-E p� NGI E �A �'BSSIONAI' DESIGN DETAILS PROPOSED WASTEWATER ABSORPTION SYSTEM LOT 1 BLOCK 3 SAMPSON ESTATES SUB PREPARED FOR: M M & M CONTRACTING PO BOX 670485 CHUGIAK, AK, 99567 NOT TO SCALE ® I CONSTRUCTING ENGINEERS 346-2000 10 9601 BUDDY WERNER DR 694--9098 I ANCHORAGE, AK, 99516 688-1236 DRAWN BY CAL 1-12-94 DRAWING H 93-52-09-1 PERFORMED FOR m (Y\ LEGAL DESCRIPTION: DEPTH d �.p k(_(FEET) T3 1 2 3 4 5 J �1 6 8 9 10 11 12 13 14 15 16 17 18 19 i E 2D COMMENTS 5 lei PrRc. No'L C-LE4 $P 4YaCA1r on 1 I HUENR YI SON DATA�n 1732 O ED: '\�,-% �SSIONAL Township, Range, Section: NW _ SLOPE SITE PLAN WAS GROUND WATER N0 ENCOUNTERED? 1" S L IF YES, AT WHAT O DEPTH? P E Depth to Water After F.innitnrino7 ''-.Ndp Date: _ -- Reading DateTime ,�-%,&INEER'S SEAL) me ]Net Depth to Water - OF' AL Municipality of Anchorage SERVICES 5 Mr DEPARTMENT OF HEALTH & HUMAN ®� 82.5 "L" Street, Anchorage, Alaska 99502-0650 - � SOILS LOG -- PERCOLATION TEST --p m (Y\ LEGAL DESCRIPTION: DEPTH d �.p k(_(FEET) T3 1 2 3 4 5 J �1 6 8 9 10 11 12 13 14 15 16 17 18 19 i E 2D COMMENTS 5 lei PrRc. No'L C-LE4 $P 4YaCA1r on 1 I HUENR YI SON DATA�n 1732 O ED: '\�,-% �SSIONAL Township, Range, Section: NW _ SLOPE SITE PLAN WAS GROUND WATER N0 ENCOUNTERED? 1" S L IF YES, AT WHAT O DEPTH? P E Depth to Water After F.innitnrino7 ''-.Ndp Date: _ -- Reading DateTime Gross me ]Net Depth to Water - Net Drop r 5 Mr 4„ 6 d r1� p n a IJote iaKtro PERCOLATION RATE 3 (minutes/i nch) PERC HOLE DIAMETER Z�11 TEST RUN BETWEEN �' o— FT AND �l. e FT USf_ sap 5 (, r k�'' ,n 13oTrby)- F10 ISFtEV 64ZIC A('A - 6RA0E PERFORMED BY: �'�ns�l5 I -- CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: -- 72-008 (Rev. 4/85) PLOT PLAN S,/j i r1 V 7V.J Ute^ 4o k, �a I1 QH ffi ry0 FA1.\ FyE'D 'T I URIf� TION 41 .ar SHOL \ ptrVD boa CS^` Z� pA,Ot"o f/ J W IJI Aj W _ \\ O PROPOSED CTLL SITE 100" PP.OTECTR'F. WELL RADIUS - \1 -- ----- - �/ DRAii�:<.G`� X340 � 5/8" REUAR SET OR MIND ALL CORNERS UNLESS OTREMUS'F. S1/OWN OF AL 4 A E[CNRY H.Y;LSON �r 3082-5 I I HEREBY CERTIFY THAT A SURVEY OF LOT 1 BLOCK 3 SAMPSON ESTATES SUB CONSTRUCTsIr WAS !./ADE ON AUGUST 25 ,1993 ,AND THAT THE IMPROVEMENTSI ENGINE L:;i S .SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND DO NOT OVERLAP OR ENCROACH ON THE PROPERTY LYING ADJACENT THERETO, THAT NO IMPROVEMENTS ON THE PROPERTY LYING ADJACENT THERET I-IC83 BOX 192A MYRTLE Di ENCROACH ON THE PREMISES IN OUESTION AND THAT THERE ARE NO EAGLE RIVER, AK, 99677 .ROADWAYS, TRANSMISSION LINES, OR OTHER VISIBLE EASEMENTS ON SAID PROPERTY EXCEPT AS SHOWN HEREON. IT 1S THE RESPONSIBILITY OF ?'HE OWNER TO DETERMINE THE EXISTENCE OF ANY EASFAIENT.S. COVENANTS OR RESTRICTIONS U'IIICH DO NOT APPEA I`rele. (907) 346--2000 ON THE RECORDED SUBDIVISION ( PLAT. UNDER NO CIRCUMSTANCES \90'7)-694-9096 SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OR FOR— ESTABLISHING BOUNDARY OR PENCE LINES DATE: JAN 12, 1994 7 rr n1 RRw cry. I Parcel I.D. # MUNICIPALITY OF ANCHORAGE ® DEPARTMENT OF HEALTH & HUMAN SERVICES.o i Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Q 051-81-127 HAA# A A l� ILQ 1. GENERAL INFORMATION Complete legal description Lot 1, Block 3, Sampson Estates Location (site address or directions) Sampson Drive Property owner M 'M & M Contracting Day phone 688-1236 P u' Mailing address, P O i -"Box 670485 Chuaiak Alaska 99567 Lending agency =' $ Day phone Mailing address Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual well XX Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XX Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA#21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm KND Engineeri Address Engineer's signature 6. DHHS SIGNATURE Approved for Four (4) bedrooms. Disapproved. Conditional approval for Additional Comments M Phone 594-2359 Date 5/26/94 A,. 9Q� 4 e0009JYOOOn •i 1090�OBOp 0000090y PJO0000 A Kenneth M. Duff 8 yI✓� J ,o CE 711 o �« Q©�OpROF00 ESS���P bedrooms, with the following stipulations: Date F- 2 6 - l — 1,01 The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA 021 MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 051- 81 E��1-1 HAA # 4 QCA L 1. GENERAL INFORMATION Complete legal description Lot 1 Block 3 Sampson Estates Location (site address or directions) Sampson Drive Property owner M .M &%'.M Contracting Day phone 688-1236 .•::..,, P. 0.�`' ox 670485, Chugiak, Alaska ?95G7 Mailing_ t xs� , ,.. • ..,. , M. Len di.ftng agency,• • t Day phone c' rr p ' Mailin a dress" Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well XX Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XX Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I furtherverify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Phone Address '/111 �c��„rn c a , 2EZ2� Jr>L` n c,�� t� d I� IC 'iir S- -77 Engineer's signature o,at/ Date S�. 3� C, 7 6. DI HS SIGNATURE Approved for 3 bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments CAUTION The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesyto purchasers of homes and their lending institutions in orderto satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA R21 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lot 11 Bk 3, Sampson Est. Parcel I.D. 051-81-127 A. Well Data Well type Ind. If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Y Date completed 3/94 Driller Sullivan Total depth 176 ' Sanitary seal (Y/N) Y Date of test Cased to 176' FROM WELL LOG 3/94 Static water level 1231 Casing height 24" Wires properly protected (Y/N) Well flow 40 9 -P.M. Pump Ievell unk. SEPARATION DISTANCES FROM WELL TO: AT INSPECTION Septic/holding tank on lot 1221 ; On adjacent lots + Absorption field on lot 12 0' ; On adjacent lots +100, Y Public sewer main +200, Public sewer manhole/cleanout +2 a0' Sewer service line 1201 Petroleum tank +100, - WATER SAMPLE RESULTS: Coliform 0 Nitrate 2.05 Other bacteria 0 Date of sample: 4/28/94 Bact Collected by: WI.Z('L 5/5/94 Nitrate B. SEPTIC/HOLDING TANK DATA Date installed 5/12/94 Tank size ,;$ Compartments 2 Cleanouts,(Y/N); y Foundation cleanout (Y/N) y Depression (Y/N) N High water alarm (Y!N) NT/A Alarm tested (Y/N) Date of pumping New system Pumper -- SEPARATION DISTANCES A6m SEPTIC/HOLDING TANK TO: Wells) on lot ` 122' On adjacent lots +100' Foundation 95 To property line 281 Absorption field 5' Water main/service line +50' Surface water/drainage +100' 72-026(3/93)• Front CONTINUED ON BACK PAGE m Z -< m Z > R1m O M. m A a C_ A v o vi m 0 Z Public sewer main +200, Public sewer manhole/cleanout +2 a0' Sewer service line 1201 Petroleum tank +100, - WATER SAMPLE RESULTS: Coliform 0 Nitrate 2.05 Other bacteria 0 Date of sample: 4/28/94 Bact Collected by: WI.Z('L 5/5/94 Nitrate B. SEPTIC/HOLDING TANK DATA Date installed 5/12/94 Tank size ,;$ Compartments 2 Cleanouts,(Y/N); y Foundation cleanout (Y/N) y Depression (Y/N) N High water alarm (Y!N) NT/A Alarm tested (Y/N) Date of pumping New system Pumper -- SEPARATION DISTANCES A6m SEPTIC/HOLDING TANK TO: Wells) on lot ` 122' On adjacent lots +100' Foundation 95 To property line 281 Absorption field 5' Water main/service line +50' Surface water/drainage +100' 72-026(3/93)• Front CONTINUED ON BACK PAGE C. LIFTS ION N/A Date installed Size in gallons Vent(Y/N) High water alarm level _ rer Manhole/Access (Y/N) "Pump on" level Meets MOA electrical codes (Y/N) tested FROM LIFT STATION TO: on D. ABSORPTION FIELD DATA Date installed 5/12/94 Length 32' Width Total absorption area 768 On adjacent lots Soil rating (GPD/Ft2) 0. 8 241 Gravel thickness Cleanout present (Y/N) Y Date of adequacy test NA New Results (pass/fail) off" Level at Surface water Systemtype Bed Varies 2.0-3.5 0.5' Totaldepth from orig. grd. Varies 4.0-5.5 from fin. Depression overfield (Y/N) -- grd. for Bedrooms Water level in absorption field before test After test _ Peroxide treatment (past 12 months) (Y/N) If yes, give date _ *New system. To be finish graded no later than 6-15-94. SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 120 ' On adjacent lots +10Q, Property line 10, To building foundation 20 ' To existing or abandoned system on lot N/A On adjacent lots +50, Cutbank +100' Water main/service line +501 Surface water + i n n ' Driveway, parking/vehicle storage area +201 Curtain drain +100, E. ENGINEER'S CERTIFICATION 1 certify that 1 have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature oo a &�.:'.:,: Engineer's Name t/6- /7/ o`ew aaat�n ©6ao ° f}� Kenneth M. Duffus o �3 Date�i--'—A 'E crew n ��.. . _ HAA Fee $ 'PI&I- Date of Payment Receipt Number 72.026 (3193)' Back Waiver Fee $ Date of Payment Receipt Number Commercial Testing & Engineering Co. Environmental Laboratory Servicesoo�00000�00000��000000000000000a SINCE 190B LABORATORY ANALYSIS REPORT CT&ERef.# 94.2098-1 Client Sample ID Ll B3 SAMPSON ESTATES Matrix WATER ClientName BLS &ASSOCIATES, INC WORK Order 78136 Ordered By CHUCK LANDERS PrintedDate 05/11/94 @08:25 hrs. Project Name Collected Date 05/05/94 @07:45 hrs. Project# Received Date 05/06/94 @ 13:20 hrs. PWSID UA Technical Director STEPHEN C. EDE Released -- -- -- ----------------------------- SampleRemarks: --------- -- ------- SAMPLE COLLECTED BY: C.A.L. QC Allowable Ext. Anal Parameter Results Qual Units Method Limits Date Date Init – ------------------------------------------------------------------------------------ Nitrate-N 2.05 mg/L EPA 353.2/300.0 10 05/09/94 MICE -------------------------------------- -------- See Special Instructions Above UA = Unavailable * See Sample Remarks Above NA=Not Analyzed U = Undetected, Reported value is the practical quantification limit. LT= Less Than D = Secondary dilution. GT= Greater Than �t 5633 B Street, Anchorage, AK 99518-1600 — Tel: (907) 562-2343 Fax: (907) 561-5301 ENVIRONMENTAL FACILITIES IN ALASKA, COLORADO, FLORIDA, ILLINOIS, MARYLAND, NEW JERSEY, OHIO, UTAH, WEST VIRGINIA