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HomeMy WebLinkAboutDEBORA BLK B LT 5k*4 cxl, Aut�td� # 050 D35 2& MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street • Anchorage, Alaska 99501 Telephone 2644720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME 14 % S G PHONE - y'I EW s❑UPGRADE MAI LING ADD S X 'L-2,7 C • /P. LEGAL DESCRIPTION L <5 �J �� o,P -s�tex,5 LOCATION NO. OF BEDROOMS Uy DISTANCE T0: / 47 40Well Absorption area of Dwelling PERMIT yy W Q ~ Manufacturerp& C re MaterialsC�,� No. of compartments 1� N Liq. capa y jp g5'r IF HOMEMADE: Inside length Width Liquid depth d sc J2 DISTANCE TO: Well Dwelling PERMIT NO. _ —Z Manufacturer • Material Liquid capacity in gallons Lux DISTANCE TO: Well f Q Foundation p Nearest lot bne PERMIT NO. Z No. of lines Length of each line, / Total length of li7s Trench width Inches Distance between lines fes- O Top of tile to finish grade s �� /` Material neath the „ 4 inches Total eller 've bsorptn area d W Length idth Depth PERMIT NO. Q H Wa W Type of crib Crib iameter Crib depth Total of leetive absorption area yWsv DIST NCE TO: Building foundation Nearest lot line J J Class Depth Driller Distance to lot line PERMIT NO. W 3 Building foundation DISTANCE TO: Sewer line Septic tank Absorption area OTHER PIPE MATERIALS gg to 7 "r SOIL TEST RATING 9, 3f J INSTALLER / o . 1 REMARKS 0 APP VED DATE LEGAL 72013 (Rev. 31781 r .i i = C) c): s s i O s T {a.3. i N : •: ; Ii : CDi'.T�j Oi � 0= O ; s s _ i r C) - %0 - CN. s s s LLI U w C x u O G V s s fn s T f i i L i O O 0.0 i i O E .>i F FFF F R �: i F H ,,.E ex -d i tom% 4D i ttL• V?' e i s T i 3 s P = ft i i o: + , a i U' W: p: s i i Jy: : r4: I-1: s qy b: M. CO: CO' T j cy: N' �• i 7p o x; +T; c i a C o s O: W p K w p Tn h fH. V) w w C4 i`3. 1 I 1 O La G q J H F :7 O A < W r p A E2 i s s i s s x s s s s i s s s O O O O O 0.0 O O O O O F FFF F H F H F H H H F H i e i s T i 3 s i = i i �• i i s s i i i i s i T C pa' a 0 a Oi O i C ' C C a C K w w w w w w w w w SA. Lk L+ I»; Td: cd: cd: T): TJ TO TO: LT: 54: ft1: Ri:n: 10 CJ: iii fd IA: C7 i V1: N: CS:: N: N: i T Vl O O. 0. O Ni c-%: C1 OE O O O O O O O O O O O O H H F H F H F H H F H F f s s i i f i O n O r O n O n O i O i O 0 iO 0w Oi iC www w kw w w w ww N d O rl Jr -1 I rY I F�faL_ I TY OF FirJGHORF=l GE DEPARTMENT QB HEALTH AND ENVIRONMENTAL MOTECTIOFJ 825 STREET, ANCHORAGE, AY,. 9S 1 pp 264-4720 71iih!JELL_ Fir.lO 4FJ—SITE SE4JER PERM I PERMIT NO. ( 810388 ) Ir IT;dT APPLICAFJT EINAR A. LARSON PO BOX 227 E. R. 694-2188 LOCATION ELENORA ST. LEGAL LOT 5 ELY, B DEBORA SUB LOT SIZE •10125 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING CSO FT/BP.)= 233 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: DEPTH= 1I+ LENGTH= 44 GFZn%60EL_ DEPTH= E ID'. 0 THE LENGTH DIMENSION IS THE LENGTH CIFJ FEET> OF THE TRENCH OR DRAINFIE D.�� THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE `$IaQlgl GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IFJ FEET). REG!LJ I REL7 SEPT I r TF t= 031210== 1CDQG GFfL_L0r45 PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING TH� INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND,THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. --- TW CA C 2 ] I NSPECT I ONS FIRE REGU I FREL', BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LIFJE IS 25 FEET AND TO A COMMUNITY SEWER LIFJE IS 75 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PERMIT EXP I RES F7ECEMLDER 31s 1.El51 I CERTIFY THAT 1: I AM FAMILIAR. WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: I UNDERSTAND THAT THE ON-SITE SEWER. SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. SIGNED: IOWA, `f _L^ APPLICAFJT zlINAR R. LARSON ISSUED BY__1�7_ __ _DRTE__��/ V4. 0 O & E ENCNEERING & DEVELO MENT CO. 7S�-'`3S • . Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Russell Oyster 694-2774 SOIL LOG Earl Ellis 688-2280 Performed for. Name: n1'e • Q • L.4-4sS on) I Tel. No. Mailing Address: Q�• v 22 7 �QG�6' �r U.=Qf JK, "--G-77 Legal Description: LD -r- 5 -IF � 8SO4" r. •: _!I t. c;• :ar s 23 8 �c��=/rrr� se�pT :oma = �% ft Soll Characteristics 5-oosa-. 6 8 ,�2,ec,�o.✓ Jr: P...� r� • •t�r, DecALc�o 9 � C/EP_C. ...-x.101 �Es+r hl— / 11_ y-12 13 — 16_ ....PLOT PLAN 238 sow//17.J Ground Water Encountered: Yes—No—n-- If yes, what depth Proposed Installation: Seepage Pit_ Drain Field Comments: Performed by: Date: -Z& /98) PERC.TEST yea, r. •: _!I t. c;• :ar s 23 8 �c��=/rrr� se�pT :oma = �% ft Ground Water Encountered: Yes—No—n-- If yes, what depth Proposed Installation: Seepage Pit_ Drain Field Comments: Performed by: Date: -Z& /98) i/ - • 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, townsh _LS B <B) A ,6z) e, 4 S-) Location (address or directions) r7 C"7 (b) Applicant Name A Pest/ 67- - A Telephone: Home Application Date — 8 range) Business 69,11- Vzo Applicant Address .4-' ry YY, � (c) Applicant is (check one): Lending Institution O ; Owner/builder ❑ ; Buyer O ; Other,&- (explain); (d) Lending Institution Telephone Address (e) Real Estate Company and Agent _, 1�i1 Q X • E - 2 L Address Telephone A 62!52&- (f) Mail the HAA to the following address: - 5 es 5 Engineering Eagle River, Alaska 99M 2. TYPE OF RESIDENCE Single -Family, Multi -Family 0 Other Number of Bedrooms 3 3. WATER SUPPLY Individual Well Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsitsll Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025(11,84) 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION 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 shows that the on-site water supply and/or wastewater disposal system is safe, f unctional 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 S & S Telephone Address SRS 19Lx Date Eagle River, Alaska 99577 6. DHEP APPROVAL Approved for fl"' ` �S bedrooms by A.""� Approved Disap�yed ConXnal _ Terms of Conditional Approval CAUTION 1�a�llr, i• O Date /" a -8'-8G The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions In order to satisfy certain federal and state requirements. Employees of DHEP 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 engineers work. r n MUNICIPALITY OF ANCHORAGE (Mo..r' HEALTH AUTHQR1AY APPROVAL (HAA) MUN DEPATI A -13RUARY 1ti84 ENVIRONMENTAL PROTEfii M720 AN 2 0 �egal Description: L� SiL A. WELL DATA RECEIVED Well Classification If A, B, C, D.E.C. Approved (Y/N) )A Well Well Log Present &N) Date Completed (a - tto ' 01 Yield • S 6'E6-"- Total 1'MTotal Depth Cased to Depth of Grouting Static Water Level X01 '% f2 Pump Set At Casing Height Above Ground 3a� Sanitary Seal on Casing(fN) Electrical Wiring in ConduitON) Depression Around Wellhead (YLQ Separation Distances from Well: 9 a�;aCA- 1 To Septic/Bokkffg Tank on Lot On Adjoining Lots To Nearest Edge of Absorption Field o Lot cy 1 ; On Adjoining Lots 1 oar To Nearest Public Sewer Line a A To Nearest Public Sewer ) Cleanout/Manhole A To Nearest Sewer Service Line on Lot Water Sample Collected by �� 6y�tO66q'144 ; Date 1- Ilc ' f3(O Water Sample Test Results S/L'*'t S rah cir7x ✓.n Comments—WCA-t-- sp t_a '( sf S41.l.%Erl '[ _xeint,_ =D E"D" trJ * sS oP �SG1P�`t B. SEPTICAWGLOW&TANK DATA Date Installed f3'2- a -8t Size _j ax::40 No. of Compartments Z Standpipes (SAN) Air -tight Caps&VN) Foundation Cleanout (YA% Depression over Tank (YO Date Last Pumped k-13-8Lo Pumping/Maintenance Contract on File (Y/N) a A ; for Holding Tank High -Water Alarm (Y/N) � Temporary Holding Tank Permit (Y/N) a16 Separation Distances from Septic/itekhng rank To Water -Supply Well 1, ��� 1 To Building Foundation Sa 1 1 To Property Line % 17 To Disposal Field S To Water Main/Service Linp x in. 1� To Stream, Pond, Lake, or Major Drainage Course Comments Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 233 �i$r✓ Type of System Design Date Installed {x'28 f3 t Length of Field Ali) Width of Field alt A7_ Depth of Field Of N Gravel Bed Thickness Square Feet of Absorption Area —_�oCl r1 Standpipes Present (N) Depression over Field (Y.9 _ Results of Last Adequacy Test Date of Last Adequacy Test 1-115—at-1 Separation Distance from Absorption Field: To Water -Supply Well e�f To Property Line s To Building Foundatip `s To Existing or Abandoned System on Lot ` ; On Adjoining Lots 1 To Water Main/Service Line 171 ( Tq Cutbank (if present) N To Stream/Pond/Lake/or Major Drainage Course a A 1� To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Date Installed Dimensions Size in Gallons Manhole/Access (Y/N) "Pump On" Level at •Pump Off' Level at High Water Alarm Level at Vent (Y/N) Tested for Electrical Codes (Y/N) Comments '• Check Permitted Bedroom Rating Against HAA Request •' Pumping Cycles during Adequacy Test. Meets MOA I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed S 5 Ernin"r• Date i —%&—etc }.3 19uX CompanyMOA No. " • dSKd .pp , Receipt No. 31 p4K- Date of Payment I - 2a �b Amount: $ S •ct'�> Page 2 of 2 72-026 (11,84) � �'< �• T�f�� •., � (,p Engineer's Seal ......,,I.\ r� A A. Shd., u,� ; No 1157.E J'y 'CHEMICAL X -c;EOLOGICAL LABORATORIES OF ALASKA, INC. TELEPHONE (907) 5622343 5633 B Street �+ Anchorage, Alaska 99518 •�•' Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER II TO BE COMPLETED BY LABORATORY ❑ PUBLIC WATER SYSTEM I.D.M _ PRIVATE WATER SYSTEM SSS C \f.l,� •.�G (all157 Name Phone No. s tui tti x Mallino Address _ City State SAMPLE DATE: © EFFE g Mo. Day Year Zip Code SAMPLE TYPE: @"-Routine ❑ Check Sample (for routine sample with lab ref. no. 1 ❑ Treated Water ❑ Special Purpose f? Untreated Water SAMPLE Time Collected NO. LOCATION Collected By 1 11- o'r.5 (SL. 4. i i i I z I t700CLA s( I 3 1 I 41 I 3 READ INSTRUCTIONS BEFORE COLLECTING SAMPLE Analysis shows this Water SAMPLE to be: Satisfactory ❑ Unsatisfactory ❑ Sample too tong in transit; sample should not be over 30 hours old at examination to Indicate reliable results. Please send new sample via special delivery mail. Date Received / 6 — d L Time Received Cy -D Analytical Method: Membrane Filter No. of colonies/100 ml. Lab Ref. No. Result* Ani / 211 - //I m BACTERIOLOGICAL WATER ANALYSIS RECORD Membrane Filter. Direct Count Coliformltoomf Verification: LTB BGS Final Membrane Filter Results Ccoo/lllform1100ml Reported By. Date��' A� Time: L� a.m. p.m. . TNTC = Too Numberous To Count OB = Other Bacteria n 1 '— ROBERTA.SHAFER CIVIL ENGINEER 6942979 ' R & Januaty 11, 1986 HEALTH AUTHORITY APPROVALS Municipality o6 Anchotage Depattment o6 Heatth and Human Se vices 825 L Sheet SEWER&WATER Anchonage, ACaska 99501 MAIN EXTENSIONS ATTENTION: Susan Oswalt REFERENCE: Lot 5; BCock B; Debta Subdivision SEWER & WATER INSPECTION Request you apptove the attached Hea.Cth Authoai ty Apptovat and grant a waiver to the hotizontat sepatation distance between the wet on the te6enenced ptopekty and the neighboring septic system. A hotizontat aepatation distance o694beet was measuted at this time.Thee♦topogtaphy ENGINEERING STUDIES in his a4ea is eneAaU Cat and the Ao.itA ane enefL(. U hitt. sand ANDREPORTS (SM). Thete is a Cayet o66sand between the deptho615 and 20 beet and again between 52 and 63 beet. The static water Levet is at apptozimatety 20 beet. In accordance with tisk anatysis pottuti.on o6 the wet 6tom this septic system is untikeYy, thete6ote, it is out opinion that the WELLINSPECTION &FLOW TEST hotizontat separation distances ptescnibed by 18AAC012.21 ate not tequited in this case. e o6 6utthet 6eAvice, pteaae contact us. SITE PUNS WRlaa ROAD DESIGN ER, P.E. SOILTEST PERCOLATION TEST STRUCTURALS MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSALSYSTEM DESIGN I SRB 196X EAGLE RIVER. ALASKA 99577 Municipality of Anchorage January 28, 1986 P.O. BOX 6650 ANCHORAGE, ALASKA 99502-0650 (907)264-4111 TONY KNOWLES. MAYOR DEPARTMENT OF HEALTH t HUMAN SERVICES Robert A. Shafer, P.E. S 6 S Engineering SRB 196X Eagle River, Alaska 99577 Subject: Lot 5 Block B Debora Subdivision Waiver Request, WR86-011 Dear Mr. Shafer: Your request for a waiver of the minimum separation distance required by 18 AAC 072.021 has been granted for the subject property. The 100 foot minimum separation distance required between the well on the —s subject property and the septic tank on the adjacent lot (Lot 4) has been waived to 94 feet. This waiver is valid for the existing three bedroom single family dwelling only. Sincerely, Stephen S. Morris Civil Engineer On-site Services SSM/ljw MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF A. DEPARTMENT OF HEALTH 6 ENVIRONMENTAL PROTECTION DEPT. OF -' fMlIRCNMENTAL B25 L Street • Anchorage, Alaska 99601 • f ;,LTE ION ENVIRONMENTAL ENGINEERING DIVISION SEP 1 1 1rDal�� Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FAD CTEIVDIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processin . 1. PROPERTY OWNER ❑ Two ❑ Five PHONE E L 7. WATER SUPPLY 43-� MAILING ADDRESS ' ATTACH WELL LOG. A well log is required for all wells drilled C c .2 17JF9- 996-,77 since June 1975. For wells drilled prior to that date, give well PROPERTY RESIDENT (1f different from sbovel depth (attach log if available.) H NE Atom 9 G9' 2. BUYER If system is over two (2) years old an adequacy test is required ❑ PUBLIC UTILITY t� o NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. - MAILI GADDRESS r 3. LEN ING 1 I UTION PHONE 00q 08 ►` Fe9 -,�c2� MAILING ADDRESS I LL , toL- 0. REALTOR/AGENT PHONE a7 -9s MAILING ADDRESS . 3ro L f s c 202 A 94503 5. LEGAL DESCRIPTION V7 L t S --k STREET LOCATION E E c S - 4' 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS SINGLE FAMILY ❑ One ❑ Four ❑ Other ❑ Two ❑ Five ❑ MULTIPLE FAMILY atom Three ❑ Six 7. WATER SUPPLY JX 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 UTILITY depth (attach log if available.) S. SEWAGE DISPOSAL SYSTEM Q t eelfindividual/on•site, f� INDIVIDUAL/ON-SITE" give installation date_ NEu/ If system is over two (2) years old an adequacy test is required ❑ PUBLIC UTILITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-01013/78) 4a'-) V "13 12 THIS SIDE FOR OFFICIAL USE ONLY INSPECTION APPOINTMENTS DATE RECEIVED TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE ❑ SINGLEFAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ 'ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL .. - DATE DRILLED LOG RECEIVED - - 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON-SITE ❑PUBLICUTILITY Connection Verified PERMIT NUMBER DATEINSTALLED G A 1 INSTALLER ❑Septi Tank or ❑Holding Tank Size: � Q If Tank is homemade give dimensions: SOILS RATING - TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES W ELL T0: Septic/Holding Tank O U Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE BY Title GAG j. LEGAL DESCRIPTION 72010 (Rev. 3/78) j CHEMIC& OLOGICAL LABORAT"RIL 1 ALASKA, INC. )NE (907)-278.4014 ANCHORAGE INDUSTRIA4 CENTER 274-3984 5633 B Street Drinking Water Analysis Report for Total Coliorm Bacteria TO BE COMPLETED PY WATER SUPPLIER WATER tjYSTtItA: ' I.D. NO. Water system Name � Phone No. Mailing Address i .` - city 1 State Zip Code SAMPLE DATE: 5 I6 I '-T 5-6-F] ' Mo. Day Year ;' SAMPLE TYPE: 7 ` Routine Check Sample (for routine Samle / with lab ref. no. 1 Treated Water a O special Purpose Untreated Water SAMPLE NO. 1 2 3 4 5 LOCATION :SCik3 READ INSTRUCTIONS I ( BEFORE i COLLECTING SAMPLE Time Collected Collected,; �/ft TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: Satisfactory Unsatisfactory ❑ Sample too long in transit: sample shoulC not be over 48 hours old at examinatior to indicate reliable results. Please Senc tnew, sample. Date Received en Ii& Ti1� me Received a Analytical Method: 1 O Fermentation Tube Membrane Fitter Lab Ref. No. •I Result* Analyst 4asl'-91 1 ' EID t( I m l� I m m ED ! eNa 01 [p1eMr/leg ml allo Of YOVlw. ppam 0e-1220(bl BACTERIOLOGICAL WATER ANALYSIS RECORO It". 1911 Oats CopMeo source _ a.m. EMB Broth 24 hours. Broth 48 houn\ Multiple Tube A"Oft, 10ml Tubes Posittw/rotal 10011 Patton aMmbwne Filler\ Olrect Count Coliform/looml Verification. LTB BGB Final Membrane Feta Results �J ( collfone/looml Reported M C-* • -�'�'a r -I :� I,� Oste lr• --� ` '� f Time --.may a -n4