HomeMy WebLinkAboutBIRCH ROAD ESTATES LT 2Bi ch Road
Estates
Lot 2
#015-494-02
Pump Installation Log
Well Drilli~g Permit Number:
Date of Issue: __
Parcel IrlentdJScadon Number:__
-~egal Descripdo, n
Pump Installation Date: d:" -p c7
"-' --jC
Pump Man~acmrar's Name.¢'~ (' '-'~-
.Pump ~Iodei:. C ~- ~7'~,~ 5~... 1~:
Pump
Pifless Adapter BmiM Dep~: [ ~ feet
Pidess Adapter ~[ana~acmrer's ~ame:
?Sttess .&daprar Installer:
~erhod o¢ D~sinfec~ioa:
CocHineals:
The purmp installer shall provide a pu~p installa~on log to the D$]D weigh 30 days of pump
/
MUNICIPALITY OF ANCHORAGE
DEPART.ENT O" HEA'TH AND HU.AN SERV, CES 0/~
Environmental Health
825 "L" Street, Anchorage, Alaska 99502. Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
DISTANCES
/~'4W~-~5 SEPTIC ABSORPTION
SEPTIC ~ HOLDING
TYPE OF SYSTEM j ~ ,.
~TRENCH D BED a W. DRAIN D OTHER _~1 I~
WELLS ( I1~
FT FT ' '; -J
72-0t3 (3/85)
,
MUN I 0 I PAL I T Y OF ANCFtORASE
o I-q,
Department of Health ~,. Human Services
825 L Street, Anchorage, Alaska ~501 545-~
' ·_
0 N - ~ I T E S E ~ E R P E R M I T
880225 Upg r adc
10/10/88 Engineer De~iqned
PAUL REYNOLDS· ' Day Phone:
~"".~,,,~ MOOSE MEADOW LN. 5&5-5804
ANCHORAGE, AK ~951&
Subdivision: BIRCH RD. EST. Lot: 2 Block: 1
Section: 25 ~ownship: 12N R~nge:
59550 (sq. tr. or
· his Permit: 5 Total Capacity:
cap~city: 1,000 gallons. Each septic
Depth to top o~ septic tank~(s) < 4.0
i am familiar with the requirements ~or on-site sewers and wells~ as set
~orth by the Municipality o~ Anchorage (MOA) and the State of Alaska.
I will install the system in ~ccordmnce with all MOA codes and r~gulmtions,
and in compliance with the design criteria o~ this permit.
I will adhere to all MOA and State o~ Alaska requirements ~or the set back
distance~ lrom any existing well, wastewater disposal system or ~ublic
seweraq~ system on this or any ad.~mcent or nearby lot.
I understand that this permit is valid ~or a maximum o~ 5 bedrooms. I
also undorstand that tho capacity ot tho total system is 5 bedrboms and
I:'~r mit Number:
Date Issued:
Parc:el
Lot I .~:~,j~ 1
Lot Size
£h ~drooms:
S[]PIJU I'ANK: Minimum total septic tank
tan!~ must have at least~ ~) compartments.
fec~t requires insulation over tank(s).
INSFALL PER ENGINEERS ATTACHED PLANS. NOTIFY DHHS PRIOR TO
EACH IN'd:'L~:FION. l-HIS PERMIT IS ISSUED FOR THE EXISTING ~ BDRM.
RESIDENCE ONLY AND EXF'IRES 12/51/88.
I CERTIFY TNAT:
1.
any enlz~g~. ~ent will require an additional permit.
Municipality Gl Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 'L" Street, Anchorage. Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
PERFORMED FOR:
LEGAL DESCRIPTION:
2
3
4
5
6
7
8
9
10
13-
14
15-
16-
17-
18-
19-
20-
"PT
~H
SLOPE SITE PLAN
WAS GROUND WATER
ENCOUNTERED? dO
IF YES, AT WHAT O
DEPTH?
Depth Io Water kRer ~./ Dale:
Dlonilorifl{i?
Cross Net Depth to Net
Reading Date Time Time Water Drop
~, Il?elo 1/ ~,,,'7 - ,~7 I
t ""' ,., (
COMMENTS
PERFORMED BY:
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
PERCOLATION RATE 4'~ (mmuleshnch} PERC HOLE DIAMETER
TEST RUN BETWEEN 4''~'" FT AND
I ~ ~' '~'~' CERTIFY THAT THIS TEST WAS PERFORMED IN
72-008 (Rev. 4;85)
ALASKA I DUIRODIDE DTAL CODTROL SI RUICI S, IFIC.
(~nciin,tin(I ~, EnuiroDmcnJd SIuI~i~$
S?ECIFICATION$ FOR A TREXCII-TYPE WASTEh'ATER DISDOS^L SYBTEM -
BIRCH ROAD ESTATES SUBDIVISION . BLOCK 1, LOT 2
1.O
2.0
CEXERAL
1.1
The drawings, sheets I through 4, shall be n part of this
specification.
1.2 All materials and workmanship shall meet the rcqulrement~ of
the Municipality of Anchorage, Department of tIealth & IIuman
Services (BI!IlS), the eondttfons of the permit, and all o~plleable
rules and regulations currently in effect.
Ali elevations and depths are advisory, and are to be verified
or modified in the field by the engineer or Inspecting agency.
1.4 It Is the responsibility of the owner or installer tn adhere to
approved designs for Installation, matntaln the speclfle~ separation
distances, and have the appropriate inspections. '
1.$ If the installation Is not Inspected by an AECS engineeri AECS will
not be responsible for the installed system. An engineer at AECS
should be consulted prior to construction to determine the number of
inspections that will be required and to explain what th~se
inspections will involve.
SEPTIC TANK
2.1 If there is an existing septic tank, it may be used if It meets the
capacity requirement for the residence and the approval ~f the MOA.
2.2 The septic tank shall be a UPC-Approved two-compartment tank,
constructed of 12-gauge steel with bltumastlc coating and set
level on undisturbed soil. If the tank Is buried at a d~pth of 4
feet or less, It must be insulated wlth an overlying layer of 2 inch
burial type polystrene rigid board insulation.
2.3 The septic tank and trench shall be a minimum of 100 feet from an)'
private well or body of water, 150 feet from Class C wells, and 200
feet from Class A or B wells, unless otherwise specified] Less than
the required separation distance must have prior approval or ~aiver
by ADEC or MOA.
2.4 The septic tank shall be a minimum of 5 feet from the ho~se
foundation, and a minimum of 5 feet from th~ absorption ~rea,
2.5 Plptn~ shall be fitted with n mechanical watertight cald~r coupling
on the outlet and inlet of the septic tank. Piping shal! be 4-inch
solid PVC ASTM D~034 or cast iron, sloped a minimum of 1~4 Inch per
lineal foot. If the piping is buried at a depth of 4 feet or less,
1200 [U~s! 33rd Aucnue. Suile B * Anchoracie. Alaska 99503 * (907) 276-1361
3.0
it must be insulated with an overlying layer of 2 inch burial type
polystrene rigid board lnsulatlon.
2.6 Cleanouts shall be installed ns designated and capped with air-tight
rain caps (Jim caps or equivalent), and extended a minimum of ! foot
above ground level.
2.7 If a lift station Is required it shall be n combination lift station
septic tank per Anchorage Tank nad Welding, Inc. design.*
Speclficnttons nrc attached.
Absorption Area
3.1 The gravel for the trench shall be 0.5 to 2.5 inch, screened rock
with less than 3% passing ~200 sieve residual. Ail substitutes must
have prior DIIHS approval.
3.2 The bottom and sides of the excavation shall be raked with the
backhoe blade to Insure that it has not been compacted d~rtng
excavation. The,bottom elevation ~hall be level, d
3.3 Monitor standplpt.(s) shall be placed as sho~n In the ra~lngs, and
shall be 4 inch rigid PVC ASTM D3034, or cast Iron. Thelsectton
shown with holes may be 0.5 inch holes drilled on 6-1nchlcenters on
opposing sides of the pipe, or a regular section of perforated sewer
pipe clamped to a solid section with either a no hub coupling or
a solvent Joint. A rubber rain rep (Jim cap or equivalent) shall be
installed over the top of the pipe. [
3.4 The distribution pipe shall be perforated 4 inch rigid PVC with a
minimum crush strength of 1500 lbs and shall meet the approval of
DHIIS for use as dralnfleld pipe. All distribution plpesishall be
lald level.
3.5 Trenches may be paralleled, but must haw? a minimum separation
distance between the trenches of 10 feet or 2 times the {ravel depth
(whichever Is greater). 75 feet is the maximum allowed linear length
of any trench.
3.6 If the final grade over the trench Is less than 4 feet above gravel,
Insulation is required, using burial type polystyrene rigid board
insulation. There shall be 1 fncb of insulation for eve{y foot of
soil less than the required 4 feet of cover, but there must be at
least 2.1 inches of soil cover even though insulation is ~sed. The
solid pipe extending from the septic tank to the dralnft~ld shall
also have 4 feet of cover or an equivalent layer of insulation to
prevent freezing of the line.
3.7 If insulation ls not necessary, the gravel shall be covered with a
layer of nonwoven Geotextlle fabric (such as Mirafai, Ftbretex 200
grade, Poly Filter X or equivalent).
4.0 INSPECTIONS
4.2
4.3
A minimum of two inspections are required for the instal ation of the
trench. The first Inspection will be of the open excavation to
assure that the system ts installed in thc proper soil s[rata,
correct depth and meet minimum specified design parameters.
The second inspection will be after placement of the gravel, monitor
standpipe and distribution pipe to verify proper installation and
position prior to backfill.
The Inspection of the septic tank Installation can be incorporated
with any one of the above listed inspections.
ALASKA ENVIRONMENTAL
CONTROL SERVICES, INC.
1200 West 33rd Avenue, Suite B
ANCHORAGE. ALASKA 99503
(907) 561-5040
CHECKED BY DATE
8CALE
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· --'"' ~ "'" -C":' . ' · ~to:,~o~.~ ~.-v. t.
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ALASKA ENVIRONMENTAL
CONTROL SERVICES, INC.
1200 West 33rd Avenue, Suite B
ANCHORAGE, ALASKA 99503
(907) 561-5040
, , ....~,.~ I . ~ , · / ~ . . i
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[:,EPRRTMC~T OF HERLTH ~E., EN'...'IF'.ONHENTRL F'ROTECTION
825 eL" STREET, RNC:HORRGE, tBK'. 99501
27~-2511
I-.lEI_I_ F'[--]~-:ld I T
PERMIT NO. ( 77542: )
APF'LICRf~T ~LE, oN '.' SHITH
SRA E.J..', 165iR
_~ ,4-0182
_ . ~, ....... '-~'~-'-'-'~'-~ ~ .- ~'"._ LOT...SIZE 603:9C~ SQLIRRE FEET
f.lIf-~If'ILIH [:,ISTRfICE E=ETWEEf~ R WELL RND FIH'¢ ON-SITE ~EI4RGE [:,ISF'O%RL S~STE~'I
dAA FEET FOF: R F'RIVRTE WELL OR 2¢0 FEET FOR B PUBLIC WELL. '
WELL Lm3GS ~:E REQIJIRE[~ 8ND HI]ST E:E RETURNED TO THE DEF'RRTHENT WITHIN 30
AF THE WELL COhlF'LETIOH.
OTHEP F:E~?I._IIF:Ef. IEflTS MRY RF'PLb'. SF'ECIFICRTIONS RND CONSTRUCTIOfi DIRGRRHS
RVAILRF:LE TO It~SIJRE FF. LFEE INSTRLLRTION
F'EF:I'I )- I E:=<:F' ] ~:ES E:, IS ~D [S I'I E: iS F: 2:~.. J-5~77
I CERTIFY THqT
J: I Rt.1 FRHILIBF: WITH THE REQUIREHEHT~ FOR ON-SITE SE~4ERS RN[:, WELLS R% SET
FCRTH F:'¢ THE I'ILINIC:IF'RLIT¥ OF RNCHORRGE.
2: I WILL INSTRLL THE ~TEH.~f~ RCCOR[~FtHCE WITH THE C:O[:,ES.
RF'PLICRf~T ~/_r:,~w-¥.? SMITH
Eldon Smith
WeH Owner '
Location (address of: To~hip, Range, Section, if known;ordistance main road
Elk 2 Lot % Birch Road Eztates
M-W DRILLING, INC. )
DRILLING LOG .,. ~.. ~ , ~ ~ ,~'~
' Use of Well
Dom.
Size of casing 6" Depth of Hole 195 feet Cased to 194.1 feet
Static water level l? 5 ft. (ahoy-a) , (below) land surface. Finish of well (check one) open'end (
Screen ( ); Perforated ( ).
Describe screen or perforation tl/A
Well pumping test at $- 10 gailons per (hour)
of drawdown from static level,
Date of completion $ / 15 / 7 7
(minute) for ! hours with 100%
WELL LOG
xx) ;~
f~
Depth in feet from
ground surface
0 TO 2
2 TO 4
4 TO 10
10 TO 42
42 TO. 59
59 ~TO. 8O
$0 ~TO. 82
82 TO. 109
109
TO__ 114
114 TO_ 120
]2D TO. 150
]5~ .TO. ]65
]~;5 .TO. ]70
]70 .TO, ]OO
!o~ TO ~5
Give details of formations penetrated, size of material, color and hardness
CasinE stickup
Organics
Silty gravel, cobbly
Loose gravel, cobbly
Sand
Sandy zravel
Sand
~Silt~ Kravel
Sand ~ravel
Silty sand
Silty Fravel hardpan
Wet sand and Fravel
C].V and ~r~vel
2 -- STAT£
.~,, DATE RECEIVED
INSPECTION APPOINT ~,ENTS/~
TIME TIME~ TiME
DATE DATE DATE~ '
~UNI~IPALITY OF ANOHOHAG[ DEPT. OF
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIONE~IRONM[NTAL ;': L
DEC 2 2 lgB0
ENVIRONMENTAL SANITATION DIVISION
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS: Complete all parts on page 1, Incomplete r~u~ will not ~ pr~. Please allow ten (10) days for pr~sing~
1. PROPERTY OWNER
?. LENDING INSTITUTION ' . ~ __ ~
~. RE~JOR/AGENT PHONE
5. LEGAL DESCRIPTION
STREET LOCATION
6. TYPE OF RESIDENCE NUMBER OF~BEDROOMS
~ ~ One ~ Four ~ Other ~
SINGLE FAMILY Two ~ Five
~ MULTIPLE FAMILY ~ Three ~ Six
7. WATER SUPPLY
INDIVIDUAL"
COMMUNITY
r-I PUBLIC UTILITY
8. SEWAGE DISPOSALSYSTEM
(~ INDIVIDUAL/ON-SITE*·
I-'1 PUBLIC UTILITY
· ATTACH WELL LOG. A well log is required for all wells drilled
since June 1975. For wells drilled prior to(t~at~date, give Well
depth (attach log if available.) ~"~ ~-¥L~ J ~ q"~'"'J
,YEAR ON-SITE SYSTE~ WAS INST~LBO.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
r--I SINGLE FAMILY r-1 ONE I'-I THREE I--1 FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
2. WATER SUPPLY PERMIT NUMBER
[] INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRI LIED
[] PUBLIC UTILITY
Connection Verified LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[]INDIVIDUAL/ON -SITE DATE INSTALLED
[]PUBLIC UTILITY
Connection Verified
INSTALLER
[]SepticTank or [--IHolding Tank
Size: If Tank is homemade SOILS RATING
give dimensions:
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
4. DISTANCES WELL TO: ~ePtrC/H°lci'ng Tank IAb$°rpt'°n Area ISewer Line INearest L°t Line
Absorption Area to nearest Lot Line
5. COMMENTS
I~/APPROVED FOR "~ BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
[] DISAPPROVED
DATE BY
72.010 (Rev. 6/79)
ALASKA
el]UIROI]I el]TAL COI]TROL SeRUICIB, IFIC.
~UNICIPALITY OF
~nclincerincI $ J~nuir'onmcntoJ Stu~lics g~Pt. o~: J'-'!"[ ~T N
ENVIRONM;:~.T .- J _ t0
/
DEC 2 9 I980
RECEIVL )
DEEMBER 26 1980
SECURZTY NATIONAL BANK
880 H STREET
ANCHORAGE AK 99501
SELLER - ELTON SMITH
SUBDIVISZON-BIRCH ROAD ESTATES E:LOCK-O LOT-2
THE TYPE OF ABSORPTION SYSTEM IS A PIT WITH AN UNKNOHN AREA.
THE SYSTEM IS CAPABLE OF ACCEPTING 300 GALLONS OF HATER
BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A
2 BEDROOM HOME.
THE SEPTIC TANK HAS PUMPED ON DECEMBER 26 1980 ·
THE SEPTIC TANK SIZE IS 1000 GALLONS.
~20 West nth Auenu¢ · An&o~q¢, Alesl~ e~So3 · (9~7) 276-1361
PER DAY,
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMs APPROVAL
FOR A SINGLE FAMILY DWELLING
ParcelI.D. ~15'- 'Yq ¥-O~.
1. GENERAL INFORMATION
Complete legal description
Location (site address)
Current Property owner(s)
Mailing address
Lending agency
cos^#
Expiration Date:
Day phone
Mailing address
Real Estate Agent
Mailing Address
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class
Public Water System
[] Individual On-site []
I'-1 Individual Holding Tank
· [] Community On-site []
[] Public Sewer
[]
Well
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On-Site Systems
Approval (COSA) based only upon the representations given In paragraph 4 by an independent profe{slonal civil
engineer registered In the State of Alaska. Certificates of On-Site Systems Approval are required for th(~ transfer of
title (except between spouses) for propertJes served by a single-family on-site wastewater disposal ahd/or water
supply system. DSD also Issues COSAs upon request to homeowners. Certificates of On-Site Systems Approval.
are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued
with new water sample results. (Certificates may be reissued for a period of up to one year with ~,alid water
samples.) Certificates are valid for one year for properties served by Class A or B weIIs or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions In the professional engineer's WOrk.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of Ihe validation date shown below, I verify that my Investigation,
based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wsstewater disposal system is (are) 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(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the lime of installation.
Name of Firm ,,='l~./-/..f
Address I~/&'-,.~' ~'cA~, ~_~,^y~..~ ~,~'.~
Engineer's Printed Name "~
Phone 3
Date 21
5. DSD SIGNATURE
., ~ Approved for *~
Disapproved.
Conditional approval for
._ . WATERAND .
~ ; WASTEWAT~
'., PROSP M .-'
Attachments:
COSA Checklist
Septic System Advisory
Well Flow Advisory
Nib'ate Advisory
X
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
Original Certificate Date:
(Rev. 11,~5)
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Westewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
If A, B, or C provide PWSID # --
Legal Description:
A. WELL DATA
Well type
Date completad
Total depth I~'" ft. Cased to 19 Y ft.
FROM WELL LOG AT INSPECTION
Date of test
Static water level ! '/,,C' ff. I ~' ff.
Well production ~- ;~ gp.m. ~,~' '~ gp.m.
Parcel ID: ~'~ e'-¥~¥ --~Z
Well Log (Y/N)
Wires properly protected (Y/N)
Casing height (above ground) l ~. in.
WATER SAMPLE RESULTS:
Coliform ~ colonies/100 mL Nitrate ~ mg/L
Arsenic: ~. ppb date of sample: ~/O ·/o~' '?'*'¢,~
B. SEPTIC/HOLDING TANK DATA
TankType/Material ~'~,,e~. / ~'~¢'~'~ ~
Tank size ~ gal. - Number of Compartments !
Foundation cleanout (Y/N) Y' Depression over tank (Y/N) I~ ~. 4',
Date of pumping ~'[ Z,~'/~'~' Pumper _.~,$ ~,,~ ~
C. ABSORPTION FIELD DATA
' Date installed I~ / t$/,~ Soil rating (g.p.d./ft= or ft2/bdrm) ~_/_~_~ System type. "r'~.-~¢~l
Length .. 7'~ ft. Width ~ ft. Gravel below pipe ~. ~ ft.
Total depth Il . ff. Eft. absorption are~'~''7 ft2 Monitoring tube 'r' Depression over field /~.,
Date of adequacy test o.~ Results (Pass/Fail) ~'~' For ~,Ibedro°ms
Fluid depth in absorption field before test ~'~ in. Water added'??.~gal. New depth77..~ in.
Elapsed Time: t*~' min. Final fluid depth '71.¥ in. Absorption rate >= ,f..~ i g.p.d.
Any rejuvenation treatment (past 12 mo.) (YiN & type) /~,,,~. b¢.~.,~.,~ If yes, give date
Other bacteria ~ coloni,
Collected by: /="1~,~
Date installed
Cleanouts (Y/N)
High water alarm (Y/N)
#100 mL
D. LIFT STATION J~. ~..
Date installed
'Pump on' level at __ in.
Datum
E. SEPARATION DISTANCES
Size in gallons
'Pump off level at in.
Cycles tested
Manhole/Access (Y/N)
High water alarm level at
Meets alarm & circuit requirements?
in,
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot
Absorption field on lot ~
Public sewer main ~'.
Sewer/septic service line
Animal containment areas
On adjacent lots ~ t~o ~
On adjacent lots ~, t o~. ·
Public sewer manhole/cleanout A/- 4.
Holding tank ,'~. ,,~
Manure/animal excrele storage areas ~ I~ '
Building foundation ~ tO'
Water main k/. A.
Wells on adjacent lots ~. t~.,o '
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON I~OT TO:
Property line.
Water service line
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line ~ '7~' ~
Water Service line ~. to ~
Curtain drain ~.4~,~ .ge'~,,~
F. COMMENTS
Absorption field ~ 3,.~' '
Surface water > ~oo,
Building foundation
Surface water ~, too
Wells on adjacent lots
Water main l~'. ,~.
Driveway, parking/vehicle storage
Waiver Fee $
Date of Payment
Receipt Number
COSA Fee $,
Date of Payment
Receipt Number
(Rev, 11/05)
G. ENGINEER'S CERTIFICATION
I cedi~ that l have dete~in~ through field inspect~ns and
rev~w of Mun~ipal ~o~s that the above systems are
confo~ance with MOA COSA gu~elines in effect on this date
.~06/03~2~B3 16:33 9B734§8002
DEL NORTE SURVEYING
pAC_.~
Plot Plan:
O'Molley Pork
' (N89~7'20'£)
NSg"59'O8'E ·
- -F ....
Lot 3
,-¢
(197.98')
198.06'
115th Avenue
of Lot 2, Birch R~3d £st;,tes Subdlv~slon, Plat 77-189 SURV[Y DA~: "~M~RILI 29. 200:.3
I Guy Greet, hereby certify that I hove performed o physical ~urvey of this let and
I hove found or eot the lot co~ner~ as ~hown hereon end to the.beat of n~y
])el ]~OT[e knowledge and obilltles, all dimensions hove been measured true 'and correct.
It la the respons~blllty of the owner to determine the existence of any easements.
~=~ *.,a,~,~n covenants, o~ restrlctone which (Io not appear on the recorded ~,Jbdivfei~n plot.
~ ~-i~3~..-(t~ :4~-~! r~z Under no clrrumetonces {ihould uny data herI~ be used for estobilshln<J boundary
G. Greer Grid 2638 Scale 1"----50' Dote June 3, 2003 File No.~.. 'BRE-PP.DWG
SGS Ref.#
Client Name
Project Name/#
Client Sample ID
Matrix
1064509001
Flattop Technical Srv.
L2 Birch Road Est.
L2 Birch Road Est.
Drinking Water
All Date~Times are Alaska Standard '~ime
Printed DatWTIme 08/21/2006 16:51
Collected Date/Time 08/07/2006 14:00
Received Date/Time 08/07/2006 15:20
Technical Director Stephen C. Ede
Samplc Remarks:
Allowable Prep Analysis
Remits PQL
Units Me~ho~ Container ID Limits D~c Date Init
~atals by ZcP/Ms
Arsenic
ND $.00 ug~L EP200.8
C (<10) 08/09106 08/17/06 Mil
Waters Department
Nilrale-N
Microbiology Laborator~
Total Coliform
0.159 0.100 mg/L EPA 353.2 B (<10)
cottl00mL SM20 9222B A (<1)
08/07/06 ALR
08/07/06 TLF