HomeMy WebLinkAboutROLLING HILLS VIEW ESTATES BLK 3 LT 7AI olling Hill
View Estates
Block
Lot 7A
#050-322-34
www.sullivanwaterwells.com
Pump Installation Log
Well Drilling Permit Number: SW Date of Issue
Parcel Identification Number: 050-322-34
Legal Description Property Owner Name & Address
Rolling Hills View Estates Block 3 Lot 7A Joyce O’Connor
19204 Upper Skyline Drive Eagle River, AK 99577
Pump Installation Date:
3-22-21
Pump Intake Depth Below Top of Well Casing:
270 feet
Pump manufacturer’s Name:
F&W
Pump Model:
4F07G10305
Pump Size:
1 hp
Pitless Adapter Burial Depth:
10 feet
Pitless Adapter Installer:
Unknown
Disinfected Upon Completion?
yes no
Method of Disinfection:
Chlorine 50 PPM
Comments:
Pitless Manufacturer: Unknown
Pump Installers Name:
Sullivan Water Wells
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.
Municipality of Anchorage Page I of
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-Site Wa,slewater Disposal System and/or Well Inspection Report
Permit Number: ~'J '~ \C)"~'~(~' PID Number: ~
Na~.~.. ~t~~ Wastewater System: ~New ~ Upgrade
A~ess:
~. ~ ~~ ~,~ ~~ ABSORPTION FIELD
Ph~ne:~ ~~ No. of~rooms: ~eepTrench ~ Shallow Trench ~ Bed ~ Mound ~ Other
LEGAL DESCRIPTION soi,..~..: ~, ~ GPD/Sq. Ft. Total Depth from origi~g(ade:
!Lot:~ ~ Block~ ~~ ~ Depth topipebottomfromorigina~:Ft' Gravel depthbeneathpipe ~t Ft.
Township: Range: I Se~ ~ Fill addedaboveoriginalgrade: 1~ Ft. Gravel length: ~ ' Ft.
~ Numb~ lines: Distance between lines:
WELL: New ~ Upgrade Gravel~h:~,~ ~ Ft. [ ~ Ft.
tion(~rivate, A,B,C): Total Depth: Cased To: Total absorption area: ~ Pipe material: ~ ~/~
Driller: Date Drilled: ~taticWater Level: ~aller: ~ ( O~ . ~ Date i~stailed:
Yield:GPM Pump Set at: Ft. Casing Height Above Ground:Ft. TANK
SEPARATION DISTANCES ~eptic ~ Holding ~ S.T.E.P.
TO Septic Absorption Lift Holding Public/Private M~nu~actu[er: ~ Capacity in gallons:
From Tank Field Station Tank SewerLines ~~~~ ~ ~
Material: Number ~f Compartments:
Surface
Water t~l~ t~ ~ ~ ~ ~ LIFT STATION
Lot I I Size in gallons: ~
Line ~ [~ ~ ~
Foundation ~'~ ~ I~ ~ ~ ~ "Pump °n" level at: 'Pump off" level ~arm at:
Curtain ~Drain 0~'~ ~ ~ ~ Pump Make & M°del I Electrical Inspecti°ns Ped°rmed bY:
Remarks: BENCH MARK
Location and Description:
Assumed Elevation:
ENGIN~'~ SEAL
Eagle.iver, Alaska 99577 2nd¢~/~U?~ ~.~;.
Department of Health and Human Services approval -e~[~;~,.~...~.~~ ~. --
Reviewed and approved by:/~ ~~ Date: ~ ~/~= '~'~0F~ss'~
72-013 (1/91) MOA 25
Pea'mit.No. ~,,/~ I;"~2~/~' Page . ~
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
of '7.-
Legal Description:
P.O.,j,Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-S~.~stewater Disposal System and/or Well Inspection RePort
72-013 A (2/91) MOA 25
by
DOC CO. ciba
SULLIVAN WATER WELLS
P.O. BOX 670272, CHUGIAK, ALASKA 99567 · TELEPHONE 688.2759
OWNER OF LAND Dl~'07'~'/...~ ~-¢.~"~'~ DEPTH OF WELL 2 ~ 'O'
ADDRESS ~ ~ ~ 7 70 d/0 ~ ~ STATIC LEVEL OF WATER F'F. ' ~
LEGALDESCRI~ION~ ~ ~C~ ~ ~0~'~ ~ ~/~RAW DOWN FT.
DATE- Sta~ed Ended ///~/ GALS. PER HR 3~ ~'
· .i ;om
From Ft. to
From Ft. to
From Ft. to
From Ft. to
KIND OF FORMATION:
From'' Ft. to
From
From~Ft. to
From
F~m ' '. Ft. to Ft.
From ,.~ Ft. to ~ Ft. C~ ~ ~d0~ -
From Ft. to Ft.
From ~'~ Ft. to~ Ft.
From '
MISCL: INFORMATION:
Ft.
From
From
From
From __
From
From
From
From
From
From'
From
Ft. to Ft. '
Ft. to Ft; '
Ft. to . ' Ft.
Ft. to Ft, '.
Ft. to Ft '
FI to Ft, ·
Fl. to · Ft.,
_Ft. to , Ft.,
.Ft. to Ft.
Ft. to , ,Ft.
Ft. to ,, Ft. ·
Ft. to Ft.
Ft. to--Ft.
· Ft.
From· Ft. to Ft.
Ft.
From Ft. to .Ft. '
Ft.
From Ft. to Ft.
RECEIVED
APR 2 1 199
Municipality of Anchorage
Dept;' Health & Human Services
DRILLER'S NAME
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:SW910336
DESIGN ENGINEER:S & S ENGINEERS
OWNER NAME:DISOTELL CARL A
OWNER ADDRESS:P.O. BOX 770210
EAGLE RIVER, AK 99577
PAGE 1 OF 1
PARCEL ID:05032223
LEGAL DESCRIPTION:
DATE ISSUED:10/23/91
EXPIRATION DATE:10/23/92
LOT SIZE: 52688 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
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 FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
HEALTH AUTHORITY
APPROVALS
SEWER & WATER
MAIN EXTENSIONS
SEWER & WATER
INSPECTION
ENGINEERING STUDIES
AND REPORTS
WELL INSPECTION
& FLOW TEST
SITE PLANS
ROAD DESIGN
SOIL TEST
PERCOLATION
TEST
STRUCTURAL &
MECHANICAL
INSPECTIONS
ON SITE
WASTE WATER
DISPOSAL SYSTEM
DESIGN
ROBERT SHAFER, P.E.
ROGER SHAFER, P.E.
CIVIL ENGINEERS
(907) 694-2979
FAX 694-1211
October 18, 1991
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
825 L Street
Anchorage, AK 99519-6650
REFERENCE: Rolling Hills View Estates,
MUNICIPALITY OF ANCHORAGE
ENVIRONMENTAL SERVICES DIVISION
Block 3, Lot 7
We request you issue a permit to drill a well and install a
septic system to serve the proposed 3 bedroom house on the
referenced property.
Two test holes were performed on the property on October 3,
1991. The approximate locations of the test holes are located
on the attached site plan. The monitoring tubes within the
holes have been checked and found to be dry.
This property has enough area for a septic upgrade which can
be seen on the attached site plan. We do not anticipate any
adverse effects on neighboring properties by the installation
of the proposed septic system.
If you have any questions, or require additional information
for your review, please contact us.
Sincerely,
RJS/lsu
MUNICIPALITY OF ANCHORAGE
ENVIRONMENTAL SERVICES DIVISION
RECEIVED
17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577
SCALE
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
LEGAL DESCRIPTION~"J~J..4~* ~ ~ '~ Township, Range, Section:-l~[.4~l~ ~:
SLOPE SITE PLAN
1
3
4
5
6
7
9
10
11
12
WAS GROUND WATER
ENCOUNTERED?
iF YES, AT WHAT
DEPTH?
S
L
o
13
14-
15-
16-
17
18
19
2O
Depth to Water Afl..~,. /
Monitoring? rL~ Date:
Gross Net Depth to Net
Reading Date Time Time Water Drop
I lo:=5.R1 2-: 1~ . ,._ ~ t/.,~,, .~ .'
~ ~ :~ ~. ,, ~ el~" ~l~ ,,
PERCOLATION RATE ! _¢~-, ;~(minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN ~ FT AND ~ FT
PERFORMED BY: 17~"~.,! ~1~ ~?~ ~ m..~ ~. ~ ~ CERTIFY THAT THIS TEST WAS PERFORMED IN
................... ~ ~ Y ~ ~
ACCORDANCE WIT~~A~¢EGUIDELINES IN EFFECT ON THIS DATE. DATE:
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
LEGAL DESCRIPTION: "~~ ~ ~
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16-
17
18
19
20
[~'-'-~-Township, Range, Section: '-'F'i.Z[..~
SLOPE SITE'PLAN-
WATER
ENCOUNTERED?
S
L
IF YES, AT WHAT O
DEPTH?
.P
E
Oepth lo Waler. JE,~tK-,~,~_ /'
MonilorinD? ~ Date:'~
COMMENTS
Reading Date Gross Net Depth to Net
Time Time Water Drop
~ ~:~ ', ~/~ I"
PERCOLAT,ON RATE l 1'4-' (minutes/inch) PERC HOLE DIAMETER
TESTRUN BETWEEN ¢¢ FTAND ~ FT
S & $ EI%IGINEERING ~ ~ ~ ~
PERFORMED BY: ~-~,~,~- -,-J- ~-- .... , --- ,~--.~ l,- ~ ~ ~ ~ ~
ACCORDANCE WIT~X~~L GUIDELINES IN EFFECT O~ THIS DATE.
CERTIFY THAT THiS TEST WAS PERFORMED IN
DATE: ~ ~:":":":":":~'~ I(~::>~'~:::~ 1
1�1 a f.. t -
• Municipality of Anchorage
On -Site Water and Wastewater Program
(907)343-7904 �.
Parcel I.D. 050-322-34
Certificate of On -Site Systems Approval /
Expiration Date: Q r
1. GENERAL INFORMATION
Complete legal description Rolling Hills View Estates, Block 3, Lot 7A
Location (site address) 19204 Upper Skyline Drive Eagle River, AK 99577
Current Property owner(s) Roger & Julie Ayres Day phone
Mailing address 19204 Upper Skyline Drive Eagle River, AK 995.77
Real Estate Agent Day phone
2. TYPE OF DWELLING:
El Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: Three
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
Individual
FX71
Individual Water Storage
❑
Holding Tank
❑
Community Class Well
❑
Community
❑
Public Water System
❑
Public Se%,yer
f, -1
WaiverNariance request for..
Received by:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee
Date of Payment 6 a l
Receipt N/umgber�I /��(a� C (T
COSA #
Date:
Waiver Fee $
Date of Payment
Receipt Number
Waiver #
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,
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 wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further ved~ 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 time of installation.
Name of Firm Anderson Engineering Phone 522-7773
Address P.O. Box 240773 Anchorage, AK 99524
Engineer's Printed Name Michael E._Anderson, P.E. Date 6/21/14
. ;.?,.
6. DSD SIGNATURE ~,~..v~..~? ..~=...
I/System #1 Approved for ~ bedrooms ;~ .~.;MIC~i~ND~,SON;
System #2 Approved for bedrooms ·:~..~.~ '.
Disapproved ~ ~ ?0 FE S 5~,~%~,~,'~
Conditional approval for bedrooms, with the following stipulatio~
By: ~'~~ ~/.4M ~-4~_, OriginaI Certificate Date: -7- '~-/Z'~
Tl~e l,~ i~'ciici yia~yS;~CCA~~velopment ~e~',ices Division (DSD) issues CerUflcates of On. Site Systenls Approval (COSA) based only
upon the representations given in paragraph 5 by an independent professional cml engineer regl~ered in the State of Alaska. The Municipality
of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist
Septic System Advisory
Well Flow Advisory
X
Nitrate Advisory
Arsenic Advisory
Other
If more than 'i septic system ia on the lOt:
COSA Checklist # of
Structure served by this system __
Certificate of On-Site Systems Approval Checklist
Legal Description: Rolling Hills View Estates, Block 3, Lot 7A
A. WELL DATA
Well type Private
Date completed 11/91
Total depth 300 ft.
Date of test
Static water level
Well production
WATER SAMPLE RESULTS:
Coliform 0 coloniesll00 mL
Arsenic ND ug/L
IfA, B, or C provide PWSID #
Sanitary seal (Y/N) Y
Cased to 48 ft.
FROM WELL LOG
11/91
52 rt.
5.0
g.p.m.
Nitrate 2.45 mg/L
Date of sample: 6/17/14
Parcel ID: 050-322-34
Well Log (Y/N) Y
Wires properly protected (Y/N) Y
Casing height (above ground) >18"
AT INSPECTION
6/16/14
81 ft.
5.0
g.p.m.
in.
Collected by: S. Gilbert
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Septic/Steel Date installed 10/26/92
Tank size 1,000 gal. Number of Compartments 2 Y
Foundation cleanout (Y/N) Y Depression over tank (Y/N) __ N
Date of pumping 6/23/14 Pumper
Cleanouts (Y/N)
N High water alarm (Y/N)
Denali Pumping
C. ABSORPTION FIELD DATA
Date installed 10/26/92 Soil rating (gp.d./ft2 or fC/bdrm)
Length 42 and 33 ft. Width 3 ft.
Total depth 9 ft. Eft. absorption area 600 f¢ Monitoring tube__
Date of adequacy test 6/16/14 Results (Pass/Fail) Pass
Fluid depth in absorption field before test 48/0 in. Water added 900
Elapsed Time: 0 min. Final fluid depth 48/0 in.
Any rejuvenation treatment (past 12 mo.) (Y/N & type)
,8 GPD/SF
System type Trench
Gravel below pipe 4 ft.
Y Depression over field N
For 3 bedrooms
gal. New depth® in.
Absorption rate >= 450 g.p.d.
U If yes, give date
Do
LIFT STATION
Date installed
"Pump on" level at __ in.
Datum
Size !n gallons
"Pump o~ level at in.
Cycles tested
Manhole/Access (Y/N)
High water alarm level at
Meets alarm & circuit requirements?
in.
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot > 100'
Absorption field on lot > 100'
Public sewer main N/A
Sewer/septic service line >25'
Animal containment areas >50'
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation >5'
Water main N/A
Wells on adjacent lots > 100'
ABSORPTION FIELD ON LOT TO:
Property line > 10'
Water Service line >25'
Cudain drain None Noted
Properly line >5'
Water service line
On adjacent lots >100'
On adjacent lots > 100'
Public sewer manhole/cleanout N/A
Holding tank N/A
Manure/animal excrete storage areas > 100'
>10'
Building foundation >10'
Surface water >100'
Wells on adjacent Pots >100'
Absorption field
Surface water >100'
Water main N/A
Driveway, parking/vehicle storage > 1 0'
F. COMMENTS
Absorption system consists of two trenches at different elevations. The upper trench overflows
to the lower trench. The upper trench is totally submerged. The lower trench is currently dry.
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this date.
Engineer's Printed Name Michael E. Anderson P.E.
Date 6/21/14
COSA brown sheeLl0-10-12.doc
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
Parcel I.D. #
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
¢.--) .z..~ _ ~.;.Q ._~.. ~ .~ HAA#
1. GENERAL INFORMATION
..Complete legal description
Lot 7; Block 3; Rolling Hills View Estates
Location (site address or directions) Upper Skyline Drive
ProPerty owner
Mailing address
Carl Disot~ll Day phone 694-5797
P.0.Box 770210 Eagl~ River, Alaska 99577
Lending agency
Mailing address
Day phone
Agent
Address
Day phone
Unless otherwise requested. HAA will be held for pickup.
NUMBER OF BEDROOMS: 3
TYPE OF WATER SUPPLY:
Individual well
XX
NOTE:
Community well
Public water
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
NOTE:
Public sewer
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
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 $ & s ENGINEERING
I/u34 P. agie ~iver Loop I~oa~ NO~. ~_1~,~. Phone
Address Eagle RiYer, Alasl(a 99577
Engineer's signature
Date '4~- "~'[ '~ ~t,~/'''''--
DHHS SIGNATURE
~ Approved for ~'-/~¢--~- ~(/~ bedrooms.
Disapproved.
Conditional approval for
bedrooms, with the following stipulations:
Additional Comments
By: ~~ ~ Date
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~)25 (Rev, 1/91) Back MOA #21
Municipality of Anchorage
Department of Health & Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: l..~J'F"7
A. WELL DATA
Well type'~/~ If A, B, or C, attach ADEC letter.
Log present~;~N) '~/
Totaldepth .'.~
Sanitary seaK_~N)
Parcel I.D.
Date corn pleted
Cased to
FROM W/ELL LOG
Date of test ~,'~
Static water level ~'~
Well flow
Pump level
Absorption field on lot
Public sewer main
Sewer service line
SEPARATION DISTANCES FROM WELL Tel:
Septic/holding tank on lot \~--~
Casing height
Wires properly protectecl~3~N)
ADE/C water system number
1,\ /'~ ~ Driller
g.p.m.
; On adjacent lots
; On adjacent lots
Public sewer manhole/cleanout
Petroleum tank ik~ ~/-~
WATER SAMPLE RESULTS:
Coliform '~ Nitrate
Date of sample:
Collected by:
Other bacteria
B. SEPTIC/HOLDING TANK DATA
Cleanouts ~N) y', Foundation cleanoul::~i~TN)
High water alarm (Y/N) fi~J
Date of pumping
Compartments
7 Depression (Y~]~
Alarm tested (Y/N)
Pumper
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
I
Well(s) on lot /~-'~
To property line ~ ~.4--
Surface water/drainage
On adjacent lots
Absorption field
Foundation
Water main/service line
72-026 (Rev. 7/91)Front x,. , CONTiNUED ON BACK PAGE
C. LIFT STATION
Date installed
Size in gallons
Vent (Y/N)
High water alarm level
"Pump on" level at
Manufacturer
Manhole/Access (Y/N)
"Pump off" level at
Cycles tested
Meets MOA electrical codes (Y/N)
SEPARATION DISTANCE FROM LIFT STATION TO:
Well on lot On adjacent lots
Surface water
D. ABSORPTION FIELD DATA
Date installed
Length '~ ~:~* Width
Total absorption area
Depression over field (y~:~, [ . ~1~
Results (pass/fail)
Peroxide treatment (past 12 months) (Y(~
Soil rating
Total depth
Gravel thickness
Cleanouts present ~N)
Date of adequacy test
for
If yes, give date
bedrooms
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot \-e- .- ' On adjacent lots \ ~ Property line
To building foundation .~:~ I.~
To existing or abandoned system on
On adjacent lots ~W Cutbank ~[~ Water main/service line
Surface water ~ ~ Driveway, parking/vehicle storage area
Curtain drain ~~
E. ENGINEER'S CERTIFICATION
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect =. date of this inspection.
Signature
Engineer's Name
Date
S & S ENGINEERING
17034 Eagle River Loop Road No. 204
Eagle River, Alaska 99577
HAA Fee $
Date of Payment ,L / - ~ ~ - c~ ~L
Receipt Number
Waiver Fee: $
Date of Payment
Receipt Number
CHEMICAL & GEOLOGICAL LABORATORY
A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO.
5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343
ANALYSIS RESULTS for INVOICE # 52264
Chemlab Reg.# 92,1208 Sample # 3 Matrix: WATER
FAX: (907) 561-5301
Client Sample ID
PWSID
Collected
Received
?resezved with
L7 B3 ROLLING HILLS VIEW EST.
UA
MAR 26 92 @ 16:00 h~e.
MAR 27 92 ~ 15:30 bxe.
AS REQUIRED
Client Name :S & S ENGINEERING
Client Acct :SNSENGP
BPO# :
Req# :
Ordered By :
PO# :NONE RECEIVED
Analysis Completed : MAR 30 92 Send Reports to:
C. EDE lis ~ S ENGINEERING
Laboratory Sup~visox,: STEPHEN
Released By: ~d, ~ 2)
........ ;iiii;<!ir ................................. ~r:~---u-T~i; ........ ;;?i;~i!; ....... ~!!rrr~ii_!~_~_~: ...................
Sample ROUTINE SAMPLE COLLECTED BY: R.J.S.
I Tests ?erfozmed ' See Special Inst~uotions Ahove UA-Unavailable
ND- None Detected ** See Sample Remarks Above
NA- Not Analyzed LT-Less Than, GT-Oreater Than
~'~-~'~-__~ Member of the SGS Group (Socidt~ Gdn4rale de Surveillance)