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PROSPECT HEIGHTS #3 BLK 9 LT 2
Prospect Heights #3 Block 9 Lot 2 #015-133-30 APR -17-2007 05:22A FROM: 70:3437997 P.3/3 0evdepetsM WOO" 0trytmN m ruHttltD al" Wells oe-an. witw A WmMrMw ho r" 4700 woo.:en.t P.O. rat "Allo Asdtwps. ak !latt�ua tTwf ter�Tet Pump 1f�Y0etalle to Loy woo Dfuum pwode Numbnt coredIdaft flognNuft rto-15im;9 ME Dat! SIT IlTaei lbi"t' 0mw Nsas • AM SuSa v+ (%za r rump ltstititD.ptti 1.b. �+.p.rw.n ourto�,�p„_ nn ?ttmp DUlaEtttart3z+"1 nm A� rti,�r4� r MADMedd:T 1a 1= POMP slob I rf l wAftpewswldDlpW -* hift TttlwAttspWM= telorresnsaw: TltlmAdspuluft0m W400hbtuWUPM CW$d*W! Attu 0 No Melhsd of Dh t adopt n:AA GweusYe CALL FOR SERVICE —Co"VeteWater system Samos — AARow PUMP & WEtt StavicE, LLC "— ANCHORAGE entAN WRLE (907134&9355 EAGLE RIVER (e071 e22-eM Attiordal itis /o* brWYr 4W p oib s pump Wiam tss t.$ tg M wWa 30 op OrVMW fw lls&&. MUNICIPALITY OF ANCHORAGE S DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE NEW PI L /i'1 , U o Z aytq._ ❑UPGRADE MAILING ADDRESS LEGAL DESCRIPTION LOCATION NO, OF BEDROOMS J U Y DISTANCE TO: Walk O � ' Absorption area 7 % Dwelling �� O PERMIT [N)O. C -6 c�73 _ a z LU F¢- Manufacturer/- GJea Material No. of compartments co Liq. capacity in gallons IF HOMEMADE: Inside length Width Liquid depth s—� 0(7z DISTANCE TO: Well Dwelling PERMIT NO. 02< Manufacturer Material Liquid capacity in gallons ❑ Well Founds 'on Nearest lot line PERMIT NO w= DISTA NCETO: LU LL z No. of lines Length o each line Total length f lines Trench width Distance between lines F?¢ >0 C O i p inches a Top finish Material beneath tile Total effective absorption area F p of tile to grade -18-t- `XQC> w (n` inches -f-JYf Length Width Depth PERMIT NO. LU 0 Type of crib Crib diameter Crib depth Total effective absorption area CL a W cn Well Building foundation Nearest lot line DISTANCE TO: - Class Depth Driller Distance to lot line PERMIT NO. O � LU DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER 4— PIPE MATERIALS Cast- feu t N SOIL TEST RATING s1 INSTALLER set// REMARKS A XnISAAAkA MOLQEi "s G' wt'- _AdA 1;0,tiO_r "qcr J#q APPROVEDDATE LEGAL T`rPE OF SOIL ABSORPT I Ohl SYSTEM IS: T RENJC:H N•d1_11BER OF BECIF:Cii.M__, .... 4 _OIL- RATING (50 FT, --"BR)= 125 THE F:E:i-li_j I F::ED SIZE OF THE SOIL. ABSORPTION DEPARTMENT HEALTH AND ENVIRONMENTAL `.OTECT I ON i•.i I THOi_IT FINAL I Na__ PEC= T I OP.d Af-4D APPRO%-lAL. BY THIS 2,5 'i-. -STREET: AN C.HOF:F=IGE: AE:. 99*01 Tt-i PROSECLiT I ON. F 1-11 264-4720 9 ! 30 AM $l-2-2-- lZZE=- E=-IL_ IL.._ s=e PA C d CH 0-4 __ S_ I -'F EE = EE 11-4 � Fe �" � �: � � 9 � � Ld nq 0 FEF. -MIT No. ( ) and, >o 3"7 C9 3 M-PPL.ICANJ T PAUL 1'1. ''•=CiZFiF'°: W. NORTHERN LIGHTS 24.:,-4447 i_OC :AT I O'N LEG3 A L L. "'i F:LF; 9 F'F:OSPEGT HE.. LCAT SIZE 999:=99 SQUARE FEET T`rPE OF SOIL ABSORPT I Ohl SYSTEM IS: T RENJC:H N•d1_11BER OF BECIF:Cii.M__, .... 4 _OIL- RATING (50 FT, --"BR)= 125 THE F:E:i-li_j I F::ED SIZE OF THE SOIL. ABSORPTION SYSITEN 15: AhlY _,YSTEN i•.i I THOi_IT FINAL I Na__ PEC= T I OP.d Af-4D APPRO%-lAL. BY THIS DEPAF:TIlENdT I•.I I LL. BE E;U&JEr:T Tt-i PROSECLiT I ON. F 1-11 THE L.-E.k-JGTH DIPiENJS•.I.ONJ 15 THE LENGTH F. IP•J FEET? OF THE TRENCH OR DF:AINJFIELD. THE C1EF"T H iF A T F:Ef-.!C.H -OF: FIT IS THE C:-FIP-J,:E BETWEEN THE SURFACE OF' THE GROUND AP -JD THE ROTI-ON4 OF THE E:>;CA`•r'ATI OI%I :: II'J FEET). THERE IS NO SET WIDTH iDTH FOR TREtI HE_=•. THE. GRFIVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BE.TWEEi'-J THE OUTFALL. PIPE AND THE BOTTOM OF THE E.;C:A%JAT I ONJ (IN FEET:. I c - -F f--1 l" --o H---' ° 3E 7:-� 9-_ ;1 L- c =® p-4 -° PEF:N I T APDL I CF-iN•J-F HA S� Ti 1E RESPOi .-IS I B I L I TY TO INFORM RM TH I DEPAF: THENJT C?i_IF:: I F-16 'THE iNJSTALLATION•J !hISPEC:TIONJS OF ANY I. -JELLS ADjAC:ENJT TO THIS PROPERTY ANUG:' THE Ni-ii-IBEF:: CIF= F:ES 11.?EN,pC ES THAT THE WELL I•.I I LL S,I=R% E. N'I I NJ I I'U_ P1 C:- I STAN-JC::E E:E'1-IdE.E.N4 A WELL AN -ID ANY ON-SITE SEWAGE DISPOSAL S YSTEP'I I .I_00 FEET FOR A PRIVATE WELL... OR 150 TCl 200 FEET FROM A PUBLIC WELL. DEPENDING i=P 1P•d THE TYPE OF FLiE;L..I. WELL. HINdIN'UJN DISTANCE FR.1-111 A "RI'•<<FITE. WELL. TO A PRIVATE SEWER LINE IS 25 FEET AND TO A C.Oi-iHk.INJ I T'r' SEWER LINE IS kIEL-L i_.i:ii i' • ARE: REQUIF:ED FIN f.l MUST BE RETURNED TO THE DEPAF~:TMEI'•JT I.'.IITHINd -,.,0 Di -YS OF THE idE'Ll. C:ONPLETION•J. THEE: REQUIREHENTS HA`,' APPLY. -SPECIFICATIONS AND C:ONdS•TRUFTIONd DII•iGRAM'_• ARE A'•r'AILRBLE TO .Ihi'=Ji_RE. F;ROPEF:: II`J FALLATIONd. ' lE= F -;r IP- If R" 1_ Q.=_ F=' Y 6--:_ Ems. "--7 fC-a I—E C:: iE ._ F "1 E_ IGE F' -1 = n I i_.E'Fe i I FY THAT i j..: I AM FANII_:i:FIF: WITH THE REQUIF:EFIENJT FOR OP -,I ---'::.'ITE SEWER--; ANJD WELLS AS SET FOF::TH t,r' TF -i E: iili-lr-41C:IPALIT'r OF ANJC:H! RA3E. : I WILL. I NJS•TALL THE SYSTEM 11,1 AC:C:OR.DF11' C E Id I TF -I THE CODES. _.: I Li NJC: EFtS,TFINJL: THAT TI iE: (-iN+i--=ITE SEWER S'r STEI'-I HAY F::EQU I RE EN+ILAF:GEI' IEN•JT IF THE ��c--oX)-' RESIDEi'•J+_`E: I:+ REMODELEf_i TO INC:Li_IDE MORE THAN 4 BED)r:OOPIS.. HF'F`L:EC- T PAi,li- i'i.'DEAF=: _ ISSUED - - BAC:E::F• I LL..I NJG OF AhlY _,YSTEN i•.i I THOi_IT FINAL I Na__ PEC= T I OP.d Af-4D APPRO%-lAL. BY THIS DEPAF:TIlENdT I•.I I LL. BE E;U&JEr:T Tt-i PROSECLiT I ON. N'I I NJ I I'U_ P1 C:- I STAN-JC::E E:E'1-IdE.E.N4 A WELL AN -ID ANY ON-SITE SEWAGE DISPOSAL S YSTEP'I I .I_00 FEET FOR A PRIVATE WELL... OR 150 TCl 200 FEET FROM A PUBLIC WELL. DEPENDING i=P 1P•d THE TYPE OF FLiE;L..I. WELL. HINdIN'UJN DISTANCE FR.1-111 A "RI'•<<FITE. WELL. TO A PRIVATE SEWER LINE IS 25 FEET AND TO A C.Oi-iHk.INJ I T'r' SEWER LINE IS kIEL-L i_.i:ii i' • ARE: REQUIF:ED FIN f.l MUST BE RETURNED TO THE DEPAF~:TMEI'•JT I.'.IITHINd -,.,0 Di -YS OF THE idE'Ll. C:ONPLETION•J. THEE: REQUIREHENTS HA`,' APPLY. -SPECIFICATIONS AND C:ONdS•TRUFTIONd DII•iGRAM'_• ARE A'•r'AILRBLE TO .Ihi'=Ji_RE. F;ROPEF:: II`J FALLATIONd. ' lE= F -;r IP- If R" 1_ Q.=_ F=' Y 6--:_ Ems. "--7 fC-a I—E C:: iE ._ F "1 E_ IGE F' -1 = n I i_.E'Fe i I FY THAT i j..: I AM FANII_:i:FIF: WITH THE REQUIF:EFIENJT FOR OP -,I ---'::.'ITE SEWER--; ANJD WELLS AS SET FOF::TH t,r' TF -i E: iili-lr-41C:IPALIT'r OF ANJC:H! RA3E. : I WILL. I NJS•TALL THE SYSTEM 11,1 AC:C:OR.DF11' C E Id I TF -I THE CODES. _.: I Li NJC: EFtS,TFINJL: THAT TI iE: (-iN+i--=ITE SEWER S'r STEI'-I HAY F::EQU I RE EN+ILAF:GEI' IEN•JT IF THE ��c--oX)-' RESIDEi'•J+_`E: I:+ REMODELEf_i TO INC:Li_IDE MORE THAN 4 BED)r:OOPIS.. HF'F`L:EC- T PAi,li- i'i.'DEAF=: _ ISSUED - - 'SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ❑ PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERFORMED FOR: paotyCSC' I•' Y� DATE PERFORMED: LEGAL DESCRIPTION: Prn51De-c-'I"-��.{c��'�}S 4l`o�-I� r.� �-�'�- 2- p F1 Fffl OL, Orjn,l Seip) SLOPE SITE PLAN 1 jn1, 2 3- 4 5 6- 7 8- 9 10 ®, 12 13- 14-, 15- 16- 17 51617 18- 19- 20- Comm 81920 COMM �d rtk. SP Sea:.�S C�, V�Sv._S 1-diia� i7� G� (narM . > WAS GROUND WATER S ENCOUNTERED? I(L O P IF YES, AT WHAT E DEPTH? Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE TEST RUN BETWEEN FT AND (minutes/inch) FT O 7: PERFORMED BY: Mrtic G -k0, -,e_ CERTIFIED BY: DATE: •— 2�Z J WATER WELL RECORD STATE OF ALASKA DEPARTMENT OF NATURAL RESOURES Division of Geological a Geophysical Surveys Drilling Permit No. LOCATION OF WELL (Please complete either la, Ib or Ic.) A.D.L. No. ta. Borough Subdivision Lot Block Ib. y W gtrs. Section No. Township N ❑ Range E ❑ Meridian nchoxa e Prospect His 2 9 —or. Graf—of— s❑ w❑ Ic. DISTANCE AND DIRECTION FROM ROAD INTERSECTIONS 3. OWNER OF WELL: 11ul Int Sandra Vozar tldress: -Street Address. and Area of Well Location 2. WELL LOG Feet Below, Surface 4. WELL DEPTH: (final) 5. DATE OF COMPLETIQN 5 24 FjLt 180 I'L — -. Material Type TOP Bottom Loose sand & gravel 0 2 6. OCoble tool ❑ Rotary ❑ Driven O Dug B.r tm sandv Mill 2 17 ❑ Auger ❑Jetted ❑ Bored ❑ other: Brown Till W Vlore Silt 1.1 28 7. USE: 13 Domestic ❑ Public Supply ❑ Industry Med. fine washed grkivel 28 34 ❑ Irrigation ❑ Recharge O commerical ti et streaks 34 49 ❑ Test Well ❑ Other: Med. coarse grey, sandy till 49 S, CASING: O Threaded C3 Welded B own 'fill 61 e61 66 diem. 6" in. to ft. Depth Weight 17 1be./ft. Coarse gravel w brn stand & water 65 69 dram. In. to ft. Depth Stickup ft. Med, hard dark grey rack 69 115 9. FINISH OF WELL: Med, hard rev rock w/black creamy Type: Open :End Diameter: streaks 115 1.55 Slat/Lileeh Site: Length: Hard, prey–white rock; -clean chips set between ft. and ft. and runoff 155 13Cj Backfilling Gravel pack 10. STATIC WATER LEVEL: 51 ft. 5/24/84 ❑ Above or © Below land surface Dote ANCHORAGE used 7a1 t. Valve Bailer DEPT. OF HEALTH &Equipment EN I I. PUMPING LEVEL below land surface and YIELD 3ft. 4 after hrs. pumping g.p.m. FEB ft. after hre. pumping g. p.m. . _ C. E In 12.GROUTING Well Grouted: ❑ Yee ❑ No _ - -EL Malarial: ❑ Neat Cement ❑ Other: - 13, PUMP: (if available) HP Length of Drop Pipe ft. capacity g.p.m. O Subm. ❑ Jet ❑ Centriflcal ❑ Other 14. REMARKS: Yulnped n 20 gpm w/DD to 611. TPL + 7lf 5411 5t — 68' Pprforatefrom6 16. WATER WELL CONTRACTOR'S CERTIFICATION: 15. Water Temperature ° O F ❑ C _ Thiswell.was drilled under my jurisdiction and this report is true to the best of my knowledge and belief; Dotten Drilling AA0512 Registered Business Nome Contract License Number Address; 8537 ArtzeJA Stre t A chore a Alaska 99507 . Signed: = Data: August 31, 1984 Authorized presentative Form 02-WWR (11/81) Copy Distribution: WHI TE -State DOGS, PINK -Driller, CANARY- Customer Municipality of Anc On -Site Water and Wastewater (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS Parcel I.D. 015-133-30 1. GENERAL INFORMATION l,TliL�I� f� Expiration Date: 4,g // 6 Complete legal description PROSPECT HEIGHTS #3 BLOCK 9, LOT 2 Location (site address) 10001 SLALOM, ANCHORAGE AK 99507 Current Property owner(s) JANE B. LITTLE Day phone Mailing address Real Estate Agent 10001 SLALOM, ANCHORAGE AK 99507 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 5 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $_� Waiver Fee $ _ Date of Payment bp 11 Is Date of Payment Receipt Number �j�gyQ Receipt Number. COSA# Waiver# 5. STATEMENT PECTION 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 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 time of installation. Name of Firm ARCTERRA CONSULTING, INC. Phone 868-3791 Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date 9-28-2015 Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen QL , encroachments, deficiencies or discrepancies exist. / v Ff l *14q Tt-t �x 6. DSD SIGNATURE KE\fiETH ?� Ni. LF 'nF System #1 Approved for bedrooms. � ��n 7118 System #2 Approved for bedrooms. ,, o ` — ! a e�ssroSati .i Disapproved. Conditional approval for bedrooms, with the following stipulations: ��lllll(tll(iir,rr Off/ C1 OW < AND Vvr, p� �o WASTEWATER PRD o� l��h FNT S By: Y (/ Original Certificate Data, of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered 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 X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 10-10-1Zdm If more than 1 septic system is on the lot: COSA Checklist # of Structure servedby this system _ Certificate of On -Site Systems /approval Checklist Legal Description: PROSPECT HEIGHTS 43 BLOCK 9, LOT 2 Parcel ID: 015-13330 A. WELL DATA Well type PRVT Date completed 5/24/1984 Total depth 180 ft. Date of test Static water level Well production If A, B, or C provide PWSID # Sanitary seal (Y/N) Y Cased to 40 ft. FROM WELL LOG 8/31M984 WATER SAMPLE RESULTS: fi# 9 - p.m - Coliform NE& colonies/100 mL Nitrate &09 mg/L Arsenic: Nb ug/L Date of sample: B. SEPTICIHOLDING TANK DATA Tank Type/Material SEPTIC / STEEL Well Log (YIN) Y Wires properly protected (Y/N) Y Casing height (above ground) 24 in. AT INSPECTION 9-21-2015 0 .. - Collected by: ARCTERRA Date installed 8/23/1983 Tank size 1500 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping 'I -V1 -I S Pumper ,A,c44cr C. ABSORPTION FIELD DATA Date installed 8/23/1983 Soil rating (g.p.d.M2 or ftz/bdrm) 125 System type DEEP TRENCH Length 90 ft. Width 2.5 ft. Gravel below pipe 4 ft. Total depth 9i5 ft. (Measured 9M/15) Eff. absorption area 720 ft2 Monitoring tube Y Depression over field N Date of adequacy test 9121/2015 Results (Pass/Fail) PASS For 5 bedrooms Fluid depth in absorption field before test 0 in. Water added 800 gal. New depth 1 in. Elapsed Time: 5 min. Final fluid depth 0 in. Absorption rate >= 750+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION Date installed "Pump on" level at Datum Size in gallons in. "Pump ofP'tevel at in. _ Cycles tested E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 100'+ Absorption field on lot 100'+ Public sewer main 751+ Sewer /septic service line 25'+ Animal containment areas 50'+ SEPTIC/HOLDING TANK ON LOT TO: Manhole/Access(Y/N) High water alarm level at Meets alarm & circuit requirements? On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout 100'+ Holding tank 100'+ Manure/animal excrete storage areas 100'+ Building foundation 5'+ Property line 51+ Absorption field 51+ Water main 10'+ Water service line 101+ Surface water 100'+ Wells on adjacent lots 1001+ ABSORPTION FIELD ON LOT TO: Property line 101+ Building foundation 10'+ Water main 10'+ Water Service line 10'+ Surface water 1001+ Driveway, parkingivehicle storage 10'+ Curtain drain 50'+ (NONE KNOWN) Wells on adjacent lots 1001+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that l 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 KENNETH M. DUFFUS Date 9-28-2015 COSA canary sheet 2-e-15.doc Ar °� A , * 49TH* 7 t SW 3® 'O nr si; oKPti -r in. Municipality of Anchorage Community Development Department ° Development Services Division „ 'r On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 Nitrate Advisory Certificate of On -Site Systems Approval # OSC151546 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 9, Lot 2 of Prospect Heights #3 subdivision. This inspection revealed a nitrate concentration of 5.09 milligrams per liter (mg/L) was reported for the property's well, water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. IN -*Scf m\A 0 A e-,c—R- 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 Parcell.D. ble-133-30 COSA# nqopt Expiration Date: D 1. GENERAL INFORMATION Complete legal description Lot 2; Block 9; Prospect Heights #3 Location (site address) 10001 Siaaiom96. Current Property owner(s) Sandra Vozar Day phone 907-252-4207 Mailing address PO Box 1430 Kenai, AK 99611 Lending agency Day phone Mailing address Real Estate Agent Michael oroego Day phone 230.3372 Mailing Address Unless otherwise requested, COSH will be held by DSD forpickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well [Z] Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site❑ Individual Holding Tank ❑ Community On-site ❑ Public Sewer ❑ 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 professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/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 valid water samples.) Certificates are valid for one year for properties served by Class A or B wells 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 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 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 time of installation. Name of Firm S a s Engineering Address 15861 S. Birchwood Loop Rd. ugial K 99 67 Engineer's Printed Name 5. DSD SIGNATURE f/ Approved for r bedrooms. Disapproved. Phone 694-2979 Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory �%— Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: Original Certificate Date: 7-6-0-7 (a« 11M) Munfcipality of Anchorage ' Development Services Department Building Safety Division On -Site Water & 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 CHECKLIST Legal Description: L dT a A. WELL DATA Wen typeeRI WgTE bate completed 4�/e� Total depth ACL�ft. If A. B, or C provide PWSID # — Sanitary seal y) �F'S i Cased to W 4- ft. FROM WEL LOG Date of test e31oA i Static water level 5i ft. Well production g.p,m, WATER SAMPLE RESULTS: Coliform D colonies/100 mL Nitrate 'Zio L Arsenic: _� ug/L date of sample: B. SEPTIC/HOLDING TANK DATA Tank Type/Material '56FTl c sm Tank size Iwo gal. Number of Compartments Z' �o f s. eer ID: 6/.S- /33 -30 Well Log (YIN) Wires properly protected©I) Casing height (above ground) �Z11} in. AT INSPECTION S2' ft. g.p.m. Other bacteria _0 colonies/100 mL Collected by: so- 45 F y t)M214" Date installed 3 Cleanouts l&) E� Foundation cleanoul&) _Vr5 Depression over tally .0'/— High water alarm 00 /i.91_ Date of pumping ��3/0 3 Pumper _ A -t- F11�11 g�i2 ty I c r -s C. ABSORPTION FIELD DATA Date installed 3 Soil rating (g.p.d./ft2 0 /bdrm a5 System type T/LEA_" Length _Lv ft. Width ' ft. Gravel below pipe _ q ft. r Total depth �� ft. Eff ab sor tion area ��yft' Monitoring tube -lam Depression over field k)U Date of adequacy test (v 21 Result Pas ail For � bedrooms �� n Fluid depth in absorption field before test Q in. Water added gal. New depth in. Elapsed Time: � min. Final fluid depth 11 P p in. Absorption rate >= !Z$QY g.p.d. Any rejuvenation treatment (past 12 mo.) (l& type) 00 If yes, give date D. LIFT STATION 11114 Date Installed 'Pump on" level at _in. Datum E. SEPARATION DISTANCES Size in gallons erm�ess trrrrl Mp cis=i at _ in. High water alarm level at in. Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: r Septic tank/lift station on lot /GY' 1 Absorption field on lot Public sewer main AJlfff Sewer /septic service line g sJ 14 Animal containment areas �rQ1f- On adjacent lots /G27 r On adjacent lots Public sewer manhole/cleanout Holding tank r Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: / r Building foundation 5' Property line Absorption field S '1 Water main A�_ Water service line /D r 1 Surface water /� t Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: 1 � Property line /D ~ Building foundation /D Water main / Water Service line {D Surface water /nl1'- Driveway, parkingivehicle storage /to + Curtain drain 1'btc "-Ttu1V Wells on adjacent lots IV F. COMMENTS G. ENGINEER'S CERTIFICATION 1 certify that I have determined throw review of Municipalrecords at h conformance with MOA COS gui e Engineers Printed Name Date 6/ o field inspections and above system; are COSA Fee $ y30 Date of Payment AM Receipt Number ��Sd (Rev. 11105) 619 Waiver Fee $ Date of Payment Receipt Number 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 Nitrate Advisory Certificate of On -Site Systems Approval # 070216 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 9, Lot 2 of Prospect Heights #3 subdivision. This inspection revealed a nitrate concentration of 5.7 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. 3 LOT 26 ')C/ B9 °50rJ4 f / E 397 TH—/ �Nt- W`/pr LOT /P Nj fonC/Pft 1 0 v¢ l;/fie /tt Grla 2s�f zp , GrG / /f .... ..... •' / A;-dUtLT NO.CORNERS SET T1 IIS HATE << No. 3255.5 :.} i �� E ,...r.�A I hereby certify that I have' a Mort2gCe's is -i spectioa of the foUowing desrnb ro les" al mecmdiag preciact, lca, and that .the improve -i I� loves and do • c : ,� 9. tkodo�. not overlap or encroach an the rroperteyPin dYdoeat there-! ' ( N�•.�r No.'riNi �,� 0, that no'improvemenis anPre inyy PITY lyinC»�_dlaeent theretoi RFD~ �£FSSIam nd' encroach asn��•F�O o' roadways On th�ia�li610n Kaes 4DDpoottyjj������oth°er visible�teasements oi�+ . ,C•• ... said Property except 4L9 hereon. EASEMENTS OF RECORD, OTHER THAN TMnCF SHOWN ON THE RECORDED BBB -i 200/ZOO'd Us -i EYOZ59SLOO - Dated at An nomge. Alaska this 2.3 � say P /'. / r I9— i BRF1) W_ALATSA & ASSOCIATES' sill! t>ItaRiY-Yloai (1Yf2�01 �o-at-Nnr Sample Remarks: • f - ' i of Y SCS RtLM 1072735001 All Datesfimes are Alaska Standard Time Client Name Project Name/# S & S Fngincering L2 D9 Prospect I Its No 3 Printed Drte/1lme stemD410a : 06/ 06/17/1007 8:28 Client Sample 1D 42 D9 Prospect Ills No Fonted '�"',' "5'' /2007 14:13 111atds Drinking Water Received Daldrime a:TKhnieal 06/14/1007 14:45 Dirsetor Stephen C. Ede MID Arsenic ND 5.00 f 'pg/L FF200.8 - C (<10) ' Sample Remarks: Y Prep Analysis . . . Dole Dale In Puunemr Rcwlu Allowable PQL �, - Units t e Method i .' • Conuiner ID Limits ' Metals by SCP/M9 Arsenic ND 5.00 f 'pg/L FF200.8 - C (<10) ' 06/1W 06/27/07TK' Haters Department r TotatNilraleMitrite-N 5.70 0.100 mg/1. SM204500NO3-F D (qO) 0619/07? 7DS w 1 ; r Microbiology Laboratory - ." Total Colifoml 0 cop100mL,SM2092220 A (<)) 0614/07" DLC '' p MUNICIPALITY OF ANCHORAGE, • DEPARTMENT OF HEALTH & HUMAN SERVICES p}j 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. # ('.I - I � -_ 1. GENERAL INFORMATION HAA# iW-1'3 3Ll LA -D i� \, Complete legal description Lot 2; Block 9; Pnaspect He,.Qht3 Subdivision. #3 Location (site address or directions) 10001 Statom C.inate, Anchorage Property owner Pawl and Sandra Vozar Day phone 346-1333 Mailing address P.O. Boz 111269, Anchorage Ata,6ka 99511-1269 Lending agency Mailing address. Agent Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water 3 Y Day phone Day phone 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 XXX 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 Sg, c crlrwNi:FRlNG Phone 17034 Eagle River Loop Road No. 204 Address Eagle Piver, Alarka 99577 Engineer's signature Date Tj�� Y� V, 0 '° No. 13215 .as t11 a� ee 5 ROFESSOt 4v 6. DHHS SIGNATURE Approved for 2 bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments By: /G Date Il mrj 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 H21 O Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: LcT 2. SL 9 Pr20S66c% HTS Parcel I.D. 4/=/S�--?6 A. WELL DATA Well type P—IV81-C If A, B, or C, attach ADEC letter. ADEC wa er system number NSA tt 'g Log present YON) f ES Date completed Driller Lb7TE12 :-221L1-I P& Total depth /95 Sanitary seal O/N) Date of test Static water level Well flow Pump level Casedto 4o" -t- Casing height 17- 4 - Wires properly protected ON) S'ES FROM WELL LOG V3�/�� 20.o g.p.m. NOT' K00w N AT INSPECTION 11 li/ q3 54 A>oT' kNOWAv g.p.m. 1 rri SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot —1 0(o On adjacent lots yo't i Absorption field on lot '-/05 ; On adjacent lots /00"1- n OU1- Public sewer main 100N€ F2E5EA1 f Public sewer manhole/cleanout P1eASE"/U7_ Sewer service line 50 dd- Petroleum tank NdWE KAJoWR1 WATER SAMPLE RESULTS: Coliform Nitrate 3.08 y & Other bacteria oofNt Q Date of sample: �I x/93 Collected by: S� S EG{JG/N4f/2/NG B. SEPTIC/ TANK DATA Date installed '9JZ3JqV Tank size �Do ��� Compartments Z Cleanouts YN) �165 - Foundation cleanout (Y/N) `/L"'�_ Depression (Y/A /JO High water alarm (YA@ Alarm tested (Y/N) Date of pumping i/30 / Z Pumper X0%6 K06 % e YZ SEPARATION DISTANCES FROM SEPTIC TANK TO: Well(s) on lot i`/C)(p On adjacent lots.1(-X) 1" Foundation ~70� rr To property line /OD Absorption field ? Water main/service line Surface water/drainage 1%Nr 6e6EEJ17" 72-026 (Rev. 7191) Front CONTINUED ON BACK PAGE � z m y r_ r N O M 'n < z n n 0 <5� (NG) O M Z FT STATION Date ins Size in gallons Vent (YJ "Pump " level at High water alarm level Meets MOA electrical codes Manufacturer Manhole/Access SEPARATIO ,DiS>TANCE FROM LIFT STATION TO: on lot D. ABSORPTION FIELD DATA On adjacent lots "Pump off' level at — Cycles tested Surface water v Date installed Z3 IS3 Soil rating %ZS System type aK 77CrrcJC8 c� '/4 r Total depth f0 r Length `0 Width Gravel thickness Total absorption area 170 Cleanouts present &/N) Depression over field (Y/& /Ub Date of adequacy test Resultsas /fail) /''�sS for S 3 82 A-PP)0o✓A'i, bedrooms Peroxide treatment (past 12 months) (Y/N) /QFJN6 rwocJN If yes, give date 14A ikP61Z VZ3/$3 lAJSPEctOON 26_P01q SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 1* -10S 1 On adjacent lots /00 � Property Line To building foundation, �7 To existing or abandoned system on lot N On adjacent lots �� fi Cutbank N o <J P,'z ra TWater main/service line Surface water AJO,JE 1°2ESEN f Driveway, parking/vehicle storage area .SO It Curtain drain A)nNE t�OWN E. ENGINEER'S CERTIFICATION I certify that 1 have checked, verified, or conformed to all MOA and HAA guidelines in effeg�Vb" hI, inspection. NV., .•oeMOe�e�ee S 5 EIyDiNEERING 0 CO ®® 17034 Eagle Rivet, Loop RoadN*.2614 *:- 49 e4 Signature ueeaoaeeeeeN• a®ose eea ° Engineer's Name ®•'°O"'ir e e j49 t RR J. tiAFBR ; � No.a 5 ;00 Date ®��00 -®%®'"ROFESSt�����®� HAA Fee $ 1� eD Waiver Fee: $ Date of Payment \ Date of Payment Receipt Number 7 r 7ln 1 Receipt Number 0..��IEWClbL & GEOLOGICAL IABORC1TOR A DIVISION OK COMMERCIAL TESTING & ENGINEERING CO. X63'3 B F3TREET Ap1GHQFiAQS, A(,ASKA 99519 TELEPHONE (907) 56223,13 FAX- (907) 561-5301 Client Sample 10 L2 R9 PROSPECT. NTS $/D PNSID UA Collected 01/10/93 1 1.4:40 tire. Rsceivsd 0.1,/08!93 E 16:10 ht F. Preserved eith Analysis Completed , 01/11,/93 Laboratory SupazvisFP'<EN C. ED? Released Eq L ��+ /�J ANALYSIS RBSULTB fax INVOICI t 52193 Chatslab Ref .t 93.0112 Sample t 1 Matrix, KRTBR Cliant Name :S h S ENGINEERING Cliant Acct :SN98NGP RFOt : Regi : Ordered By +R. SHAFER Sand Reports to: I)$ & S ENGINE"t9q 2) POt :NONE RBCIP91) ep•p�•' ^yy,en`R0.iaY.tlAi Far6rater 'lP' Resulte Urals Method Allowatle Lirsits H1tRATE-N 3.0E/1 EFA 35}.2/300.0 to Sampia ROMINK SAKPLE COLLRCTED BY: S.S. Remarks: .................................. ... 1 Tests Perfor.Kad Sea Special Instructions Above UA4ri&ya11ab1s HD- Hone Detected See Semple Remarks Abays HA- Not Analyzed LT•Less Than, GT -Greeter Then r2) Wje. roor of the 608 Group (80C1414 GAntiral9 de Survell!anco) MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date Z' ( Z (a) Legal Description (include lot, block, subdivision, section, township, range) c.f 1-E►s, TIZN(Z- 3 U S /li, Location (address or directions) 1'P6/�- c9 '94 C 6 TU ,5cff CE5,5 To :56,tf U /t'l (b) Applicants NameT'�v�� Sas�c�%L l�D/�%�Telephone — Home 3� Business Applicants Address 112�, (c) Applicant is (check one) Lending Institution ; Owner/builder Buyer ; Other = (explain); (d) Lending Institution .5'-r ¢El.�141UI . Telephone Adnss ✓/ l� �, OUO✓� Tl%�st �i /C �/S /j G i/� (e) Real Estate Co. & Agent /:/ r 4 A// �_1416 Address Telephone (f) Mail the HAA to. the following address: 2. Type of Residence Single—Family Number of Bedrooms 3. Water Supply Multi—Family G� til G- % cl- Other (describe) 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 Onsite 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 21 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, 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 regula- tions in effect on the date of this inspection. / Name of Firm 60615 �✓vc_ ' G °?G� �- c'- j' S Telephone G' y Z0� Address���/ /jr✓(�/ //c��d�j�✓ �j� f7//[iGl/ �T.S/�, Date U —I Z, X 6. DHEP Approval Approved for Approved Lt ry � c 'y 41— (ENGINEER SEAL)AQ1. .0.:1'112-i_ " da z. Uri ^2. 193 n 1 bedrooms By ! Date' > `� Disapproved Condition Terms of Conditional Approval CAUTION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS 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 REQUIRE- MENTS. 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 ENGINEER°S WORK. (DHEP SEAL) RR4/ej/D18 [Page 2 of 2] 7-19-84 MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION MUNICIPALITY OF ANCHORAGE (MOA) ` HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 Le al Descrip ion: A. WELL DATA FEB 131985 Well Classification s1 L)0 lQ_, If A, B. or Cr D.E.C.IApproved(Y/N) Date CcnPleted L LI - y' -f Yield Z CO Well Log Present (Y/I`I) � /JTotal Depth l %� U Cased to (� �' Depth of Grouting Static Water Level I` Pump Set At Casing Height Above Ground � I Sanitary Seal on Casing (Y/I`I�� Electrical Wiring in Conduit (Y/N) Depression Around I�llhead (Y/N) 'J Depression i Separation Distances from Well: _F- DO ) C)(o On Adjoining Lots To Septic/Holdirg Tank on Lot , a-- 1 O 0 To Nearest Edge of Absorption Field on Lot X10 On Adjoining Lots To Nearest Public Sewer Lire /J 00 t 1 At -(4o Nearest Public Sewer To Nearest Sewer Service Line on Lot Cleanout/Manhole Water Sample Collected By C;4: Date 'S Water Sample Test Results CamTents LA J & ( S- (r. O i i� i i ✓I L (� i B. SEPTIC/HOLDING TANK DATA - Z 3 Size Is Q��x No. of Compartments Date Installed Air -tight Caps (YM) Foundation Cleanout (Y/N) Standpipes (Y/I`I) / Depression over Tank (Y/N) /.) Date Last Pumped !v UJ -s- Depression ' nteranee Contract on File (Y/N) for Pumping/Mai Holding Tank High -Water Alarm (Y/N) ✓} Temporary Holding Tank Permit (Y/N)- Separation Distances from Septic/Holding Tank: r To Water -Supply dell l C (r To Building Foundation To Property Lire -L O To Disposal Field o To Water Main/Service Line O To Stream, Pond, Lake, or Major Drainage Course +( ) p Comments � /N 31 C- ` 1 (� J Receipt # Date Paid: 2 - Amount: <I.S",C�� [Page 1 of 21 2-15-84 C. ABSORPTION FIELD DATA,^ 1 Z.S` T of System Design Soils Rating in Absorption Strata Type Date Installed _ Length of Field I S' Width of Field 30 Depth of Field `r�1 rr Gravel Bed Thickness Square Feet of Absorption Area i [ Standpipes Present (Y/N) Depression over Field (Y/N) Date of Last Adequacy Test N (,(J Results of Last Adequacy Test Separation Distance from Absorption Field: To water -Supply Wall I-) , f1 / � ' To Property Line Z U To Building Foundation + 7 r To Existing or Abandoned System ccz Lot I've A ; On Adjoining Lots 1 U D To Water Main/Service Line + 0) To Cutbank(if present) �`/4 ` To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Commenti� s D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at _ Tested for Electrical Codes(Y/N) Comments Dimensions Manhole/Access (YIN) "pump Off" Level at Vent (YM) Pumping Cycles during Adequacy Test. Meets MOA Check Permitted Bedroom Rating Against HAA Request hchecked, �rified, or conformed to all MOA HAA Guidelines in effect I certify that I ave on the date of this inspection. Date Signed 2 "- 1 Z -8S Company ( u vl 5-% ✓I � LY � Jew � c s MOA No . l ' S (� Z KB1/d5/s [Page 2 of 21 2-15-84 HEMICAL & GLULOGICAL LABORATORIES dF ALASKA, INC. TELEPHONE (907) 562-2343 ANCHORAGE INDUSTRIAL CENTER 5633 B Street ANALYTICAL REPORT SAMPLE LOCATION: horaa CUSTOMER Paul Vozar FOR LAB USE ONLY DATE COLLECTED 8-13-84 TIME COLLECTED: 1100 RECVD.BY _ S— LAB #_.E. SAMPLED BY SOURCE ProGnect Heights #3 DATE RECEIVED 8-13-84 Lot 2 Block 9 8-17-84 Har water wi trice Iron DATE COMPLETED REMARKS ..Innnrrn 8-17-84 SIGNED <0.05 []P,Phosphorous <0.05 []Cyanide. []Ag.Silver []Al 0 Al umi num<0.05 []As,Arsenic — 5 []Au,Gold <0.05 []Pb,Lead <0.05 []Sulfate []Pt,Platinum <0.05 []Sb,Antimony <0.05 <0.05 []B,Boron []Se,Selenium <0.05 []Ba,Barium <0.05 []Si,Silicon 4'9 []gi,Bismuth <0.05 []Sn,Tin <0.05 []Ca,Calcium 31 []Sr,Strontium 0.13 []Cd,Cadmium <0.01 []Ti,Titanium <0.05 []Co,Cobalt <0.05 []W,Tungst []Cr,Chromium <0.05 []V,Vanadi []Zn,Zinc 0.40 [ <1.0 <0.05 []Pheno []Total Dissolved Solids []Total Volatile. Solids []Suspended Solids []Volatile Sus-_ pended Solids []Hardness as.— CaC []Al ka inity as_ CaCO3 [] [] []Cu,Copper <0.05 []Fe,Iron 0.46 []Zr,Zirconium []Hg,Mercury <0.05 []Ammonia Nitrogen -N []K,Potassium 0.40 []Kjedahl Nitrogen -N []Mg,Magnesium 5.2 []Nitrate -N _ [ ]Mn ,Mangan ese <0.05 []Nitrite -N []MO,Molybdenum <O.05 []Phosphorus — (Ortho) -P []Na,Sodium 2.0 []Chloride — ... . _, zn nr flFluoride_ <0.05 — — [] * * []umhos Conductivity_-- — []pH Units []Turbidity NTU []Color Units [] .Coliform/100ml [] []