HomeMy WebLinkAboutDENALI VIEW BLK 2 LT 3
MUNICIPALITY OF ANCHORAGE
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
E~EW
MAILING ADDRESS
LEGAL DESCRIPTION
LOCATION
~ULT ~J ~
DISTANCE TO: Well
L ~.~.p~n gall ohs ~'~-
IF HOMEMADE:
DISTANCE TO: Well
= ~,~ i Manufacturer /~//Z]r
I DtSTANCE TO: Well
I No. of ~ines~ Len~ych line
I T°P °' ti'~ t° "n"h ~d~,d,~
[Length Cribdia~r /~
] DISTANCE TO: Well
~ /Class Depth .
i
IAbsorption are~ !
Inside I e ~,~j h/A
Dwelling
JPHONE5'~Z.- ,~o~
IDwelling Id lIN
Materi~..
Width
NO'OFB~i~.ROOMS
No. of comp,~ents
Liquid depth
PERMIT NO.
Material
Liquid capacity in gallons
[] UPGRADE
OTHER
PIPE MATERIALS
REMARKS
Fou n~,ion~
Depth
tile
EAST
Nearest lot I~) /
w~en lines
Total effective absor
PERMIT NO
Crib depth Total effective absorption area
Building foundation Nearest lot line
Driller Distance to lot line
Sewer line Septic tank
DATE
LEGAL
72-013 (Rev. 3/78)
DEPARTMENT OF HEALTH AND ENVIRONME"NTAL PROTECTION
8~25 L STREET, ANCHORAGE., AK 99501
264-4'720
F:'ERMI T NE]:
I)ATE ISSUED:
APF'L I CANT:
ADDRESS:
CONTACT PHONE:
84077.4
08/2'.28/84
C/O BOWEN CONSTR. ANNE L BROWN
3605 ARCTIC ~15'71
ANCHORAGE, AK 99503
26::;-5515
LEGAL DESCRIP:
LOT SIZE:
MAX BEDROOMS:
SUBDIVISION: DENALI VIEW
SECTION: 24 TOWNSHIP: 12N
405.1.2 (SQ. FT. OR ACRES)
4
LOT: :.T.. BLOCK: 2
RANGE: 3W
L. isted below are the options available to you. in designing yOLW' septic
· system. Choose the option that best ~its your site.
DEPTH TO PIF'E BOTTOM (FT.)
GRAVEL DEPTH (FT.)
'T'OTAL DEPT'H (FT.)
GRAVEL. WIDTH (F'¥.)
GRAVEL LENGTH (FT.)
GRAVEL VOLUME (CU. YDS. )
TANK SIZE (GALS)
SOIL RATING (SQ. FT./BR)
IF;". ItE~ N E'~ ~,-II :~:~ E::, .'iL~ ~1,~{~ .. :113, ~,". ~ ::.[. tNI
3.0 0.5 2.0
6.5 4.5 5 ,, 5
2.5 32,,0 5.0
2S8.0 -~.. 61.0 :2z.t.2.0 .*.~.
93.4 72.3 :I. :1.,~?. 1
1 .,, 250. () ** , 1 .,, 250.0 ** 1..,, ,?.50.0 ..~.*
· 431 324 431
** DEI-':'TH TO PIPE BOTTOM < 4.0 Frl". MAY REQUIRE A LIFT' STATIGN
** GRAVEL. LENGTH > '75 FT. REQUIRES MULTIPI_E RUNS (NOT EXCEEDING 75 FT. EACH)
** TAI)IK MUST HAVE AT I_L=~AST TWO COMPARTMENTS
I certi£y that:
1.. I am ~'ami],iar with the requirements ~or on-site sewers and wells as set
[o~th by the Municipality o[ Anchorage (MOA) and the State o~' Alaska.
2. I will install the system in accordance with all MOA c:ode~ and ~egulations,
and in comp].iance with the design cr'ite~ia o[ tills pePmit.
3. I will adher'e to all MOA and State of Alaska ~equi~ements for' the set back
distances i'r'om any existing well, wastewate~ disposal, system or' public
sewerage system on this or any adjacent, o~ near, by tot..
4. I undepstand that this per-mit is valid ~o~ a maximum o{ 4 bedr, ooms and
.any enlar'gement will ~equice an additional pe~mi'L.
IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUlL. DING CODES,
]"HEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED,,; (2) A!..]-BU]]LTS
WIL. L. NOT BE AF'F'ROVED WITHOUT AN ELECTRICAL INSPECTION REF'ORT; AND (3) THE
EL. ECTRICAI_ WORk I IUST BE DONE BY A LICEN.~ED LLECTRIE, IA~.
AF:'F'LICANT: C/O BOWEN CONSTR. ~AN~ L BROWN ~ .... ~.
ISSUED BY~ DATE:
Department of'~Health~and EnVironmental Protection ....... ' .... ~
8"~ L Street, Anchorage, AY 99501
--~"~ 264-4720 ,..--.
"it" WELL AND/OR ON-S~TE SEWER PERMIT {'t w~
ocation: Phone Nu er: 3
Legal Description: ~ ~ ~ ~~ ~~ Lot Size: /
Typ~ of Soil ~sor~tion System Is:
.'Trench: Drainfield: ~ Seepag~ Bed~ Holding Tank:;/~
Maximum N~ber of Bedrooms: ~ So~l Rating(sq.ft/br) ~/~
The Required Size of the Soil ~sorption System Is:
DEPTH F LENGTH __/7C GRAVEL DEPTH ~ WIDTH
The iength dimension is 'the Iength(in feet) of the trench or drainfieid. The
depth of a trench or pit is the distance between the surface of the ground and
the bottom of the excavation(in feet). There is no set width for trenches.
The gravei depth is the minim~ depth of gravei between the outfai1 pipe and
the bottom of the excavation(in feet).
~ ~ REQUIRED SEPTIC(~~ TANK SIZE = ' ~' /~OGALLONS '
~ermit appIicant has the responsibiIity to info~ this department during the
Lnstaiiation inspections of any weils adjacent to this property and the number
)f residences that the weii wiII serve.
~ ~ ~ TWO(2) INSPECTIONS ARE REQUIRED ~" '
,]a~kfiiiing of any system without finai inspection and approval, by this departm~
wilI be subject to prosecution.
~inimum distance between a well and any on-site sewage disposal system is 100 f~
for a private well or 150 to 200 feet from a public well depending upon the typ~
Df public well. Minimum distance from a private well to a private sewer line
is 25 feet and to a community sewer line is 75 feet. Well logs are required
and must be returned to this department within 30 days of the well completion.
3ther requirements may apply. Specifications and construction diagrams are
~vailable to insure proper installation.
" ' ' PERMIT EXPIRES DECEMBER 1 9
I certify that:
(1) I am familiar with the requirements fo.'on-site sewers and wells as
set forth by the Municipality of Anchorage.
(2) I will install the system in accordance with codes.
I understand that the on-site system may require enlargement if
remodeled
to
include more that ~-b~,drooms. .
(3) th~--eside"~ ~a sewer
ApplicantDate:
SWP/024(1/81)
[~/' SOl LS LOG
PERFORMED FOR:
LEGAL DESCRIPTION:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
17
18
19
20
COMMENTS
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
~' PERCOLATION
TEST
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
SLOPE SITE PLAN
.~_ c/y.l il'
!
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
, q
0
P
E
Gross Net Depth to Net
Reading Date Time Time Water Drop
i i '/ .~,'~ ~ /~ ,
~ ~:~,7 ID
+H~_O ..~: . q-_~ / , ~D
PERCOLATION RATE ~...~--~ (minutes/inch)
PERFORMED BY:
72-008 (6/79)
]~OX ~I~,...~TAR ]~OUTP- A A~CHORAGE, ALASKA
SIX INCH WATER WELL DRILLED AND CASED OUT TO THE DEPTH OF
DrillED at the rate of ~22o 00 PEr fOOt.
225 Fee~
PrOPErTY owner
LOCATION OF WELL SITE
DRILLER
WELL LOG: '
0 .... 16'
16---~0' ConqJ..o~e..
30---Z25' Be.d~oc.!c. A ,~ed.L,a.¢/~¢~ ,took.
7hX.,. ,:~.e.a~ o..~ ~a,te,,t, ~oa~,c,OW. g.,rana,t.~
~ ~ ~. B~ 200 ~ ~~~ ~
162-1~8 ~. ~o 189-193 ~. 7~ ¢ood
[ao~z ¢ood ~o~ ~ ~o= 210 ~ 218
boLL f,P~. To.t. ad. ~a,O~ p, ro~n. o.~ 3.5 f~'~. 7h~ ~.ou~ ~zzv~ Za.c~ea~e ta~.22~ u~a¢.
To,ta,L Co4,t, o,f, ,tAe 9ad. Ld.~q; ope, ta,t~n,: $22.00 pet ,f.,t, X 225 ~,t.: (14950.00
COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING.
WRITE CHECK PaYablE TO RAMPART DRILLING WORKS For THE SUM Of ~4950.00
THANK YOU VERY MUCH.
////JJ~ ///~)'J~ BERNIE CLAUS Of rampart DRILLING
WORKS
SERVICE CHARGEO-= 1Va% PER MONTH WILL BE ASSESSED ON PAST
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
Application Date
GENERAL INFORMATION
(a) Legal Description (include lot, block, subdivision, section, township, range)
Lot 3 Block 2 Denali View Subdivision
Location (address or directions)
(b) Applicant Name Peter Brown Telephone: Home Business
Applicant Address . 200 West 34 Avenue; Suite 547, Anchorage, Ala.~l~m 9950'~
(c) Applicant is (check one): Lending Institution [] ' Owner/builder F~X Buyer []; Other [] (expiain):
(d) Lending Institution
Address
Alaska Mutual Bank
Telephone 338-7890
(e) Real Estate Company and Agent
Address
Telephone
(f) Mail the HAA to the following address:
Geol__ab
1131 East 76th Avenue #101
Anchorage, Alaska 99507
TYPE OF RESIDENCE
Single-Family J~ Multi-Family []
Number of Bedrooms four(4)
Other
WATER SUPPLY
Individual Well [~[]~ Community [] Public []
Note: If community well system, must have written confirmation from the State Department o! Environmental
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
attesting to the legality and status.
Page 1 of 2
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 regulations in effect on
the date of this inspection.
Name of Firm Telephone
Address
Date
Engineer's Seal
This Department has received written confirmation from the engineer(Geolab)
regarding the conditional of November 11, 1984. This property now meets
with MOA requirements and ordinances and is approved.
DHEP APPROVAL . )
Approved for -.~--txA~ (¢.~_ bedrooms by __
Approved ~ Disapproved
Terms of Conditional Approval
Conditional
Date
CAUTION
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 engineer's work.
Page 2 of 2
72-025 (11/84)
6EOLAB,Inc
I 1 31 EAST 76TH AVENUE
SUITE ~ 101
ANCHORAGE, ALASKA 99502
August 27, ! 985
~07-344-6042
rluni cipa ! i ty of Anchorage
Department of Health and Environmental Protection
825 "L" Street
Anchorage, Alaska
Reference: Denali View Subdivision Lot 3 Block 2
Gentlemen:
A conditional Health Authority Approval was submitted to DHEP on November
19, 1984 for the subject property. The HAA was submitted pending
approval of the well by DEC/DHEP, since it was encased in a concrete utility
box with a sealed lid, and was below ground.
The well casing has now been extended to 18" above ground, and the concrete
utility box has been filled with soil, mounded above grade. The sanitary
seal is in place and the well pump wires are encased in conduit. The well
now meets the requirements of the DHEP and DEC.
We request that you grant the final approval. Please contact Dave Stanley at~/.
344-8042 when the approval is ready. . ,,.,~~
Thank You, ~, ,fi., ' / ' ,,~,~/
,.,,,
David A, Stanley, P.G.
President
Oeololllcal Consulting * Testing Laboratorg · Qualttg Control · Septic Sgstern Design & Inspection
6EOLAB,Inc
1151 EAST ?6TH AYENUE
SUITE # 10 I
ANCHORAGE. ALASKA 99502
g07-344-§042
August 19, 1
Plunicipelity of Anchorage
Department of Health and Environmental Protection
825 "L" Street
Anchorage, Alaska
~lOI.L,~3/Otdd 1VIN3WNOalAN~
~ HLIV3H .40 'Ia:K]
JJi~KJH~H¥ =lC) ,M41VdDINnW
Reference: Denalt View Subd Lot 3 Block 2 - Conditional Health Authority Approval
Oentlemen:
On November 26, 1984, an application for a Health Authority Approval was submitted to your
office for the subject property. A conditional approval was recommended pending approval of the
well casing installation. The well casing is located in the parking/driveway area of the lot, and
was installed slightly below ground, with the well hsad/sanitary eeo1 enclosed in e concrete utility
box with a sealed steel lid.
The area is graded, and is to be paved soon, so that all surface drainage is directed away from the
well. The property is one of the highest 1ets on Upper Huffmn Reed. There ere only four houses
uphill from the subject lot, and they are hundreds of feet from the property. In the unlikely event
that an overflow would occur from one of the four houses uphill, the effluent would have to cross
several topegraphic barriers to reach tho property. We feel that there is eeeentially no likelihood
of contamination.
In our opinion the well meets the intent of the regulation, if not the actual letter of the law. Please
issue the final Health Authority Approval. Should you have any questions regarding this matter,
please do not hesitate to contact us at 344-8042.
Sincerely,
David A. Stanley, P.O.
President
Geological Consultin~ · Testin~ LaboratorqJ · Oualit~ Control · SeDtte s~jstem I)esign & lnsj)ection
~~?-~:~!~'- HUNICIPALII"f OF ANCHORAGE
DIVISION OF ENVIRONMENTAL HEALTH
D~-HART~NT OF HEALTH AND ENVIRONMENTAL PROTECTION
1. General Information Application Date. ~ ~dV ~
(a) Lesal Description (include lot, block, subdivision, section, township, range)
Location (address ~r~ilrecttons) .
(b) Applicants Name_ .i9¢'~¢'~z- ~r~9~: Telephone- Home Business
(c) Applicant is (check one) Lending Institution r--~ ; Owner/builde~ [5~ ;
Buyer ~ ; Other F--~ (explain); ' '
Lending
Institution
Address
(e) Real Estate Co. & Agent
Address
Telephone
(f)"Mail the HAA to the following address:'
2...T..~pe of Residence
Single-Family,~, Multi-Family~--~
Number of Bedrooms ~
Other (describe)
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
0nsite .~. 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]
5. En~ineerin5 Firm Providin~ 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 M~nicipality of A~nchorage files and from my
investigation and inspection, the on-site water supply and/or wastewater disposal
system is in compliance with all Municipal and Sta~e codes, ordinances, and regula-
tions in effect on the date of this inspection.
Name of Firm ~ ~._ (2_3 ~.-~-/';.~ Telephone__.) ~/.~' (~ () lc,.
Address //~ / ~ ~157~' ~/~-~/. ,-y~c_~-~>~l~?,
---- ~ /~ ~ ~ ~ ~ I ~ I '~ -- ,
,
Approved __ Disapproved __ Condition~
/erms of Conditional Approval
CAUT ION
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. ~ MUNICIPALITY OF ANCHORAGE IS NOT RESPOS'SIBLE 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
D~PT, OF HEALTH &
ENVIRONMENTAL PROTECTION
ae
MUNICIPALITY OF ~%NCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
Legal Description:
Well Classification
Well Log P~esent (Y/N)
Total Dspth '~ ~.A~'-/~/ caSed to
Static Water Level L~ D ' Pump Set At
Casing Height Above Ground ~/~cO .c;~~c{
Etect=ical Wiring in Conduit (y/N)
Separation Distancss f~cm Well:
To Septic/Holding Tank on Lot ~'% ~. /
To Nearest Edge of Absorption Field on Lot
To Nearest Public Se~r Line
Cleancut/Manhole , A~
Water Sample Collected By
Water Sample Test Bssults
Cum=nts
NOV '19 "
RECEIVED
If A, B, c~ C, D.E.C. Approved(Y/N)
Date C~mple~d ~ '- ~~'~9'~ Yield
Depth of G~outing
Sanitary Seal on Casing (Y/N,),~S
Deu~ression A~ound Wellhead (Y/N)
; On Adjoining Lots ,'~,10~9
I .~ / ; On Adjoining Lots ),J OO/
To Nearest Public Sewer
To Nearest Sewer Service Line on LOt ~/~
Date
B. SEPTIC/HOLDING TANK DATA
Date 'Installed ~ 5~/- ~ size l~,,b'"~) NO. Cf Compartments
Standpipes (Y/N) ~/~% Air-tight Caps (Y/N) \~ Foundation Cleanout
Dep=ession over Tank (Y/N) ~ Date Last Pumped ~/'~
Pumping/Maintenanos Contract on File (Y/N)/O/~; fc~
Holding Tank High-Water ala=m (Y/N) t9/~ Temporary Holding Tank Permit {Y/N) ~/~
Separation Distances f=cm Septic/Holding Tank:
To Water-Supply Well % % ~
To P=operty Line ~O !
TO Water Main/Service Line
co Se
To Building Foundation ~ ~1
To Disposal Field ~ '
To Stream, Pond, Lake, c~ Major D~ainage
I
Comments
ABSORPTION FIELD DATA
Soils Rating in Absorption Strata ,_~
Date Installed ~ 5~-~ ~
Square Feet of Absorption A~ea
Depression over Field (Y/N) ~0
~~ Type of System Design
~en'g~f Field ~ Z!
Depth of Field .~.'
Gravel Bed Thickness ,1 ',(8"/5~20~j ~//~'.)
/
,,~-~ Standpipes P~esent ,.(..Y/N),
Date of Last Adequacy Test
Results of Last Adequacy Test ~7~ ~-~ ~7~c-~ ......... ...
Separation Distance f~cm Absc~ption Field:
To Water-Supply Wall .. I~ ! To P~operty Line > ~) !
To Building Foundation Z5t To Existing or Abandoned System cn
5ot~ ; On Adjoining Lots ~ I~)O !
To Water Main/Se=vice Line ../~,/~ To Cutbamk(if presg..nt)' .~,/~
To Stream/Pond/Lake/c~ Major D~ainage Course
To D~iveway, Pa~king A~ea, o~ Vehicle Stc~age A~ea ~ ~ !
Comments
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Ievel at
Tested for
Electrical Codes(Y/N)
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (..Y/N)
Pumping Cycles du~ing Adequacy Test.
Meets MOA
Cc~ments
** Check Permitted Bed~ocra Rating A~ainst HAA Request
I certify that I have checked, verified, o~ confc~med to all MOA HAA Guidelines
Signed %,/\/~'{ ~ Date //~/~ ~
KB1/dL/s
[Page 2 of 2]
in effect
2-15-84
HEMICAL & GrJOLOGICAL LABORATORIES OF ALASKA, INC.
,
5633 B Street
Drinking Water Analysis Report for Total Coliform Bacteria
TO BE COMPLETED BY WATER SUPPLIER/~/t:ttr 1>
WATER SYSTEM: (*) See h on back
I.D. NO.
Water System Name Phone No.
Mailin .~ldress
City State
Zip Code
SAMPLE DATE: ~ .I-~ [~l+l
Mo. Day Year
SAMPLE TYPE:
~Routine
[] Check Sample (for routine sample
with lab ref. no.
[] Special Purpose
! r-1 Treated Water
[] Untreated Water
TO BE COMPLETED BY LABORATORY
Analysis shows this Water SAMPLE to be:
Satisfactory
[] Unsatisfactory
[] Sample too long in transit; sample should
not be over 30 hours old at examination to
indicate reliable results. Please send new
sample via special delivery mail.
..,.,.c....,
Time Received /~:~ ~
Analytical Method:
1-] Fermentation Tube
/{~ Membrane Filter
SAMPLE
NO.
1
2
LOCATION
Time Collected
Collected By
Lab Ref. No. Result* Analyst
I r-T-]
I
I
· No of COlOme$/lO0 rnl or No of POSitive Dorbons
oe-122o (b)
Rev. 1983
BACTERIOLOGICAL WATER ANALYSIS RECORD
READ INSTRUCTIONS
BEFORE
COLLECTING SAM PLE
Membrane Filter:. Direct Count
Verification: LTB
Final Membrane Filter Results
Reported By , ~~~'--/'
BGB.
Coilformll00ml
TNTC = Too Numerous To Count
CoilformllOOml
Date ((~r-~~ '- %'~"'~
Time: ) ~d'~ ~,: a.m.