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Home My WebLink AboutDENALI VIEW BLK 2 LT 5 Municipality of Anchorage Page DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O, Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: .-~W~~3 PIDNumber: Name: Address: Phone: IN°'°'Be °ms: LEGAL DESCRIPTION Lot: Block: Subdivksion: Township: J Range: J Section: WELL: ~'tN ew [] Upgrade ClassificationP~ } ¢/~ T~---~(Private' A,B,C): I Total,,.,~., J ~ Depth: Ft. Jl Cased P~"~ To: Ft. Date E~rillgd: I Static Water Level: Driller: /~LP i /g ~- ¢¢/e/¢ ~... Il~;;~ Ft. IPump Set ,at:** Casinq Height Above Ground: Yield: /, GPM "j~, ~,",/O k~ Ft. ~ Ft. SEPARATION DISTANCES Wastewater System: ~/New [] Upgrade ABSORPTION FIELD I[] Deep Trench '~ShallowTrench [] Bed [] Mound []Other Soil Rating: Total Depth from original grade: /, ,,¢, GPD/~_~.. -""~- Depth to pipe bottom from original grede: Gravel depth beneath pipe Fill added above original grade: ~ "'~ / Ft. ;Gravel width: Ft. Total absorption area: ,~ ¢ SQ. Ft. installer: Gravellength: Number of lines: Distance between lines; Pipe material: S.$I ./-j 0 Pi'C,, Date installed: TANK [] Septic [] Holding ,~S.T.E,P, Capacity in gallons: TO Lift Holding From Tank Number of, ~rtments: Well- Iii) --- l~.~O ,~_~ Surface -'" LIFT STATION Water --"- Lot Size in gallons: J Manufacturer: Line ~ .... ./~ ~ ~ "Pump on" leveliiat "Pump,,~¢off"7~level/lat: Il High water ~"alarmy~"'atT Foundation Curtain Pump Make & Model Electrical Inspect ~s performed by: Drain Remarks: BENCH MARK Location and Description~..., ,.~- Inspections performed by: "~, -'~. Dates: 1st_ '_~/~/.'¢ f Department of Health and Human. Services approval Reviewed and approved by: . _ , Date: j__Z_-jO '~(;~ 72-013 (Rev 9/gl) MOA 25 Assumed Elevation: ENG NEER S~SEAL . ,,,.'" %", 4-INCH INSULA T/ON 5'-£" MIR 6'-0" M3 + Trench #! 1-1/4 PVC WITH 1/8" HOLES AT 50" MTO Trench l-1/4 PVC WITH i/$" HOLES A ? 30" 2 X 2 X 50 DRAINFIELD 2 FT TOTAL DEPTH 0.5 FT EFFECTIVE ROCK 5 FT COVER - AIRCOMPRE$SOR ~'~~-- - Il , , ,,, , +§ -4 ~ IIIII ~ , TRENCH ~DTTDM ROCK TOP ROCK ~ BIOCYCLE 6000 6 FT ~/A TER ND IMPER, IAYE£ LEGEND: I. PRIMARY TREATMENT, SEPTIC TANK 2. AERA T/ON TANK 5. CLAR/F/CATION TANK 4. DISCHARGE TANK 5. SOIL ABSORPTION 3ENCH MA£K~ TOP FZTUNOATIUN ASSUME? ELEV, /00,00 TOBBEN SPURKLAND P.E. 205 Wl5th Ave Anchora~ Ak 99501 3ID£YCLE ~/AS?£ ~/ATER SYSTEM WASTEWATER SYSTEM SCHEMAtiC DATE: AUG. 12, 1998 SHEET: OR/D: 2741 PERMIT ii S~/9800S3 PI? # 0/:-45/-/4 DNVO£O53.?~/: \ f'c 54 ~IALE; 1" : 50 FT, ~ ~ ~ENCH ~A~K; T~P FDUN~ATISH ASSUMED ELEV, ~00,00 FT TOBBEN SPURKLAND P.E. ~A~I VI~ ~0~ 2 ~0~ 5 SEPTIC SYSTEW AS BUILT 205 W 15TH. AVENUE SULTANA DRIVE DATE: AUG, 12, ~998 ANCH. AK. 99501 RICHARD ~ANTYLA SHEET: 2/5 GRID: ~74~ (907) 279-~916 Sent By: RESTDENTZAL MORTGAGE LLC; 907 222 8895; De0-9-98 9:51AM; Page 2/2 STATE OF ALASKA DEPARTMENT OF NATURAL RESOURCES '}IVI$1ON OF MINING & WATER MGMT WATER WELL RECORD LOCATION OF WELL BOROUOH 8uliOlVlSION LOT BLOCK &LOTION QTRS OEOTION TOWNSHIP RANOE MI~III~|AN ~ m ~N ~E LOCATIONISK~CH: WELL OWNER: ......... , ........ , ......... ,,,,, DEPTH~ M~SUREb FROM~c~sinO top ~(lround surface WELL DEPTH:~__~ DATE OF COMPL~ION ...................... D~pth of hoie: ~~ ft Materia~ Type and Color From To .......... ........ P~T Et below ~ top of casing D ground sudaco ~~ METHOD OF DRILLING: ~air rotary ~ cable toot '>~ USE OF WELL: ~Oo~**tic n irrigation n /."'~ ~" D public supply D other. WELL INTAK3 OPENING TYPE: ~ open end ~ screened ,,~ perforate~ ~open t~ole SCREEN TYPt:: Dlam: in, ........... Slot/Mesh Siz~: Length: ft GRAVEL PACK TYPE: ............. Volume us=d:, Depth to top: GROUT TYPf: umW', ~ D~F~I~D Depth: from fttO ft ....... .-.%~ ~ ~ ~ ~ ..... ;, .. D~ELOPMENT M~HOD: ~ ere ~ 1( q~ Duration: ~ PUMPING L~EL AND ~ELD: Municipality of A~ chorage ~ ~ft after ~ hfs pumping, ' PUMP INTAKE DEPTH: ft Horsepower: , ..... ,,- , WELL DISINFECTED UPON COMPLETION? '~ES ~ NO CONTRACTOR INFORMATIO~N: REMARKS; .,,~ ..... - ~ -. ~:~~' PLEASE MAIL WHITE COPY OF LOG TO: 3~gnatur0 of Authorized Respr~senta~e ..... ~ DNR/[~IVlSION OF MINING & WATER MGMT 3601 C St, Suite 800 ANCHORAGE AK 99503-5935 Phone [907)269-8639, Fax (907)562.1384 MUNICIPALITY OF ANCHORAGE DEP/~RTMENT OF HEi~LTH ~ HUMAi~ SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 PAGE 1 OF 1 ON-SITE WELL ~ WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUlVlBER:SW980053 DESIGN ENGINEER:TOBBEN SPURKLAND, P.E. OWNER NA/~iE:MILNTYLA RICH/LRD OWNER 15.DDRESS:8821 SULTANA DR DATE ISSUED: 4/07/98 EXPIRATION DATE: 4/07/99 PARCEL ID:01546114 LEGAL DESCRIPTION: DENALI VIEW BLK 2 LT LOT SIZE: 49512 (SQ. FT.) NLI~IBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERPIIT IS FOR THE CONSTRUCTION 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 AiN-D THE STATE OF /~LASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) A_ND DRINKING WATER REGULATIONS (18AJ~CS0). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AiN'D CLOSED ON THE SAME DAY B. COVERED, SEALED /LND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: I DATE: PAGE 1 OF 1 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:SW980053 DATE ISSUED: 4/07/98 DESIGN ENGINEER:TOBBEN SPURKLAND, P.E. EXPIRATION DATE: 4/07/99 OWNER NAME: W---~SDORF .~-LARIA':'- RICHARD MANTYLA OWNER ADDRESS :~LT~- CITY MORTGAGE ANCHORAGE, AK 99503 PARCEL ID:.4~~3\~-~[o\-\~ ~L DESCRIPTION: ~ DENALI VIEW BLK ~ LT 5 _ LOT SIZE: 49512 (SQ. FT.) ' O B D OO S: THIS THIS PE~IT IS FOR THE CONST~IONXOF: k DISPOSAL FIELD /SEPTIC TANK / W~L ~YSTEM~ ALL CONSTRUCTION M?T BE IN ACCORtN? WIT~: [ 1. THE ATTACHED APPROVED DESIGN. ~ k ~ 2. ALL REQUIREMENT~ SPECIFIED IN/ANC~GE MUNICIPAL CODE CH~ 15.55 AND 15.65 ~ND THE STAT~ OF ALAS~ WASTEW~ER DISPOS[ ~mSUnATIONS (~SmyT~> AND ~NKINS ~AT~ ~NS 3. THE ENGINEER MUST ~OTIF~HS AT LEAST PRIOR TO EACH INSPeCt. PROVIDE ~ BY CALLING 343-4744 ( ~4 HOURS ) AW~EH~S~ ~, ~ I F~%A~IO~ ../q]~o%t R~EQU~U~ FOR WELL ONLY 4. FROM OCTOBER 15 TO APRIL 1~ A [~S~R~A~S~IL ABSORPTION SYSTEM UNDER CO~ST~U~IO~DURING FREEZING WEATHER MUST BE EITH~ ~ ~ [ A. OPENED AND CLOSED~N ~E ~E DAY ~ ~ / ~. cow,sD, S~D ~%H~D TO P~WNT F~ZIN~ ~ 5. THE FOLLOWING S~ECI~ ~ROVISIONS. P OViSiO : _ S i~U~D ~Y: /2~~ DAT~: 203 W 15th. Avenue, Suite 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 SEPTIC SYSTEM DESIGN DENALI VIEW S/D LOT 5 BLOCK 2 Municipality of Anchorage Department of Health and Social Services 820 1 Street Anchorage, Alaska 99501 March 13, 1998 We are submitting an application for the installation of a well and septic system for this lot. The submittal consists of three (3) drawings showing the present improvements on the lot and the adjoining properties, (sheet 1/3), the proposed improvements of the lot, of which only the well and septic system are subject to this permit application, (sheet 2/3), and a schematic of the septic system, (sheet 3/3). Soil logs and percolation tests of applicable testholes are also enclosed. The septic system design is based on the following: Due to the low permeability and presence of groundwater at 13 feet a BioCycle unit is preferred. The shallow soil has a percolation rate of 20 minutes per inch, allowing a loading rate of 1.2 gallons per square foot. The ground slope is less than 10% at the location of the two testholes. No Ground Water or Impervious Layer to 13 ft. Use Standard 5 Wide Trench Soil Rating. 1.2 gal per square foot per day No. of Bedrooms 4 Required Area per Bedroom: 150/1.2 = 125 sq.ft.. Total area required: 125 x 4 = 500 square feet Total Trench Length 500 / 5 = 100 ft. Use 2 trenches at 50 ft. each SYSTEM CONFIGURATION BIOCYCLE STANDARD TRENCH TOTAL LENGTH 2 x 50 FT TOTAL WIDTH 5 FT TOTAL DEPTH ~ FT ROCK DEPTH 0.5 FT COVER FT fl, MAR 1 The installation of this septic system will not prevent wells from being installed on the adjacent lots. There are no developed or natural surface / sub surface drainage courses on this or the adjacent lots. The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. U/V£PE VEL OPEP 0 ~00 ~50 £00 £50 $00 LL~I ~ £CZLE; 1" : ]00 FT. TOBBEN SPURKLAND P.E. 205 14/ 15TH. AVENUE ANCH. AK. 9950! (907) 279-5916 I J DENALI VIEW BLOCK 2 LOT 5 SULTANA DRIVE R/CHARD MANTYLA SEPTIC SYSTEM DES/ON DATE: MARCH ZS, I998 SHEET; 1/5 GRID: £74i PE£PIIT fi: S~/98XXX PIP fi: XX PNVO£OSJ,D~/6 ~5 0 ~5 50 75 SCALE: /" = 5fl TOBBEH SPURKLAND P.E. DENALI VIE~ BLOCK 2 LOT 5 SEPnC SYSTEW DES/ON 20~ ~ ~STH, AVENUE SULTANA DRIVE DARE: WARCH ~, ~998 AHCH. AK. 9950~ R/CHARD WANTYLA SHEE[: 2~ OR/D: ~74~ 4-INCH /NSULA T/ON I-I~4 PVC WITH I/8" HOLES Ar 50" WTO I-1/4 PVC WITH 1/8" HOLES A T $0" MT(Z) 2 X 2 X 50 DRAINFIELD 2 FT TOTAL DEPTH 0.5 FT EFFECTIVE ROCK V 5 FT COVER / AIRCOIWPRESSOR ~ ~ ~+ SILT BARRIER 6 F7 B/OCYCLE 6000 h PR/WARY [REA T WEN[, SEPtiC TANK 2. AERA 7ION TANK ~. CLAR/F/CA T/ON TANK ~'~~-~ QZ 4. D/SCHAROE TANK TOBBm SPURKLAND P.E. ?E~AL/ V/E~ SIP ?X 2 L~7 5 ~ASTEWA~ER SYSTEWSCHEWATIC 205 Wl5th Ave DATE: ~ARCH 15, 1998 AnchomQe Ak 99501 ~IDCYCLE ~ASTE ~ATE~ SYSTEM 279-~9 TE SHEET: 5~5 GRID: 274 PERMIT ~ sw~sxxx PI? ff ?NVO2053,?~: T/-t Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG ~ PERCOLATION TEST t (ENGINEER'S SEAL) 2 4 5 7 9 10 12 13 14 20 WO(.~.. '~%1 ( ¢~, DATE PERFORMED: Township, Range, Section: DISCLAIHFR: Grmundwater Past and future presence from these observations. N/IF-W/ SLOPE 81TE PLAN WAS GROUND WATER ENCOUNTERED? S L IF YES, AT WHAT O DEPTH? p E Depth to Water Alter Monitoring? Oate: __ ~ Date Gross Net Depth to Net ,, t=ii,~ k, Time Time Water Drop _ qY'~ iz.l~l,~ I: ~- _ PERCOLATION RATE ~ (minutes/inch) PERC HOLE DIAMETER b TEST RUN BETWEEN 3 FT AND ~ FT conditions indicated are for the dates shown only. and/or depth of groundwater can not be predicted PERFORMED BY: ~ ~ I ~.. ~ ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE', 72-008 (Rev. 4/85} CERTIFY THAT THIS TEST WAS PERFORMED IN DATE: J ~/~'Z../~,T)r:.t.. UAR 1 6 1991J Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG --- PERCOLATION TEST 5 9 10 11 12 13 14 15 16 1';' 18 19 20 DISCLAIMFR: Grmundwater Past and future presence from these obsej~_vat]ons. Township, Range, Section: SLOPE WAS GROUND WATER ENCOUNTERED? S IF YES, ATWHAT .~, ,.-~ OL DEPTH? ,~ __ p E / Depth to Water Alter I~onitorino? / ~ Dale://///' __~__ _'7 SITE PLAN Reading Date Gross Net Depth to Net ~C/A ~ Time Time Water Drop PERCOLATION RATE ~.,'~ (m,nutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN 3 FT AND ~ Y~' FT conditions indicated are for the dates shown only. and/or depth of groundwater can not be predicted ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE 72-008 (Rev. 4/85) CERTIFY THAT THIS.TEST WAS PERFORMED IN DATE: I\/T.q PROPERTY OWNER AGREEMENT FOR TR'F, MAINTENANCE OF AN ON-SITE WASTEWATER DISPOSAL SYSTEM This agreement, dated ,~fo"C-~ } ~ 199~ is made between the Munic'- Anchorage Department of ~lealth and Human Services ('DHHS) and the prope~yal~ty of owner(s) of: This agreement is made for the purpose of maintaJnin~g an on-site wastewater disposal system on the subject property. The property owners agree to th, e following: Submit to the Municipality of Anchorage, on an annual basis, an inspection and operation statement from a registered professional engineer. This inspection and operation statement shall verify that the engineer has inspected all effluent and air pumps, timers, and alarms, and that any deficiencies have been repaired and that the system is functioning as designed. (Signature) (Printed Name) Notarize Here State ,of £~lf~ On this ~ day of f](~j ~10~ ~~1~/~ personally appeared before~ - ~ me, who t~ personally kno~ to me ~ whose identity I proved on the bas:is of whose identi,~y (Printed Name) the aboy~ document· I provdd on the bath/aff±rmat±on of · a ~'ced±ble witness and he/she acknowledged that he/she signed it. My commission expires (Signature) , 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 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # Ol.-.~ -- q&~i- iz~ HAA # 1. GENERAL INFORMATION Complete legal description Location (site address or directions) Property owner Mailing address Lending agency Mailing address Day phone Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: NOTE: Individual well 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 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. ~1,'? ~ ,"5 ,? i~. Name of Firm } -,¢ ~,~ ~,) ,~ ,4 ~ ~ ~ . ~ Phone '~ Address ,¢.-~ ':~ i.~/ 16' ~ ~- 7_.,~ ':,~ = Engineer's signature DHHS SIGNATURE · /~' Approved for ¢ Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments 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, 72-025 (Rev. 1/91) Back MOA~¢21 Municipality of Anchorage E C 5IV 999 E D DEPARTMENT OF HEALTH & HUMAN SERVlCESApR Environmental Services Division 825 L Street, Room 502 · Anchorage, Alaska 99501 · (90/~TJ~?4~'ANCHoRAGE ENVIRONMENTAL SERVICES DIVISION Health Authority Approval Checklist Legal Description: l.o"r ~ ~v, ~ ~IEIV~,L! \/t~.-~¢" Parcel I.D.: A. WELL DATA W~II type Log present (Y/N) y Total depth Sanitary seal (Y/N) FROM WELL LOG If A, B, or C, attach ADEC letter. ADEC water system number Date completed Cased to ,~2 C) J Casing height (above ground) Wires properly protected (Y/N) AT INSPECTION Date of test Static water level Well production g.p.m. g.p.m. WATER.SAMPLE RESULTS: Coliform Date of sample: Nitrate O~ {~ 5 I v~/~/ Other bacteria Collected by: '~- --~ B. SEPTIC/HOLDING TANK DATA Date installed ~//3 Foundation cleanout (Y/N) Date of Pumping Tank size /Z,~:~ Number of Compartments L{ Cleanouts (Y/N) . y' Depression (Y/N) IN. High water alarm (Y/N) Pumper Cm ABSORPTION FIELD DATA Date installed S/Z'/~',~ Length 1~¢:) I Width Effective absorption area ;~crr, p Date of adequacy test I',///~. Fluid depth in absorption field before test (in.); Fluid depth ~ (ins) Minutes later: Peroxide treatment (past 12 months) (Y/N) Soil rating (g.p.d./fF ~er-.ft~bm) !, ~- System type Gravel thickness below pipe ~/! Total depth .~,~,~ Monitoring Tube present (Y/N)__~_~ Depression over field (Y/N) Results (Pass/Fail) ~' For Immediately after ~/gal. water added (in.): Absorption rate = ~ .g.p.d. If yes, give date bedrooms 72-026 (Rev. 3/96)* LIFT STATION Date installed Y~/*,~' Manhole/Access (Y/N) y High water alarm level at* Cycles tested Size in gallo.ns "Pump on" level at* *Datum "Pump off" level at* E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer/septic service line I ! I:> ~ On adjacent lots ! ~::~ I On adjacent lots Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: t Foundation ,.?, .3, Property line '~,-~ Absorption field Water main/service line ) 7,.~ Surface water/drainage I,~ ~ c) Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line J D Surface water t'J, ~ c, Curtain drain ~"~ ! C~ Building foundation ~ ~ Water main/service line Driveway, parking/vehicle storage area Wells on adjacent lots ~' I ~ F. ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal in conformance with MOA HAA guidelines in effect on this date. Signature ~ ~ Engineer's Name i-~,';, ~1~ ~ ~ ~u v I,~Ll ~ ¢J~ HAA Fee $. 'Date of Payment Receipt Number 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number APR'16--99 09:05 FROM'CTE ENVIRONMENTAL Zt~m~ C T&E Envi.o,, men,al Service~ Inc. T-ON P,02/O~ P-822 CT&E Rel'.~ Client Name Project Name/~ Client Sample ID Matrix Ordered By PWSm 991530001 Tobben Spurld~d De.ali View Denali View Drinking Wa~er Sample Rew. srks: Client PO# Pre-Paid Colis/NO3 Printed Date/Time 04/15/09 16:57 Collected Date/Time 04/13/90 1ti: 15 Received I)ate/Time 04/13/99 10:.o5 Technical Director; Stephen C. Ede EP300 Nitrate: Mer3od blank was d~r, ctable for nitrate (0.616rog/L). Sample dap and spflce met the acceptance criteria, no further action ~aken. Atlowable Prep Total cotiform 0 cot/lOgmL $M18 92228 04/15/99 I(AP Hi~ra~e-H 0.S51 0.500 mg/L EPA 300.0 10 max 04/15/99 0~/13/99 SCL