HomeMy WebLinkAboutEAGLE RIVER MID HEIGHTS BLK 4A LT 5AEagle River
Mid -Heights
Block 4A
Lot 5A
#050-271-55
GRAB H° -I GR" TER ANCHORAGE AREA BOROLIAH
HEALTH DEPARTMENT
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME / /r �L I�i � �t�/i.�T /� C ` MAILING jj�� �» �.. l Al -ell ;212 7
ADDRESS / I S �� �i�jCTL PHONE
LOCATION LEGAL DESCRIPTION�C/ �fl/_ Nlk CfZee�ACLr'K/t;t'/'
SEPTIC TANK:
/11Th iyi� � i%6D,
NUMBER OF
DISTANCE FROM WELL MATERIAL •�%%Z`L COMPARTMENTS
LIQUID CAPACITY 1 GALLONS. INSIDE LENGTH Z—" ( INSIDE WIDTH r DEEPTHD
SEEPAGE SYSTEM:
SEEPAGE PIT:
NUMBER OF PITS � -OUTSIDE DIAMETER i OR WIDTH, LENGTH / , DEPTH_ ,
LINING MATERIAL LL C . DISTANCE FROM WELL S BUILDING FOUNDATION4�*,
NEAREST LOT LINE `ZG f- TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) T� T4_ SQ. FT.
TILE DRAIN FIELD:
TOTAL LENGTH
DISTANCE FROM WELL FOUNDATION LOT LINE -.LINES
NUMBER OF INES DISTANCE B TRENCH N. TOTAL EFFECTIVE
ABSORPTION AREA SQ. FT. LENGTH OF EACH LINE
DEPTH: TOP OFF� TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE
WELL: Xe'-'Arel)/«r2 DISTANCE FROM / WATER
TYPE , DEPTH , BUILDING FOUNDATION. lD fi- SAMPLE NEAREST
C NEAREST SEPTIC SEEPAGE / _ OTHER
LOT LINE �a f' SEWER LINE , TANK �b SYSTEM, CESSPOOL SOURCES_
DISTANCES:
7 e; _-
v
2ST
r-�C7J=/�o'
`L/
T) Lf7
DIAGRAM OF SYSTEM
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DATE 6 APPROVED
HEALTH AUTHORITY
GAAB11D_2- - GREATEN. ,ANCHORAGE AREA )ROUGH Case No.
HEALTH DEPARTMENT
327 Eagle St. Anchorage, Alaska 99501 279-2511
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
p 9,.A-29sS/r, i70a�
NAME OF APPLICANT MAILING ADDRESS 41, gtwee PHONE NOe,�y--Z Z.Z7
G� Jr -1214- ATION OF INSTALLATION /34S f,, f
RESIDENCE ADDRESS %�.,� ,Z„�S��.c_ � � �a �L—
NFt6AL DESCRIPTION 4e 7" %y sl- Ar i Ale jsA SJ'
APPLICATION TO INSTALL: SEPTIC TANK' _, SEEPAGE PITS_ , DRAIN FIELD , OTHER
TO SERVE THE FOLLOWING FACILITY ze )�Oo x rc}: l
FINANCED THROUGH
TO BE INSTALLED BY
PERCOLATION TEST RESULTS AAJJ' L nri- ANTICIPATED DATE OF COMPLETIONS
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
THIS IS TO SERVE AS /— PERMIT TO INSTALL A —�•��• 5 *�� B
AS✓DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED
�rr,-j. � �Y! r
SEPTIC TANK SIZE TYPE Si°�f SEEPAGE AREA x !yX ? TYPE
/C•-�.� M<►�� DIAGRAM OF SYSTEM
DISTANCES:
s-7 �t - u''c!/
/Li.� ..t. -.j so
. =nom
T.I�k -
eo
-SC71 11741,7
Health Authority
9
I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the
above described system is in accordance with said code.
DATE APPLICANTS SIGNATURES >G /s
r
TREATER ANCHORAGE AREA BOROUGH
HEALTH DEPARTMENT CASE 4
327 EAGLE STREET
ANCHORAGE, ALASKA 99501
Performed For a.11 N e n A r( e k s n el Date Performed H
Legal Description: Loth Block__,6'�ubdivisionPr Hos.
This Form Reports a: Soils Log ercolation est
Depth
Feet Soil Characteristics
The cealvne'fs were
1 itanf Ir. 16 PIS c G,
(-nfenl. Tire 50A W15
3 COWiIpGt,i With e. low
;r o,SYLA'e ",IIen'�.
() en
s�
Was Ground Water Encountered? / 0
If Yes, At What Depth
Location Sketch
Reading Date
Gross Time Net Time
Depth To H2O Net Drop
erco a .ion a e
Minute
-
Proposed Installattiio�n:�Seepage Pit � Drain field
Depth Of Inlet � -' y , Deptn To Bottom Of Pit Or Trench /,�
COMMENTS:rn r, 1 5 -1 13 r /l
Test Performed BS:
Data Certified By:r_
Date.
N
Ter#ifirb �riiiing Klug
LN
DOC Co. 003
SULLIVAN WATER WELLS
P.O. BOX 670272, CHUG IAK,ALASKA 99567 • TELEPHONE696-2759
OWNER OF LAND OIRR:E_ -'Irak-14 IIEI'TH OF %ELL /(p( .Q 1/TC
ADDRESS STATICLEVEL OF %ATLR F7.
LEGAL DESCRIPTIONi -S %� /�4 �._srtfv r/`rI RAW DOWN FT.
DATE. • Started Ended GALS. PER IIR go, c,
PERMIT NUMBER __ KIND OF CASINO �$n-�
KIND OF FORMATION
From
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MISCL INFORMATION:
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DRILLER'S NAME
L'd 69LZ 1389 L06 SII9M /e1eM UBAIIInS d0L Z0 60 LI ADN
rl Li r -A I ij- 3 FIL-I -VR-e C-3 F= F=1 r-4 IZ-- I _J F;,> n 1:1 E= -
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PkOTECTION
825 �L' STREET ANCHORAGE, AK. 99501.
264-4720
14 [-= L_ L_ F='I= f;? rl I _r
PERMIT NO. ( 780977 )
APPLICANT
LEE SULLIVAN BOX 197 E. F'
99577
694 25SE:
LOCATION
BAFFIN ST (NR LINE)
LEGAL
L-5 B -4A E. R. MID HTS S/D
LOT SIZE
20066 SQUARE FEET
MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM Is
100 FEET FOR A PRIVATE WELL; OR
150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL.
WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS
OF THE WELL COMPLETION,
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
F=8 EE fz;-'M I _1F E= X Fz' I F;Z E: =• ED, F= C,- I -E M B I=- FR A '
I CERTIFY THAT
i: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: 1 WILL,.TNSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
S I GNED --------
TPPLICANT LEE SULLIVAN
ISSUED
OQAG �" r7 () 12 U. LJ ' 1 GJ2Yi�
4 TTL% E EW
3`
sC7 GREATER ANCHORAGE AREA BOROUGH
V Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 274-4561
v Date Received April 29, 1976
Time of Inspection In"'�n)OLLL
K r��
Date of Inspection
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES.
FOR
1. Approval requested by:
Mailing Address:
2. Property Owner:
F.H.A.
Coast Mortgage Company
Post Office Box 1200, 99510
William L. Welch
Phone: 279-0665
Phone: 694-9117
Mailing Address:
Box 948,
Eagle
River 99577
3. Legal Description:
Lot 5
Block
4A Eagle River Mid Heights Subdivision
4. Location:
Off Eagle River Road
5. Type of facility to be inspected Single Family No. of bedrooms
6. Well Data: Individul
A. Type OAOdlep
C. Construction S /)f kDr4TQD•
B. Depth / Z
D. Bacterial Analysis
7. Sewage Disposal System: On-site system
A. Installed //'5 /,70 B. Installer
C. Septic Tank: 1. Size 110c) 2. Manufacturer? S Tc c4
D. Seepage Pit: 1 Absorption Area (9 j / 2. Material
E. Disposal Field: Total length of lines 9 3 f4 e /.; rw G
8. Distances:
A. Well to: Septic tank 70� Absorption area Q/ 5 Sewer Lines ,
Nearest lot line /D f Other contamination
le
B. Foundation to septic tank l , Absorption area
C. Absorption area to nearest lot line
EQ -034 (1/74) Page 1 of two pages
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C" Street, Anchorage, Alaska 99503 — 274-4561
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER and WATER FACILITIES
1. Type of Inspection: CMRO VA FHA xxxxx CONV
2. Property Owner: William L. Welch
Mailing Address: Box 948, Eagle River AK Day Phone 69LL-9117
3. Name of Buyer: Michael A. Finch
Mailing Address: Box 9 16,Eagle River Day Phone 694 99h7
4. Name of Lending Institution: Coast Mortgage Co.
Mailing Address: P. 0. Box 1200, Anchorage, AK Phone 279 0665
5. Name of Realtor or Agent: Cloyd Mosier
Mailing Address: 14446 Business Park Blvd., Anchorage Phone 2714 3556
6. Legal Description: Lot 5. Block 4A. Eagle River Mid Heights Subdivision
Location: Off Eagle River Road
7. Type of Facility to be inspected: Single family No. Bdrms. 1r
8. Water Supply
Type of Supply: Public Utility
If Individual, number of dwellings presently served
If Individual, depth of well
9. Sewage Disposal System
Type of System: Public Utility
If Individual, date of installation
EQ -037 W74)
Individual xxxxx
Individual (on-site) xxxxx
Page 2 of two pages - Re, st for Approval of Individual r or & Water Facilities
\
Legal Description Lot 5 Block 4A EagleRiver Mid Heights Subdivision
Comments Fl/ �f(orig} T T 70 c/li!�
C� (t 4 h PC I?G) v A -J- OAK) o A-) tc !_'
Approved FAId Disapproved Date ,eW
Approv Valid for one year from date signed
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
I certify that the information contained in this request for approval to be a true and
accurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED Date
EQ -034 (1/74)
REQU ST FOR APPROVAL OF
INDIVIDUAL SEWAGE AND WATER FACILITIES
(Fill out in Triplicate),'
'tame of person requesting approval
2.� Name of property owner
3. Legal descriptio;
4. Number,of bedrooms in house
5. Water.AnalySis:
s
a. Bacterial Gtfd`t ! .�
b. Detergent
6, Well data:
a. Type e
1, 3�g
b. Depth
c. Casing Size 61 ✓ ��� l��
d. Distance from well to closest existing or propose p
1. Sewer line 56 f- ,/
2. Septic tank '7� /
3. Seepage Area �� J
4. Cesspool' /
5. Property Line_-& 1-74- 1-/
6. Other sources of possible contamination, i.e., creeks, lakes,
houses, barn, drainage ditch, etc.
7. Sewage disposal system.
a. Age of system
b. Septic tank capacity in gallons
c. Name of septic tank manufacturer"�/� / ✓
1. If "home made" show diagram on reverse side of this form.
r
d: Disposal field or seepage pit size and type Au dw
� , X99 , /
1. Distance to property, line house foundation
n
e. Percolation Test 'results
f. Percolation Test performed by
Use the reverse.side of this form to show diagram. Diagram should include
he following information: property lines; -well location, house location,
septic tank location, disposal area location, location of percolation test,
and direction of ground slope.
9. The Information on this form is true and correct to the best of my knowledge.
S €nature of Applicant Date Signed
w
TO BE FILLED OUT BY HEALTH DEPAF.TVENT PERSONNEL
r
e above described sanitary facilities are hereby approved, subject to the
following conditions.
Conditions:
0
The above described sanitary facilities are disapproved for the following
reasons:
r
r
S4:gnature of f!_.. icial> Date �• �,r, ::,'r "f
Approval is valid for one year following the date of approval.
CPJ:cw
REPORT OF INSPECTION -INDIVIDUAL SEWAGE -DISPOSAL SYSTEM
PRIMARY TREATMENT consists of ❑ Septic tank. ❑ Cesspool.
Septic Tank:
Distance from well, feet. Material, Number of compartments
Total liquid capacity, gallons. Capacity inlet compartment, gallons.
Inside length, feet. Inside width, feet. Liquid depth, feet.
cesspool:
Distance from: Well, feet-, foundation, feet; nearest lot line at ❑ front, ❑ side, ❑ rear, feet.
Inside diameter, feet. Depth, feet. Liquid capacity, gallons. Lining material
SECONDARY TREATMENT consists of ❑ Tile disposal field. ❑ Seepage pits. Other
Tile Disposal Field:
Distance from: Well, feet; foundation, feet; nearest lot line at ❑ front, ❑ side, ❑ rear, feet.
Total length of tile lines, feet. Number of lines, . Distance between lines, feet.
Trench width, inches. Total effective absorption area in bottom of trenches, square feet.
Length of each line, feet. Depth, top of tile to finish grade, inches.
Type of filter material: ❑ Gravel. ❑ Broken stone. Other
Depth of filter material beneath tile, inches. Depth of filter material over tile, inches.
Seepage Pits:
Number of pits . Outside diameter, feet. Depth, feet. Lining material
Distance from: Well, feet; building foundation, feet; nearest lot line at ❑ front, ❑ side, ❑ rear, feet.
Inspection made by: ❑ State. ❑ County. ❑ Local Health Authority.
Inspected
Date of inspection , 19_
REPORT OF INSPECTION -INDIVIDUAL WATER -SUPPLY SYSTEM
Distance to nearest public water main, --feet. Size of main, inches.
Individual wells ❑ are ❑ are not customary in neighborhood.
Give most recent record of failure of wells in immediate vicinity to furnish adequate supply of water
Properties in neighborhood ❑ are ❑ are not being developed with both individual water -supply and sewage -disposal systems.
Lot size: feet wide, feet deep. Dwelling set back from front property line, feet.
Individual water supply from: ❑ Drilled well. ❑ Driven well. ❑ Dug well. ❑ Bored well.
Distance of well from:
Building foundation, feet; nearest lot line at ❑ front, ❑ side, ❑ rear, feet,
cast iron sewer, feet; the sewer, feet septic tank, feet-, disposal field, feet;
seepage pit, feet; cesspool, feet; other sources of possible pollution, feet.
Well construction:
Diameter, inches. Total depth, feet. Type of casing, Depth of casing, feet.
Approximate depth to pumping level of water in well, feet. Approximate yield, gallons per minute.
Sealed watertight to depth of feet.
Exterior space around casing sealed with: ❑ Cement grout. ❑ Puddled clay. ❑ Ordinary backfill.
Well cover: ❑ Concrete. ❑ Wood. ❑ Metal. Openings in well cover watertight: ❑ Yes. ❑ No.
Pump: ❑ Shallow well. ❑ Deep well. Length of drop pipe, feet. Pump capacity, gallons per minute.
Located in: ❑ Basement. ❑ Pumproom off basement. ❑ Pumphouse above ground. ❑ Pump pit.
Pumproom properly drained: ❑ Yes. ❑ No. Pump mounting watertight: ❑ Yes. ❑ No.
Type of storage: ❑ Pressure. ❑ Gravity. Capacity, gallons.
Has bacteriological examination of water been made? ❑ Yes. ❑ No. If answer is "yes," give date_
Quality of water ❑ is ❑ is not satisfactory for human consumption.
Installation ❑ does ❑ does not comply with approved exhibits, if any.
Inspection made by: ❑ State. ❑ County. ❑ Local Health Authority.
Inspected by
Date of inspection
19—
* U. S. GOVERNMENT PRINTING OFFICE : 1957 O -F-427059
19
aa�wr ►�fsr�.d
Municipality of Anchorage
• Development Services Department **I
Building Safety Division
Onsite 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
Parcel I.D. 050-271-55 COSA #MQ
Expiration Date: /O
1. GENERAL INFORMATION
Complete legal description Eagle River Mid -Heights Block 4A, Lot 5A
Location (site address) 10125 Baffin Street, Engle River, AK 99577
Current Property owner(s) Brian Sr
Tanice Raisanen
Day phone 907-315-1293
Mailing address PO Box 876258, Wasilla,
AK 99687
Lending agency
Day phone
Mailing address
Real Estate Agent
Day phone
Mailing Address
Unless otherwise requested, COSA will
be held by DSD for pickup.
2. NUMBER OF BEDROOMS:
4
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
®
Individual On-site
❑
Individual Water Storage
❑
Individual Holding Tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
❑
Public Sewer
19
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, 1 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 ARCTF,RRA CONSULTING INC. Phone 868-3792
Address 20441 PTARMIGAN BLVD., EAGLE RIVER AK 99577
Engineer's Printed Name KENNETII M. DUFFUS Date _ 11/24/2009
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 .� OF q 01
system will function satisfactory for current or future ,`Q��.••••••••�;4s+�81
occupants or can ArcTerra guarantee that no unseen .. g ..•'•.?, #
encroachments, deficiencies or discrepancies exist i * �'dotu : a 4.
5. DSD SIGNATURE
Approved for bedrooms.
Disapproved.
Conditional approval for
bedrooms, with the following stipulations:
Auacnments:
COSA Checklist X
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
By: Original Certificate Date. Z Q
m. „A
Municipality of Anchorage
• Development Services Department
i Building Safety Division `
Onsite 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: Eagle River Mid -Heights Block 4A, Lot SA Parcel ID: 050-271-55
A. WELL DATA
Well type PRIVATE If A, B, or C provide PWSID #= Well Log (Y/N) Y
Date completed I 978 Sanitary seal (YIN))( Wires property protected (YM) Y
Total depth 161.75 ft. Cased to161.75 ft. Casing height (above ground) 12+ in.
FROM WELL LOG
Date of test • 10/78
Static water level 120 ft.
Well production 30 g.p.m.
WATER SAMPLE RESULTS:
AT INSPECTION
1111 N/09
123ft.
6.4 g.p.m.
Coliform 0 colonies/100mL Nitrate 2.55 mg/L Other bacteria 0 colonies/100 mL
Arsenic: NO mgA , Date of sample: 11/1.V2009 Collected by. ArcTerra.
B. SEPTIC/HOLDING TANK DATA -PUBLIC SEWER
Tank Type/Material _ Date Installed Tank size_ gal. Number of Compartments_
Cleanouts,(Y/N) _Foundation cleanout (YM) _Depression over tank (Y/N)
High water alarm (YIN) _Date of pumping Pumper
C. ABSORPTION'FIELDDATA— PUBLIC SEWER
Date installed Soil rating (g.p.d./ft2 or fe/bdrm) System type
Length — ft. Width _ ft. Gravel below pipe _ft. Total depth _ ft. (bottom of effective)
Eff. absorption area _flz Monitoring tube _Depression over field
Date of adequacy
Results (Pass/Fail) _ For _ bedrooms
Fluid depth in absorption field before test _ in. Water added_ gal. New depth _in.
Elapsed Time: _ min. Final fluid depth _ in. Absorption rate >=
Any rejuvenation treatment (past 12 mo.) (Y/N & type) _If yes, give date _
M
D. LIFT STATION —PUBLIC SEWER
Date installed
'Pump on' level at _in.
Datum
E. SEPARATION DISTANCES
Size in gallons Manhole/Access (YIN)
'Pump off level at _in. High water alarm level at _in.
Cycles tested Meets alarm & circuit requirements?
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot NA
Absorption field on lot NA
Public sewer main •50'+
Sewer /septic service line 101+
Animal containment areas 50'+
On adjacent lots 100'+
On adjacent lots 100'+
Public sewer manholetcleanout 100'+
Holding tank NA
Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: — PUBLIC SEWER
Building foundation Property line
Absorption field
Water main Water service line Surface water
Wells on adjacent lots
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: — PUBLIC SEWER
Property line Building foundation Water main
Water Service line Surface water. Driveway, parking/vehicle storage
Curtain drain Wells on adjacent lots
F. COMMENTS
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 KENNETH M. DUFFUS
Date 11/23/2009
COSA Fee $490.00
Date of Payment 1I L 0 q
Receipt Number_ 05550L
(Rev. 11/05)
Waiver Fee $
Date of Payment
Receipt Number
OF At 411 t
Kannal M •,/!us .4�,
SGS ReEN
1096211001
Client Tame
ArcTerra Engineering and Surveying
Project Name/M
E.R. Mid IIts B4A,L5A
Client Sample ID
E.R. Mid tits B4A,L5A
Matrix
Drinking Water
Sample Remarks:
Parameter
Results
PQL
(<10)
11/16/09 11/19/09
NRB
Metals by ICP/MS
SM204500NO3-F
B
Arsenic
ND
5.00
Waters Department
Total Nitrate/Nitrite-N
2.55
0.100
Microbiology Laboratory
Colony Count 0
Total Coliform 0
Fecal Coliform 0
Printed Date/time
Collected Date/time
Received Date/time
Technical Director
11/20/2009 15:31
11/13/2009 14:30
11/13/2009 15:50
Stephen C. Ede
Allowable Prep Analysis
Units Method Contamcr ID Limits Date Date [nit
ug/l.
EP200.8
C
(<10)
11/16/09 11/19/09
NRB
mg/l.
SM204500NO3-F
B
(<10)
11/20/09
LCE
col/100ml, SM209222B
col/100ml. SM209222O
col/100mL SM209222B
A (<200)
A (<1)
A (<I)
11/13/09 DLC
11/13/09 DLC
11/13/09 DLC
II
Q
Cq
LOT 6A
O
N 89'57'12" W 191.41' J
E
ab to
o
N GRAVEL LOT 5A Z� J
s-� w D/W 24.0• o BLK 4A W W
z CARPORT ^ W r_ w
rW 00 12.i 24.0• p ~ Zi O
µy W I =
o n X= n e.o' DECK I n I o 0
p LL
ARCTIC
O ENTRY W
'\ -SEPTIC Z Z
Z ®WELL /CANT 24.0' C.O. I I O
F- F-
33' 33' 1 53.5' 3O' 13' Q J
N89'58'00"W 191.38' a
Q
LOT 4
I
ANCHORAGE RECORDING DISTRICT
ASBUILT OF:
EAGLE RIVER IIID-IIEIGIITS SUBD.
LOT 5A, BLK 4A PLAT 84-014
SURVEY CERTIFICATE: I, John L Schuller, Have conducted a „ OF AL \�1 \ C ERRq
physical survey of this property as shown on this drawing and that the .•' • •' ' •.4 9� /� �
improvcmcnts situated hereon arc within the property lines and no
r
enchroechments exist other than noted. Under no circumstance should � : 4 9T '• * �, �v
any information on this drawing be used for construction offences, IV.... ,,, • ,,, .........
structures, improvements, or for establishing boundary lines. -
EXCLUSION NOTES: It is the owners responsibility to determine r
OHN L SC c
ULLERr o% 2 <q
the existence of any casements, covenants, or restrictions which ro�� t 4t
do not appear on the recorded subdivision plat. ,, LS -10408
aORx ORDER NuuuER: 9.1L srxc rum �1 `y'//:�3'�•'•d5� `�-•e �,�,
NOV 23, 2009 1'-40' sne.n9ea4.n.t
09-071 .no<a®trworuax .G , \\rofeaaiono\L�� z' ANp SUR �0�1
,LS NW0052 080364 ��\����� t, N[ 99,17-116
