HomeMy WebLinkAboutBIRCH TREE ESTATES BLK 1 LT 20
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
MAILING ADDRESS
LEGAL DESCRIPTION
IPHONEI
[] NEW
[] UPGRADE
LOCATION
O v DISTANCE TO:
~- Z I Manufacturer~
~ [Liq. capacity i~gallons [ ............
I/ I
~,-~ ~ DISTANCE TO' lWell
~ Manufacturer
~ I I Well
~= I D~STANCETO: I
~ ~ ~ No. of line~ Length 9f eaqh I~e.
~ ~ Top of tile to finish ~a~
Length Width
~ ~ I Type of crib Crib diameter
~ DISTANCE TO: Well
~ Class Depth
~ DISTANCE TO: Building foundation
OTHER
PIPE MATERIALS
SOIL TEST RATING
INSTALLER
R EMAR KS
NO. OF BEDROOMS
PERMIT NO.
IAbsorption area [Dwellin~er~
Ma
Inside length Width
No, of cor~a, r2ments
Liquid depth
Dwelling PERMIT NO.
Material Liquid capacity in gallons
Foundation Nearest lot tine PERMIT NO.
Distance between lines
Trenchgid~ inches
inches
Total length of lines
MateZ beneath tile
Depth
Total effective.absorption yea
PERMIT NO.
Crib depth Total effective absorption ~rea
Building foundation Nearest lot line
Driller Distance to lot line
Sewer line Septic tank
PERMIT NO.
Absorption area(s)
APPROVED
DATE
/0-/o .P /
LEGAL
72-013 (Rev. 3/78)
PERMIT NO.
APPLICANT SALLY LONG 5?82 W.
LOCATION METZ COURT
L.EGRL L20 Bt BIRCHTREE ESTBTES S/D
DEPARTMENT OF HERLTH .RND ENYIR.>/.;"%;.~FAL F'ROTECTION
825 '"L" STREET.. RNCHORRG'
264-4728
C.') I'-,I -- :-~; I T E S; i I-,..! i R i' E F..." r'l I 'T
84TH.
245:-.-~
LOT SIZE ]:0000 SQt..IRRE FEET
'--I .... ,'-I hr- · - , ,
TYPE OF :,JIL RBSOF.:PTION :,r:,]EH I¢'_, TRF_~'~_.H
MFI::':: I MUM NUMBER OF" E=E[."RULffl: ~ ~ C'F ,- ..... .' , ,'. -
= _, J I [_ F.: H T I N b ,:; S 6! F. T,- E, F...., -
..... ,.-- %$'. - .' ,~- ",,_-' ", , - ,r", --
TIlE ~.'E;,IIIRED _,I,:_E ~,IF,.THE _,UIL RB_,OF..FTILIN =,,~Eft I_-,' ~)~,AIf% ~C"'i(~L_~
[}',EF"TF4== ~ LEI"-.~mZ.~TH= ~ .~3RR , EL [:,iF'TH==
THE L. ENG]'FI DIMENSION I5] THE LENGTH (IN FEET;:, OF THE TRENCH OR DRRINFIELD.
THE DEPTH OF R TRENCH OR PIT IS THE DI'=;TRNCE BETWEEN THE SURFRCE OF' THE
GROUND RND THE BOTTOM OF' THE EXCRVRTION ,:lIN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRRVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETWEEN THE OUTFRLL F'IPE
RND THE BOTTOM OF THE EXCR',,,'RTION (IN FEET).
F:E~..!LI I F-:EE:. SEPT I
PERMI'F RF'PLICRNT HRS THE F. ESPON'-]I TY
· : _BILI TO INFORM THIS DEF'RRTMENT [:,UF.'.I~-itG THE
INSTRLLRTION INSF'ECTIANS AF RNY WELLS RDJRCEI'.,IT Tr] THIS F'F.:OPEF.:T'.¢ RND THE
NUMBEF.'. OF' RE'-';IDENCES THRT THE WELL WILL SEF.:',,,'E
Ti..JC! < 2 ) I ~4$F'EE:T I C,~-~S RF..'E REF:;!LI I ~,',EE:,
BRCKFILLING OF RNY SYSTEM WITHOUT FINRL INSPECTION RND RPPRO',,,'RL BY THIS
DEPRRTMENT WILL BE SUBJECT TO PROSECUTION
MINIMUM DISTRNCE BETWEEN R WELL AND ANY ON-SITE SENRGE DISPOSRL SYSTEM IS
100 FEET FOR R PRIVRTE WELL. OR ~50 TO 200 FEET FROM R PUBLIC NELL DEPENDING
UPON THE TYPE OF PUBLIC WELL
MINIMUM DISTRNCE FROM R PRI'¢RTE WELL 'TO R PRIVRTE SEWER LINE IS 25 FEE]" FIND
TO R COMMUNITY SEWER LINE IS 75 FEET.
OTHER REQUIREMENTS MRY RPPLY. SPECI F ICRT IONS FIND CONSTRUCTION DI RGRRMS FIRE
R',,,'RILRBLE TO INSURE PROPER INSTRL, L. RTION.
F'EF-"I"-I I T E,s',:F' I RES [:,EE:Ei'"IE:EE: 2:::L.. ~.:_-.-~. :~:2L
I CERTIFY THRT
±: IRM FRMILIRR WITH ]'HE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS RS SET
FORTH BY THE MUNICIPRLIT"r' OF RNCHORRGE.
;;.2: I WILL. INSTRLL ]"HE SYSTEM IN 8CCORDRNCE WITH THE CODES.
3: I UNDERSTRND THRT THE ON-SITE SEWER SYSTEM MRY REQUIRE ENLRRGEMENT IF:' THE
,
ALASKA ENVIRONMENTAL
CONTROL SERVICES INC.
1220 W. 25th Avenue · Anchorage, Alaska 99503
ENGINEERING SERVICES
(907) 276-1361
~?-~ IL 84rr~
LO1F ':~t~2
[~}' ,SOILS LOG
MUNICIPALITY OF ANCHORAGE //
DEPARTMENT OF HEALTH AND ENVl RONMENTAL PROTECTION [Yzff PERCOLATION
TEST
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
SLOPE SITE PLAN
WAS GROUND WATER
IF YES, AT WHAT
DEPTH?
Net
Drop
Reading Date Gross Net Depth to
Time Time Water
· .... . ,'
~.',7'-- , / .~ 'c., 0,:7
_ ,. ~ ,,/, 5~'
,--~ ,,.¢.:6! ~-.z. /./~/
PERFORMED BY: ~" ' "'~
72-008 (6/79)
Reid, Jr.
/
PERCOLATION RATE~ ,:~'Z · (minutes/inch)
TEST RUN BETWEEN '-" F'~ AND - ' Fl'
,.,.,'~- .... ~,,., ~, ./
;
CERTIFIED BY:
I I I II III I ....... Ill
I II
ALASKA ENVIRONMENTAL
,,, CONTROL SERVICES INC. ,,
1220 W, 25th Avenue · Anchorage, Alaska 99503
ENGINEERING SERVICES
-
(907) 276-~36~
~ I III I IIIII I I II1~11111 IIIII II IIIIII IIII I1'111
December 29, 1978
%77662
Gary Rasmussen
1510 West 12th Avenue
Anchorage, Alaska 99501
Subject~ Lot 20 Block 1 Birch Tree Estates Subdivision
A permit issued by this department for well and/or
sewer system has expired.
Permits are issued on a calendar year basis~ as stated
on the permitw by authority of Municipal ordinance.
If you have drilled the well, a well log should be
sent to this department to document the installation
date.
If there are any further questions, please contact
this office at 264-4720.
Sincerely,
Les No Buchholz,
Senior Environmental Specialist
LNB/lJw
enCl copy of permit
PERMIT NO.
bll_lr-~ IC:! F"ALIT~" IDF Ar-IC:HCI~AISE
DEPARTMENT 0w HEALTH AND ENVIRONMENTAL PROTECTION
825 'L. STREET, ANCHORAGE, AK. 99
L~ELL 8NJ:, ON--SITE SEL.~E~: F'E~:r'I IT
( 77662 )
APPLICANT
LOCATION
LEGAL
_GARY RASMUSSEN
METZ CT
L20 Bi BIRCH TREE EST.
1518 W i2 RYE
LOT SIZE
279-.3901
~9000 SQUARE FEET
TYPE OF SOIL ABSORBTION SYSTEM IS: TRENCH
MRXlMUM NUMBER OF BEDROOMS
SOIL RATING (SQ FT?BR)= 125
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
E:,EF'TH= '12 i_E[-IGTH= 27 6R:R"¢EL [:,EF"TH= 7'
THE LENGTH DIMENSION IS THE LENGTH <IN FEET) OF THE TRENCH OR DRAINF'IELD.
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 GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE
AND THE BOTTOM OF THE EXCAVATION (IN FEET).
RE~;!I_I I F~E[:. SEF"T I C: TR~IK S I ZE= l~--_-tO~--~-'~ IS R L I_ ~D [-4 :S
P~I]:~]~GE PLRf4T I]F'T I C~[-I
R PACKAGE PLANT MAY BE INSTALLED AT THE PERMITTEE¢S OPTION SUBJECT TO THE
FOLLOWING CONDITIONS:
i. EITHER R CLASS I OR II NSF APPROVED PLANT MA9 BE INSTALL. ED.
2. A CONTINUOUS MAINTENANCE AGREEMENT IS REQUIRED. IF A MAINTENANCE
AGREEMENT IS NOT KEPT CURRENT YOU MAY BE REQUIRED TO ENLARGE THE SOIL
ABSORPTION SYSTEM AND?OR YOU MAY BE SUBJECT TO PROSECUTION.
T[~O (2_) I f~SPEC:TI C~f~S R~E RE~.I_II ~E[:,
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION RND APPROVAL BY THIS
DEPRRTMENT WILL. BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
i00 FEET FOR A PRIVATE WELL OR 200 FEET FOR A PUBLIC WELL.
WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN ~0 DAYS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
F"E~"rd I T E::-;P I RES E.,EC:EPIBE~." --'-::l.. 197'F
I CERTIFY THAT
i: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS.
,--..,
=,I~NEC'_ -
APPLIC:FC~T GARY RRSblUSSEN
","3. 0
T.H. 1
7-26-77
SANDY GRAVEL w/ TRACE
SILT (GW)
Brown, Moist, Loose
0!
Block 1, Birch Tree Estates
Driveway
'"' I
? xca~ated
.: 1~0' %<~) TH-1i
Area
A
GRAVEL w/ TRACE SAND,
TRACE SILT (GP)
Many boulders
rown
8I
~t to Scale
Distances sh~ a~e apf-,,:%:ximate and 'hav'e
been me&s~red by survey methods.
Distance to property corners no't
determined.
No Water Table Encountered
16'T.D.
This log represents subsurface soil
conditions within the test hole at
the location shown.
See drawings B-01 and B-02 for
explanation of symbols.
~KD~ SM~ ,
~)~,T £.' 7-26-77
SCALE:I"=3'
TEST HOLE LOG AND
LOCATION DIAGR;U!
GARY RASMUSSEN
If'B'
GR'ID:
j LOW ..o, A-O1
SOILS
,CLA,SSIFICATION, ,CONSISTENCY AND SYMBOLS
CLASSIFICATION: Identification and classification of the soft is accomplished in
accordance with the Unified Soil Classification System. Normally, the grain size
distribution determines classification of the soil. The soil is defined according to
major and minor constituents with the minor elements serving as modifiers of the
major elements. For cohesive soils, the clay becomes the principal noun with the
other major soil constituents used as modifier; i.e. silty clay, when the clay particles
are such that the clay dominates soil properties. Minor soil constituents may be
added to the classification breakdown in accordance with the particle size proportion
listed below; i.e. sandy silt w/some gravel, trace clay.
no call - 0 - 3% trace - 3 - 12% some - 13 - 30%
SOIL CONSISTENCY - CRITERIA: Soil consistency as defined below and determined
by normal field and laboratory methods applies only to non-frozen material'. For
these materials, the influence of such factors as soil structure, i.e. fissure
systems, shrinkage cracks, slickens{des, etc., must be taken into consideration
in making any correlation with the consistency values listed below. In permafrost
zones, the consistency and strength of frozen soils may vary significantly and
unexplainably with ice content, thermal regime and soil type.
C ohe sionle ss ' '
N*(blows/ft) Relative Density
Loose 0- 10
Medium Dense 10- 30
Dense 30 - 60
Very Dense - 60
*Standard Penetration "N":
0 to 40%
40 to 70%
70 to 90%
90 to 100%
Blows per foot of
a I40-pound hammer fallin~ 30 inhhes on a
2-inch OD split-spoon except where noted.
DRILLING SYMBOLS
Cohesive
T- (tsf)
Very Soft
Soft
Stiff
Firm
Very Firm
Hard
0 - 0.25
0.25 - 0.5
0.5 -1.0
1.0 - 2.0
2.0 -4.0
-4.0
WO: Wash Out WD:
WL: Water Level BCR:
WCI: Wet Cave In ACR:
DCI: Dry Cave In AB:
WS: While Sampling TD:
While Drilling
Before Casing Removal
After Casing Removal
After Boring
Total Depth
Note.~ Water levels indicated on the boring logs are the levels measured in the
boring at the times indicated. In pervious unfrozen soils, the indicated elevations
are cons{tiered to represent actual ground water conditions. In impervious and
frozen soils, accurate determinations of ground water elevations cannot be obtained
within a limited period of observation and other evidence on ground water elevations
and conditions are required.
En~]ineerin~} t~ Geological Contultanls Inc
· ~c.o,,.~ ,,.,..... ALASKA JU.EAU GENERAL NOTES
5-1-F2 sc LE N/A OWN aY LDS C~KD BY GLB P~OJ. NO. GENERAL owe NO.
ORGANIC MATERIAL
CLAY
SILT
SAND
GRAVEL
STANDARD SYMBOLS
COBBLES & BOULDERS
CONGLOMERATE
SANDSTONE
MUDSTONE
LIMESTONE
IGNEOUS ROCK
METAMORPHIC ROCK
ICE. MASSIVE
ICE - SILT
ORGANIC SILT
SANDY SILT
SILT GRADING TO
SANDY SILT
SANDY GRAVEL,
SCATTERED COBBLES
(ROCK FRAGMENTS)
INTERLAYERED SAND
& SANDY GRAVEL
SILTY CLAY w/TR. SAND
St ..... 1.4" SPLIT SPOON
Ss ..... 1.4" SPLIT SPOON
SI .., ,'. 2.5" SPLIT SPOON
Sh . ,, . . 2.5" SPLIT SPOON
Sx., , . . 2.0" SPLIT SPOON
Sz. ,'.. o 1.4" SPLIT SPOON
Sp ..... 2.5" SPLIT SPOON,
Hs ..... 1.4" SPLIT SPOON
HI ..... 2.5" SPLIT SPOON
SAMPLER TYPE SYMBOLS
WITH 47'# HAMMER
WITH 140# HAMMER
WITH 140# HAMMER
WITH 340~ HAMMER
WITH 140# HAMJ~ER
WITH :540# HAMMER
PUSHED
DRIVEN WITH AIR HAMMER
DRIVEN WITH AIR ~MMER
NOTE;
Ts .... SHELBY TUBE
Tm .... MODIFIED SHELBY TUBE
Pb .... PITCHER BARREL
Cs .... CORE BARREL WITH SINGLE TUBE
Cd .... CORE BARREL WITH DOUBLE TUBE
Bs .... BULK SAMPLE
A ..... AUGER SAMPLE
G ..... GRAB SAMPLE
SAMPLER TYPES ARE EITHER NOTED ABOVE THE BORING LOG OR ADdACENT TO IT AT THE RESPECTIVE
SAMPLE DEPTH.'
TYPICAL BORING LOG
BO,'?/NG NC/MBE/?,,.~,T. H. ~0- 15
DATE D/?ILLED..~,qO' 21- ?0
S A MPL Et~ T Y'PE ,~, Ss
AFTE/?
WATE'/?
F~OX£N
Elev. 2746 ....--ELEVATION IN FEET
All Somples Ss.r'SAMPLEf~' TYPE
O'
ORGANIC. MATERIAL I'
Consid. Visible Ice ICE+ML
ICE -SILT
65°/o Visible Ice
90, 56.2°/o, 80. Spcf~, ML4.
7'
SANDY SILT ~'$Tt?ATA CHANGE
~,/.... APPROXIMATE STRATA
Little to NoVisible Ice 15~0' Vx ~IC~ DESCRIPRON ~ C~A~IFICARON
~ ~2, 57.1 O/o, 85.9PCf, 28~ GP_ (CORPS OF
~ ~~ --O~Y DENSITY
~--e~ows/rm~
SAMPLE NUMBER .
SANDY GRAVEL
26' '
95
SCHIST ~ GENERALIZED SOIL OR R~K DESCRIPTION
~OCATION ~0 ' ~ DMLL DEPTH
~D/T/ONA~ ~?A ~V~LABL~ ON ~U~PLEMEN~A~ LAB
16-7,2
C O.N 8U t. TANTS, INC.
JscALE NONE, ,IDWN BY
EXPLANATION OF SELECTED SYMBOLS
,LOS , GLB ~'RO,~. Ne. GENERAL Dwe NO. 8-02'
R&M CONtlULTANTB, INC. ~o24 CORDOVA · BOX 6087 · ANCHORAGE, ALASKA 995~,2 · PH. 907'279'0483 · TL,.X. 090'2~360
July 25, 1977
R&M NO. 751201
Gary Rasmussen
2038 Cliffside Road
Anchorage, Alaska 99501
Subject: Soil Investigation for Sanitary Sewer System, Lot 20, Block 1,
Birch Tree Estates Subdivision, Anchorage, Alaska
Dear Mr. Rasmussen:
At your r~quest of Uuly 20, 1977, we conducted a subsurface soils
investigation at the proposed location of the sanitary sewer system on
the subject lot. The investigation complied with tho~e procedures
required by the Municipality of Anchorage Department of Health and
Environmental Protection.
This investigation, which was accomplished on July 25, 1977, consisted
of a test hole drilled to a depth of 16' feet below the existing ground
surface. The test hole was sited according to your instructions and its
location is shown in attached Drawing A-01. Drilling was accomplished
with a rotary drill rig using continuous-flight solid-stem auger with an
outside diameter of 6 inches. A sample was taken at the depth shown on
the soils log in Drawing A-01. The sample will be held in storage at
our lab for approximately six months. In addition, all material brought
to the surface by the augers was continuously.monitored by an experienced
engineering geologist.
The topography at the drilling site is generally horizontal. At the
time of the investigation the site had been stripped. The top of the
test hole was located in an excavation approximately 6 feet below original
ground surface.
The soils encountered in the bore hole are shown in the test hole log in
Drawing A-01. The symbols used in Drawing A-01 are explained in Drawings
B-01 and B-02. This log displays specific conditions encountered at the
test location. However, subsurface conditions may vary in other parts
of the lot without any apparent surficial evidence of the change.
oundwaterwas was not encountered. At the
not
encountered.
Bedrock
~me the hole wa~sdrilled seasonal-~-~ nat present. Permafrost
was not~e.~cguntered.
Based on the visual classification of the soil and the requirements set
forth by the MuniciPality of Anchorage, a percolation test was not
necessary within the test hole on the subject lot.
July 25, 1977
Gary Rasmussen
Page -2-
We appreciate this opportunity to be of service to you. Please contact
us if you have any questions concerning this letter or if we can be of
additional service.
Very truly yours,
R & M CONSULTANTS, INC.
Staff Geologist
Jim McCaslin Brown, Ph.D.
Head, Earth Science Department
SH:JMB/sl
Attachments: Drawings A-01, B-01, B-02
Static Water Level
feet
,~L
Gallons Per Minute /6)
Draw Down
feet
Tot~Z ~eet of ~as~ ~ ?
Type, Material Drilledl
0 feet to ~--'
to
to
to
Hefty Drilling
S.R.A. Box 1553 H
Anchorage, Alaska
99507
, ': Time
'% ' : " ' i Date ' '
~)-ate ,
Inspector Inel~ector Inspe~or ' '"
Comments '
r Id~
Date Sews instal · Permli No. ' ' ' Septic Tank ~ize' t & $~ " '
' }~ ~ . Holding Tank Size
Soils Rating " Well ~o Absorption A~ea Walt Log Received
Well to Tank ~:..
.'., , ~ .... , ~ AP~.LICA~._FILLS OUT LOWER HALF ONLY .... ~. .........
'-P'rOpertyOwner ~ ~ ~ ~-'~'~ ~ ~ ~7' ' - ' '~:" : ' ' ' ' '~' ' ' .... ": Phone
Marlin: Address ~ ~ .~ ~ ~
Address
0 1
Ty~ Residence o. of B
~ingle Family
D Multiple Family N edr oma, ·
Q Other r
W~uPply
,.
~dtvldual ' '
~ Community
Q Public Utillt7 .':- : ' available') ~ ~ ~ ,
~lvldual
D Public Utility
~ Holding Tank
NOTE: THE INSPECTION ~E MUST ACCOMPANY ~CH REQUEST BEFORE PROCESSING CAN BE INITIATED.
CHEMICAL
.OGICAL LABORATORIES , ALASKA, INC.~
TELEPHONE (907)-279.4014 ANCHORAGE INDUSTRIAL CENTER
274-3364 5633 B Street
Drinking Water Analysis Report for Total Coliform Bacteria
TO BE COMPLETED BY WATER SUPPLIER
WATER SYSTEM:
I.D. NO.
Water System Name PhoneNo~ (, ~ '
Mailing Address
City State Zip Code
MO. Day Year
SAMPLE TYPE:
[] Routine
[] Check Sample (for routine ~ample
with lab ref. no.
[] Special Purpose
[] Treated Water
[] Untreated Water
SAMPLE
NO.
I
3 I
4 I
I
LOCATION
Time - Collected
Collected By
. I
TO .BE COMPLETED BY LABORATORY
Analysis shows this Water SAMPLE to be:
~] Satisfactory
[] Unsatisfactory
[] Sample too long in transit; sample should
not be over 48 hours old at examination
to indicate reliable results Please send
new sample.
Date Received
Time Received
Analytical Method:
[] Fermentation Tube
,~ Membrane Filter
Lab Ref. No. Result* Analyst
I I ~
I
*No. of colonies/100 mL or No. of Positive oort~ons.
06-1220 (b)
Rev. 1978
BACTERIOLOGICAL WATER ANALYSIS RECORD
READ INSTRUCTIONS
BEFORE
COLLECTI N G SAM PLE
Date Collected Source
Date Received Time Receive(! p.m. Lal~. No.
Presumptive 10mi 10mi Z0ml 10mi Z0ml 1.0mi 0.1mi
_ 24 Hours
48 HOURS ' I
Confirmatory
24 Hours
,48 Hours
EMB
Multiple Tube Report:
Membrane Filter: Direct Count
Verification: LTB
Final Membrane Filter Results
Reported By
Broth 24 hours: Broth 48 houri:
10mi Tubas PosJtlve/Totsl 10mi Portlonl
Collform/100ml
BGB
Collform/100ml
__ Date.,
Time: &.m,
W
bW
I