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HomeMy WebLinkAboutALDERWOOD PLACE LT 4010,14midp- a 13 re I- ry Lot 4 -D i P.C. BOX Coco AMC' 'CRAGS, ALASKA 09502-0850 +,x107) 264-4 111 v K,%CWLES, DEPARTMENT OF HEALTH & HUMAN SERVICES January 10, 1986 TO: Permit Applicant Subject: Permit # 850634 Lot 4 Alderwood Place Subdivision A permit issued by this Department for an individual well and/or on-site sewer system has expired as of December 31, 1985. Permits are issued on a calendar year basis by authority of Municipal Ordinance. A new permit must be obtained from this Department for any well and/or on-site sewer system not installed by the expiration date. If you have drilled the well, a well log needs to be sent to this Department for documentation of the installation and to close the permit. If a private engineer inspected the installation of the on-site sewer system the original as -built inspection report(three part form) must be sent to this office for review and approval,and for documentation. If there are any further questions, please call this office at 264-4720. Sincerely, &'tr� Susan E. Oswalt Program Manager On-site Services SEO/ljw enc: Copy of Permit MUNlCIPALITY OF ANCHORAGE Department of Health & Human Services 825 L Street, Anchorage, Alaska 99501 343��c�4� lt7 11z1 ON - SITE WELL PERMIT !'` nit N.v^/.er: 880207 Is 09/26/88 Owner Na.'HIDDEN RIVERS OF AK ALASKA MUTUAL Day Phone: ss: PO BOX 2117 SUITE 1 9 688-2759 EAGLE RIVER, AK 99577 P.,ce] [d: 050-281-68 :'A i�O^Q Subdivision: ALDERWOOD PLACE Lot: 4 Block: - Section: 12 Township: 14N Range: 2W Lot S.'~ 0.5 A (sq.ft. or acres) M�x 1:."jrooms: This Permit: 0 Total Capa'�ity: 3 [nit; /o" '^.,L be submitted to Municipality o+ Anchorage Department of Health ~'J Human Services within 30 days of well completion. lNS|*Li /8 ATTACHED SITE PLAN. lH1S PERMIT IS VALID FOR A SINGLE FAMILY RESIDENCE ONLY AND EXPIRES 12/31/88. I CERTIFY THAT: 1. I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality 01 Anchorage (MOA) and the State of Alaska. �. [ mill install the system in accordance with all MOA codes and regulations, and in cu*!`liance with the design criteria of this permit~ 3. l ^','. u |` ill MOA and State of Alaska requirements for the set back distances from any existing well, wastewater disposal system or pvblic sewerage system on this or any adjacent or nearby lot. 4. I understand that this permit is valid for a maximum of 0 bedrooms. I also understand that the capacity of the total system is 3 bedrooms and +..f wnlargement will require an additional permit. Cigoe`� DATE: 1___IMF �_ _______________________ (Uw:rr) HIDDEN RIVERS OF AK. AL. 3KA MUTUAL BANK Iss"=d By: DA[E: -------------------------------- RECEIPT and AGREEMENT to PURCHASE ALASKA REAL ESTATE FIRMS Listing Coldwell,� ,Banker Phone 561--`2^4^8,8 SfIIIN(i tKi1Cf ADDRf��212 Old �a�.am 91 E. R. �I� Bd9_ N EMQW=ffl Phone��fiQ_U-. At7e i%* 5 RECEIVED FROM Hidden Rivers Of Alaska Mailing P. 0. Box 1117, #189, Eagle River, Ak. 99577 Phone 694-4955 Address _ the sum of . Five and no/100---�— ------ is 500.00 i Dollars in the farm of tdtack for $_q , cash for note fors 00--1 due at C SlnCl,.r, es s deposit on end part Irayment for the real property and improvements 1h9roon so twt to the State of Alaska: describe n: 4 IV '''-'''-o, r are all fixtures anrt equipment attached to and a port of the above described property, and the personal property also to be left upon tribed in an invonswy as pan of the listing agreement, 9 Gi., ;Js which property the payw of the above deposit hereby agrees to buy for the total price of $"a4' �•0� / o which sum the above del it shall apply• Purchase terms itC '•%k, >;ubiir,l�.aksit•t, -t'1,�..-E ve /,. , Premises may be occupied under condition of snoched occupancy agreement at // $ per day. Pos� "I be #van to buyer on elesiw fen � Of COl18t "rL1Ct.LOIL loan / 1 v �y �: c i..� 3 �c ., r • r 1 1. days allowed from date of seller's acceptance w 0 title and completlori of purohae. I t%tle PA046,946 lincp4uTckssa�,'s rioi 06;19t4i within rid period, the rid deposit MINI be forfeited by purchaser. Z. This sale Is.. by said agent subject to the owner's approval. If so -approved the owner will furnish a good and sufficient warranty deed, and a showing of fres title clew of eneumbrorim, except conditions, restrictions, reservations and rights-of-way of record. 3. In the event the improvernsnts on the above described reel property shall be destroyed or materially damaged prior to consummation of this purchase, this contract shall at purchaser's election immediately become null and void and rid deposit shall be returned to purchaser on demand. 4. This writing contains tin entire agreement. Then we no other understandings, oral or written, which in any manner change or enlarge what is set forth !wait . The plural shell include the singular. 6. It n mutually greed by all ponies hereto, that "Id spent is authorized broker and agent of the seller in negotiation of this agreement but the said agent shall not be held liable in any manner whatsoever from damages, arising from defaults or acts by, or upon the part of either party to this agreement. 6. Taxes, interest, insurance and prepaid ran" to be prorated. Cost of deed and policy of title insurance to be furnished and paid for by MNIor. Escrow fees to be divided equally between buyer and seller. 7. The seller agrsy that this buyers shall have the privilege of paying any pen of ell of the unpaid balance dor to the seller at any time so long of they pay the balance to the seller at Ism a1 soon as provided. B. The Mellor agrees that the buyer shall hew the right to assign and to sell, or otherwise dispose of their interest in the above described property without notice to the seller. B. Tines is the osaance of this contract but either agent may. •without notice, extend for a period of not to exceed 10 the tkne for the performence of any act hereunder utoapt the tante for the accoptarm hereof by seller. DA" 10. Buyer and Seller hereby wthorin the landing institution to furnish Broker Agent with kissing statements upon request. Buyer and eerier authorize all lenders, escrow agents and appraisore to furnish tin Noting and/or ss&V agents, on request, any and all Into., tion and copies of dockanents, concerning fin statue, orogrese and Anal dispoaiNon of: loans. oredit: appraisal: closing: conveyancing: and any odw matter related to this sal. 11. Deed OW be drawn In tae ,tonsim r. Hidden Rivers of Alaska, IDC . DATED I/We agree to esu a s iacknowledged. I/Wex I 'binding contract. obtainanad r, ilng which said our true an ve prepared on i NAME OF LLIN FI RldCeyiew Properties, Inc. 1 By r f iftni st n AGENT FOR ABOVE SELLING FIRM on the terms and conditions herein stated. Receipt of a copy of this agresfient is hereby is herebygranied the exclusive and irrevocable right for days from date to shall be returned. Ifaccepted by the seller, I/We hereby appoint behalf, all legal documents necessery,to complete this transaction. ACCEPTANCE BY SELLER I/We accept the foregoing offgand some to sell andoonvey the p►op"describedon the arms and conditions herein stated. I/We understand this is a legally binding contract. If IM sale is not completed I/We agree to pay for title insurance. The deposit mentioned herein shah be stained by the above nal estate firm in its trustee account until this transaction is completed. or until said deposit is forfeited or returnable as herein provided. OWner hsnin acknowledges he has been advised to seek counsel of tax attorney or ;Xy Certified Public Accountant for Income ax consegw tre sections.. QX a saies price /l t eprse to pay lorthanrr, its the soova named real estate firm a Commission amounting to $ 10$ for services retidered in this transaction. In the event of a forfeiture of the deposit as above provided, the said deposit shall be paid to or retained by the real estate firm to the extent of the agreed upon commission with resi - due to the seller. I authorize said nal estate firm to payout of the cash proceeds of sale the expense of furnishing evidence of title, of recording fess and revenue stamps, of any as well as any incumbrances on said promises payable by me at/or before closing. I acknowledge receipt of a copy of this sarnesl money receipt bearing my signatures) and that of the purchaser ,tamed above. 1/We hereby appoint transaction. Dated Permanent DATE , our true and lawful attorney to have prepared on my/our behalf ell legal documents his F® the seller a to complete this ser A, t.. C.I . 1N _ O y W Q W V O Ct cn m J W J a a i W W Cc Q W a p V3 Njr a ra (D _ Z_ O Z S <[ O L > y 3 ZS m V n n c 3 Eo • v h `l Alp •1 [' • R L O •• • \ •• ti") # (-, . d . n m h c•/ n C 4)? J � � � �' •• � a o c � c o E t7 'NA O I.L.. . * p `n . x o n L n o w •c a c c +- a r.. V��•�•,��t`a..:•AT Ar Q+��R1,' J+•+ �4 c a p c �r �j •. �{e _� a C m V p p s, t- CL n - u o �r S � y � W r` p v`` 1 cp a s a� J a o a o 0 o w ,c v `l \u O\ 2 U o �'oW_ � � W W W � O J \ J M 19� I '1n �.` \ 3'SQ'� ,'7 S_=, -7 G -li 77x1 i ul t,� \ M 19� I '1n �.` \ 3'SQ'� ,'7 S_=, -7 G OZ W r � 7/JI ` S S �I (�✓ t - 2T` M7 t1 OV2 -li 77x1 i ul t,� (�rriifieb +drilling il'xg by DOC Co. d6a SULLIVAN WATER WELLS P.O. BOX 670272, CHUGIAK, ALASKA 99567 • TELEPHONE 688-2759 OWNER OF LAND Hfaoc..I Q�yc°cS Car��5�« DEPTH OF WELL172 'i` / ADDRESS 110 6,x Q117 S� tTE 1P4Z 6-1 104?• STATIC LEVEL OF WATER FT. � O LEGAL DESCRIPTION La r T 1q4 0 4''< 4.00° 4 /6'4 `f<t DRAW DOWN FT. DATE - Started Ended 11 d �` GALS. PER HR Lid PERMIT NUMBER ip ��1 KIND OF CASING on MISCL. INFORMATION: DRILLER'S NAME MOND/PqC/n, KIND OF FORMATION: ENS/ROFpj of From f-) Ft. to d Ft.� ° "� 6 %iG t<J A From Ft. to 0� qN Ft. NM C /'ROTry cP From Ft. to— Ft. D 0414 10 04 Oe—J From Ft. to—FOD y� From Ft. to 2�—Or Ft. %/6t'i/ S-11 7"IJ 64.4 4'4 From Ft. toAF ,9 From Ft. to—Ft. l�t,t .S _ From Ft. to pt.� From -c-2 toAct Ft. `S "� 4 ����� From. Ft. to—Ft cip p Ft. From -6 3 7 Ft. to / �^ il ! / ���% _ Frum Ft. to Ft. ' �� From_ _Ft. to i Z), Ft.%j_R-J+a Y C 4.Pf:' From Ft. to Ft. From Ft. to Ft. A /4 ✓ 4L mac` ! From Ft. to Ft. r From3 Ft. to Ft.�'[ /t 4 � 6Q/lJtc 4 From Ft. to Ft. From 6 Ft. to _Ft. J14 s%f`'y'd From Ft. to Ft. _. From �s0 Ft. to8Ft. 6 J f'''�'`�� � From Ft. to Ft. From Ft. to b I Ft. <:'4 q y From Ft. to Ft. From6Ft. to 173 S14''JId 9�''AF From Ft. to Ft. From Ft. to Ft. UJ.4 %C� From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft MISCL. INFORMATION: DRILLER'S NAME DEF" AIF( TI'll ENT OF HEALTH AND ENVIRONMENTAL PROTECTION --825 L STREET, ANCHORAGE, r- 99501 264-4720 PERMIT NO: 850634 DATE ISSUED: 09/30/85 APPLICANT: cV0BODA@& MILLER CONS ADDRESS: 129 TOAKOANA EAGLE RIVER, AK 99577 CONTACT PHONE: 694-9302 LEGAL DESCRIP: SUBDIVISION: ALC0ERWOOD PLACE SECTION: 12 TOWNSHIP: 14N LOT SIZE: .5A (SQ.FT. OR ACRES) LOT: 4 RANGE: 2W BLOCK: NA I certify that: 1. I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of' Anchorage (MOA) and the State of Alaska. 2. I will install the system in accordance with all MOA codes and regulaticx and in compliance with the design criteria of this permit. . 3. I will adhere to all MOA and State of Alaska requirements for the set ba' distances from any existing well, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot. � SIGNED `--� DATE: �=~�/~� t _� ---- --- ---------------- APPLICANT SWOBOD MILLER' CONS ISSUED BY DATE: ` - . MUNICIPALITY OF ANCHORAGE i Development Services Department J Phone: 907-343-7904 On -Site Water & Wastewater Section —'' Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 050-281-68-000 Legal description ALDERWOOD PLACE LT 4 Site address 10144 LEE ST Eagle River AK 99577 Current property owner(s) HICKS JOSHUA PETER Expiration Date: 12/15/2024 The On-site system(s) is/are approved for bedrooms X Conditional approval for 5 bedrooms, with the following stipulations: Comments or advisories: The well casing must be brought above grade to the current code standard of 18"+ on or before 12/15/2024 or this CCOSA will be rescinded. Original Certificate Date: 11/15/2024 his Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA Approval—June 2022 MUNICIPALITY OF ANCHORAGE Development Services Department `, Phone: 907-343-7904 p p , On -Site Water & Wastewater Section �`—� Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 050-281-68 Complete legal description ALDERWOOD PLACE LT 4 Location (site address) 10144 LEE ST, EAGLE RIVER AK Current property owner(s) HICKS 2. ON-SITE SYSTEMS SIZED FOR 5 BEDROOMS Day phone 3. TYPE OF WATER SUPPLY: ❑■ Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ❑ Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ■❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested:❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ Date of Payment COSA # Waiver Fee $ Date of Payment Waiver # COSA Application—June 2022 COSA Checklist Legal Description: ALDERWOOD LT 4 Parcel ID: 050-281-68 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system _ A. WELL DATA ❑01 Well log is filed with Onsite (or attached) Date drilled 9/88 Total depth 173 ft Cased to 172.3 ft ❑Q Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 24 in. Date of flow test for COSA 10121/24 Static water level at beginning of test 104 ft. Comments B. TANK DATA Measured operating fluid level in septic tank Date of pumping ❑ Required maintenance completed, ifAWWTS Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) ❑ ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade ft (min) ❑ N/A — pressurized field. ❑ Per record drawings, field is insulated. ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) _ If yes, enter date Comments/Deficiencies: COSA Checklist June 2022 Well production at time of test 5+ gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑Il Coliform bacteria is Negative Nitrate 1.05 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L 0 Arsenic less than MRL (ND) Collected by MNA Date 10/21/24 C. LIFT STATION ❑ Required maintenance completed Age of lift station _ years Lift station material Comments: Adequacy test date Results Pass Fluid depth prior to test _ in Water added _gal New fluid depth _ in Elapsed time _ min Final fluid depth _ in Absorption rate _ gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) _ in Effective depth used _ in Effective depth remaining _ in E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' 0 Yes if No _ ft Neighboring Tank > 100' R] Yes if No _ ft Absorption Field on Lot > 100' I] Yes if No ft Neighboring Absorption Fields > 100' ❑e Yes if No _ ft Community Sewer Manhole/Cleanout > 100' . 71 Yes if No $6 ft Private Sewer/Septic Line > 25' Q Yes if No _ ft Holding Tank > 100'9Yes if No _ ft Animal Containment > 50' Q Yes if No _ ft Manure/Animal Excreta Storage �> 100' Community Sewer Main > 75' ❑Q Yes f No _ ft Lo I Yes if No _ ft ❑ N/A — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No _ ft Surface Water > 100' ❑ Yes if No _ ft Tank to Property Line > 5' ❑ Yes if No _ ft Field to Property Line > 10' ❑ Yes if No _ ft Water Main > 10' ❑ Yes if No_ ft Water Service Line > 10' ❑ Yes if No ft Wells on Adjacent Lots: Private Wells > 100' Community Wells > 200' ❑ Yes if No _ ft ❑ Yes if No _ ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS * SEPARATION WAIVED DURING PREVIOUS COSA G. CERTIFICATION & 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, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm Ile(, A i� I�(�Q�d s J 6 d Imo/ �� Phone 727-8864 Engineer's Printed Name Date 11/2(o(Zi� COSA Checklist—June 2022 Nov. 26, 2024 Municipalities of Anchorage On -Site Water and Waste Water Section 4700 Elmore Rd Anchorage, Alaska Phone 343-7904 Re: Well inspection Legal: ALDERWOOD PLACE LT 4 To whom it may concern: Per your request a well inspection was done on the above referenced lot. The existing well was extended per the required MOA code. The welds were inspected and found to be excellent workmanship. The electrical conduit was also extended as required. Bentonite clay was used to seal around the casing to prevent contaminates from leaking around the well and the well was chlorinated. Sincerely A/]' Michael N. Anderson, P.E. 4661 Natrona Anch, Ak 99516 Ph 727-8864 Epuq JS M UHMPALITY OF A HCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section - Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 050 281 68 1. GENERAL INFORMATION Expiration Date Complete legal description ALDERWOOD PLACE LOT 4 Location (site address) 10144 LEE Current property owner(s) HAUGSTAD Day phone Mailing address Real estate agent Day phone 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 5 10-2-0,?- 0 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well El Private Septic ❑ Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer El Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ a g o r 1499 Waiver Fee $ Date of Payment a l I f AD /Date of Payment Receipt Number Qui a. / D I G U&& Receipt Number COSA# 05C a616(44 Waiver# 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, 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 C&M ENGINEERING Phone 8545558 Address 20182 TULWAR Engineer's Printed Name CHARLES BALZARINI Date 2/3/2020 B Original Certificate Date: ?—Cg Z C> The Municipality 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 engineers work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet of •�qs�l ���� TH *: 49 •.* 6. DSD SIGNATURE • • • • • • System #1 Approved for -6—bedrooms t♦¢ CHARLES G BALZARINI System #2 Approved for bedroomsr� ``��s.. • CE -13854 • • \5 AW Disapproved AW �iliF�PROFESSIONP Conditional approval for bedrooms, with the following stipulations: .,it . B Original Certificate Date: ?—Cg Z C> The Municipality 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 engineers work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet COSA Checklist Legal Description: ALDERWOOD LOT 4 Parcel ID: 050 281 68 If more than 1 septic system on lot: COSA Checklist # 1 of 1 Structure served by this system 1 A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 9/88 Total depth 173 ft Cased to 172.3' ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) +12 in. Date of flow test for COSA 1131/20 Static water level at beginning of test 106 ft. Comments B. TANK DATA Age of tank(s) years Tank type/material Measured operating fluid level in septic tank ❑ Standpipes/foundation cleanout per record drawing Date of pumping D. ABSORPTION FIELD DATA Which system tested (date installed) ❑ ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet Well production at time of test +5.7 gpm Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by C.Balzarini Date of Sample 1/28/20 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date Results ❑Pass For bedrooms Fluid depth prior to test in Water added gal New depth in Elapsed time min Final fluid depth in Absorption rate gpd Any rejuvenation treatment (past 12 months) If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ❑ Yes if No ft Wells on Adjacent Lots: Community Sewer Manhole/Cleanout > 100' $6 ❑ Yes if No ft r7 Yes if No ft Neighboring Tank > 100' ❑✓ Yes if No ft Private Sewer/Septic Line > 25' ❑✓ Yes if No ft Absorption Field on Lot > 100' ❑✓ Yes if No ft Holding Tank > 100' ❑✓ Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' ❑✓ Yes if No ft ❑7 Yes if No ft Manure/Animal Excreta Storage > 100' —❑✓ Community Sewer Main > 75' ❑✓ Yes if No ft Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No ft Surface Water > 100' ❑ Yes if No ft Property Line > 5' ❑ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ❑ Yes if No ft Private Wells > 100' ❑ Yes if No _ Water Main > 10' ❑ Yes if No ft Community Wells > 200' ❑ Yes if No _ Water Service Line > 10' ❑ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ❑ Yes if No ft If absorption field is under driveway comment below Property Line > 10' ❑ Yes if No ft Wells on Adjacent Lots: Water Main > 10' ❑ Yes if No ft Private Wells > 100' ® Yes if No Water Service Line > 10' ❑ Yes if No ft Community Wells > 200' ❑ Yes if No Surface Water > 100' ❑ Yes if No ft F. ENGINEER'S COMMENTS COSA FOR WELL ONLY, NO SEPTIC SEPARATION DISTANCE BETWEEN WELL AND SEWER MANHOLE WAS WAIVED DURING PREVIOUS COSAs/HAAs G. ENGINEER'S CERTIFICATION / 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. 2/03/20 COSA Checklist yellow sheet oF 49 CHARLES G BALZARIN.1 CE -13854 FO ft ft ft ft 0 N 0 N m N �-1 41 m W" M ri N Ln 00 m u) ME o 00 @ U a NO l ++ c w N v O O C U 7 () O. a) 6 O 'O 0 .9 (-�- N N O a E d y � FF' -"i'•1 O d@3 a) Q o mZZ-0 @ ) d N a w o` N O O @ c a @ N N 'C O 03 O aO 0)i -0 Q -2 y O @ N @ c n c O) 3 a UbD = a L a J O@ -co N @00 00 S N U 1] by N Ln l.l1 m a) O a N 3 m N Ol Q O N CC� Ol O N J c E U A O0 Y E U `o a° > c `o c N Fa a m a ° rn O w @ @ 0 s a =5 a ai Y bD u fu @ LL CL CL to I- c ('6 •,N t < cc:Z> C: -6 O )c0 -0 AO U E i'O 7 L,U a Q JW 20 iw LL- Ln =3 a 6 CL) vii oaxi� Qm� v i > @oC 0 UowN ME MC 0 o=Y t0 O Ln 0010 = •V �' a N o 0 @ N Z E Do 0 o°T'n m N��N� � as O C) Ln 0 LL a N NC 0 Ll l0 Ol 3 LLO c: O 0 0. 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GENERAL INFORMATION Complete legal description Expiration Date: / a - a A " / a. Location (site address) �) o ) yy L,*� . 5 j�„�¢_j— Ealig fZt`y t- � V Current Property owners)1 6 tlnft Day phone '101 %l Eo' yg)G Mailing address Real Estate Agent 5use" 916k4n4h Day phone 2. TYPE OF DWELLING: g Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: C� 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 Received by: _ COSA to be released to the Imineer, unless requested by the engineer. Date: COSA Fee $ y01 O ' Waiver Fee $ Date of Payment Ia �11� r Date of Payment Receipt Number J�) �P�I Receipt Number COSA# O'SP— Waiver# iL 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, l 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 S(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ?_0jPe,4 P. g,t1 A5i'0cle L_g b1c. Phone 8197..6q4- U32 Address )6571% Lcu 4em," t % Ni... 9. t, ,4 K amr-n Engineer's Printed Name Re h2.ta � �Hafm 3 fir, Date � a. OF AZq%t1 6. DSD SIGNATURE System #1 Approved for. bedrooms. System #2 Approved for. bedrooms. Disapproved. Conditional approval for bedrooms, with the following r i rd yP. Kinney. Jr. By: `- Original Certificate Date: '9 2 g The - nicip of n age Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSH) based only upon the represent tions given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsiblefor 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 9-1-12.doc - If more than 1 septic system is on the lot: COSA Checklist # of _ Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: f r ✓jdoacl T /4 c` 10 Lot Parcel ID: Sa 48l l0 8 A. WELL DATA Well type 1 vim# If A, B, or C provide PWSID # = Well Log (Y/N) Y Date completed 4'29- 58 Sanitary seal (Y/N) `>' Wires properly protected (Y/N) _ Total depth 112.3 ft. Cased to 113.& ft. T. 4. Casing height (above ground) Z4 in. FROM WELL LOG AT INSPECTION Date of test a " Zq' SS a1- 6' 1 Z Static water level l01. ft. 98 ft. Well production L$ g.p.m. Zi g.p.m. WATER SAMPLE RESULTS: Coliform D colonies/100 mL Nitrate 0AM mg/L Other bacteria colonies/100 mL Arsenic: 4.011 ug/L dateofsample: 9-6^ia. Collected by: [Zod ?Crnn..t B. SEPTICIHOLDING TANK DATA I N orte > Tank Type/Material Tank size gal. Number of Compartments Foundation cleanout (Y/N) _ Depression over tank (Y/N) Date of pumping Pumper Date installed Cleanouts (Y/N) High water alarm (Y/N) C. ABSORPTION FIELD DATA (NoAe. Date installed Soil rating (g.p.d./ft2 or ft2/bdrm) System type Length ft. Width ft. Gravel below pipe ft. Total depth —ft. Eff. absorption area _ft2 Date of adequacy test Results (Pa Fluid depth in absorption field before test _ in. Elapsed Time: —min. Final fluid depth _ in Any rejuvenation treatment (past 12 mo.) (Y/N & type) Monitoring tube Depression over field_ ss/Fail) For _ bedrooms Water added_ gal. New depth_ in. Absorption rate >= g.p.d. If yes, give date D. LIFT STATION L ry aoel Date installed "Pump on" level at _ in. Datum E. SEPARATION DISTANCES WELL ON LOT TO: Size in gallons _ "Pump off' level at Cycles tested Septic tank/lift station on lot MA Absorption field on lot NA Public sewer main 94 r Sewer /septic service line ky r Animal containment areas NA SEPTIC/HOLDING TANK ON LOT TO: Building foundation Property line Water main Water service line Wells on adjacent lots ABSORPTION FIELD ON LOT TO: (NA ) Property line Building foundation _ Water Service line Surface water Curtain drain Wells on adjacent lots Manhole/Access (Y/N) in. High water alarm level at Meets alarm & circuit requirements? On adjacent lots +loo 1 On adjacent lots +106 r Public sewer manhole/cleanout Holding tank NA S41 Manure/animal excrete storage areas NA Absorption field Surface water Water main Driveway, parking/vehicle storage in. F. COMMENTS Sac a44ayd aL re, v4,I y-av {eaucs% to✓ watvt✓ 4v- Well +0 pa61 fewar nnarn �1, i't. scjpa✓t Ado . SIAW �Iou S�c� IS remove -I& . Q.Koi„c uh W ` ail wr'res av< rH Cow G. ENGINEER'S CERTIFICATION fG''�Il%"^^Get @ (o. v; 9Ph I certify that l have determined through field inspections and ®®ems review of Municipal records that the above systems are in�� OF A+ .r .. `{ conformance with MOA COSA gwde6nes m effect on this date. � , • , ^y „ c Engineer's Printed Name M. °° �9f� Date _ _ _ _ _ /0 .. `f„ d s* s COSA brown sheet 9-1-12.doc 1 ALDERWOO VIS ON OE SUB LOT 2 1 LOT 3 N00'02'00"E 82.50' LOT 4 1 STORY WOOD 2 STORY WOOD ---------- L--------- 15' ELECTRIC EASEMENT DECK A.C.: DRIVEWAY 19.4' LEE STREET SOO-02'00"W 82.50' -8.1' HEIGHTS EAG S RIVER s VI 18N 4 00 M N LOT 9 w cc M Co Ln 6 03 In FOUND REBAR, TYP_ LEGEND SURVEY CERTIFICATION: iOF A `%\l — ADJACENT PROPERTY LINE RODNEY P. KINNEY ASSOCIATES, INC. HAS i�'- "" L.Q — — — — EASEMENT LINE CONDUCTED A PHYSICAL SURVEY OF THIS 4` ' 's� PROPERTY AS SHOWN ON THIS DRAWING AND ��i PROPERTY LINE / 49� THAT THE IMPROVEMENTS SITUATED THEREON � * � ARE WITHIN THE PROPERTY LINES AND NO .... "' _ ENCROACHMENTS EXIST OTHER THAN NOTED. GRAPHIC SCALE "' ' "" " "� ao o zo ao EXCLUSION NOTES:Kevin M. Smith o IT IS THE OWNERS RESPONSIBILITY TO r+i'�s •• x-9234 DETERMINE THE EXISTENCE OF ANY EASEMENTS, '�e+• �.�,(,o%� Z./ COVENANTS, OR RESTRICTIONS WHICH DO NOT ��� $ w ( IN FEET APPEAR ON THE RECORDED SUBDIVISION PLAT. ofessivnal 1 inch = 40 ft. � RPKI ALDERLOT 4 LOT 1-4 AS -BUILT v..WOOD PLACE SUBDIVISION gwy��y PLAT 85-213 s s 2012 FIGURE 1 ANCHORAGE RECORDING DISTRICT MUNICIPALITY OF ANCHORAGE • Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel 1. D. # Lam 0 ^ � - (-0,9i HAA # W fi� 0 Cj(—j 6Q 1 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Alderwood Place Subdv. Lot 4 T14N R2W Sec. 12 Location (address or directions) NHN Lee St. (b) Property owner Micheal Quinn Constr. Telephone: (home) 11.4 Business 694-4955 Mailing Address 11432 Business Blvd.. Suite 189. Eagle River Ak 99577 (c) Lending Institution N/A Telephone Mailing Address (d) Real Estate Company and Agent Address Telephone (e) Mail the HAA to the following address: (or check here ®, if hold for pick up.) List contact person and day phone number below: Pickup by Engineer 2. TYPE OF RESIDENCE Single -Family If Number of bedrooms 3 3. WATER SUPPLY Individual Well t� Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site ❑ Public$] Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 72-025 (Rev. 7/88) Page 1 of 2 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 regulations in effect on the date of this inspection. Name of Firm Eagle River Engineering Telephone ( 907 ) 694-5195 Address P.O.Box 773294, Eagle River, Ak. 99577 Date Z- - f Z/ t ,, aa a , gineer's Seal d{ scar:. ,.+.+*TCsa.• op Qon 6. DHHS APPROVAL Approved for bedrooms by Date Approved Disapproved Conditional Terms of Conditional Approval CAUTION 12 -4/, -90 The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated 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. 7/88) Back Page 2 of 2 jar �\s�0 ,\GAS MUNICIPALITY OF ANCHORAGE (MOA) ���P • Health Authority Approval (HAA)ARM CHECKLIST - FEBRUARY 1984 `J 343-4744 Legal Description: ° f se A. WELL DATA Well Classification fir' ��y-r- If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) Date Completed Yield Total Depth Cased to /'7.)- " Depth of Grouting N/ A Static Water Level /oA Ise >', Pump Set At �` //$ Casing Height Above Ground -1 Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) V Depression Around Wellhead (Y/N) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot n' 14A; On Adjoining Lots f4 io� To Nearest Edge of Absorption Field on Lot ^'Z4 ; On Adjoining Lots i f /C J .. To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole 11 To Nearest Sewer Service Line on Lot yy Water Sample Collected by e "'p^'��� ; Date Water Sample Test Results 0 '-V.J Comments B. SEPTIC/HOLDING TANK DATA Date Installed Size Standpipes (Y/N) Depression over Tank (Y/N) ,✓%<F pd.,6/. ` No. of Compartments Air -tight Caps (Y/N) Pumping/Maintenance Contact on File (Y/N) Holding Tank High -Water Alarm (Y/N) 86 / Foundation Cleanout (Y/N) Date Last Pumped ;for Temporary Holding Tank Permit (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water -Supply Well To Building Foundation To Property Line To Water Main/Service Line To Stream, Pond, Lake or Major Drainage Course Comments To Disposal Field 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA I VA Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of Absortion Area Type of System Design Length of Field Depth of Field Gravel Bed Thickness Depression over Field (Y/N) Results of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Supply Well To Building Foundation Lot To Water Main/Service Line _ Statndpipes Present (Y/N) Date of Last Adequacy Test To Property Line To Existing or Abandoned System on On Adjoining Lots To Cutback (if present) To Stream, Pond, Lake, or Major Drainage Course - To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION ""Ay Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. ""Check Permitted Bedroom Rating Against HAA Request" I certify that I have checked, verified, or conformed to all MOA and HAA guidelines the date of this inspection. 0° Al %1 Signed 9 Eagle River Engineering Services iA` • 113294 Eagle River, AK 99577Company 0 694-5195 00a ® ••0°`�°"�°"�M91rer's Seal Date �'z�3h" �.. •••oaa .....,..®.•.....®,. �* MOA No. L��;� .: A. sutera ♦a •• CE -6736 R0FESS1���� 2 3 6 � `` Receipt No. Receipt No. Date of Payment Amount: $ 7 Q Waiver Fee: $ Date of Payment 72-026 (Rev. 7/88) Back Page 2 of 2 � I Municipality of Ancnorage Department of Health and Human Services Tom Fink, 825 "L" Street Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 October 4, 1990 Lou Butera, P.E. Eagle River Engineering Services PO Box 772394 Eagle River, Alaska 99577 Subject: Waiver Request for Lot 4 Alderwood Place Subdivision Waiver Request #WR900043, PID #050-281-68 Dear Mr. Butera: Your request for waiver of the required 100 foot separation of a private well to public sewer manhole has been approved. The approved separation distance is 86 feet. This waiver approval applies to sewer manhole only. Any future separation distances be met or department. Since ely, � t- 1 Robert W. Robinson Civil Engineer On-site Services ljw #9 the existing well and public upgrade will require all another approval from this CokhnSmi h, P.E. rogram Manager On-site Services N N V1 rrr W W W N � N Q y�7 •. N K au ht�lC r�vN '0004M K �I-fAl? f- 1 1 1 • A L 1' 1 1.1 1„ L- 1 1.1 1 1'•. ►.. v �. 1 �. .� 1 1 s .._..... . Auti-7.e' 7&S7w oI- c.-�sr,•vcy /,^J-, ..a4w•-ra t.rwrrt•wi�" 7-0 -7, S / p -7. 7i Z.• ' Lo�O�C' Il f 8 L7 �u s� 7111Ar4� ilwtAp•" :,1/er rlx+w a Z noel;lrlf rc< W4 s'lz, -Z;7 NORTHERN TESTING LABORATORIES, INC. 2505 FAIRBANKS STREET ANCHORAGE, ALASKA 99503 907.277-8378 - FAX 274-9645 3330 INDUSTRIAL WAY FAIRBANKS, ALASKA 99701 907.456-3116 - FAX 456-3125 Eagle River Engineering PO. Box 773294 Eagle River AK 99577 Attn: Louis Butera Our Lab #: Location/Project: Your Sample ID: Sample Matrix: Comments: A107266 Alderwood Lot 4 Water Report Date: 11/30/90 Date Arrived: 11/28/90 Date Sampled: 11/28/90 ' Time Sampled: 1320 Collected By: LAB Flag Definitions U = Below Detection Limit DL Stated in Result B = Below Regulatory Min. H = Above Regulatory Max. E = Below Detection Limit Estimated Value Date Method Parameter Units Result Flag Analyzed ------------------------------------------------------------------------------------- EPA 300.0 Nitrate -N mg/l 0.5 11/28/90 Reported By: Francois Rodigari Anchorage Operations Manager Municipality of Anchorage Department of Health and Human Services Tom Fink, 825 "L" Street Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 October 4, 1990 Lou Butera, P.E. Eagle River Engineering Services PO Box 772394 Eagle River, Alaska 99577 Subject: Waiver Request for Lot 4 Alderwood Place Subdivision Waiver Request #WR900043, PID #050-281-68 Dear Mr. Butera: Your request for waiver of the required 100 foot separation of a private well to public sewer manhole has been approved. The approved separation distance is 86 feet. This waiver approval applies to the existing well and public sewer manhole only. Any future upgrade will require all separation distances be met or another approval from this department. Since' ely, Robert W. Robinson Civil Engineer On-site Services ljw #9 /onur: Smi h, P.E. ram Manager On-site Services EAGLE RIVER ENGINEERING SERVICES Lou Butera, P.E. iiiiio& P.O. Box 773294 Eagle River, Alaska 99577 Telephone (907) 694-5195 September 21, 1990 Mr. John Smith, P.E. Department of Health 825L Street Anchorage, Ak 99501 & Human Services RE: Lot 4, Alderwood Place Dear Mr. Smith, MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION SEP 2 41990 RECEIVED a6D -1A At the request of our client, Mr. Michael Quinn, we are applying for a determination of waiver for a private residence well to sewer manhole distance of 86 feet versus the required 100 foot distance. The well is located as shown on the attached plot plan. The sewer manhole is the terminus of a 8 -inch ductile iron lateral installed in 1985. The manhole is not utilized as the closest service point is 90 feet down grade of the manhole. The manhole is designated Type A and is 12 feet below grade in SM type soil material. Ground surface slope is minimal between well and manhole. The well log shows a total casing depth of 173 feet with a measured static water level of 102 feet. The well penetrates confining soil layers of "tight silty gravel" (4-28 feet) and various silty , clayey gravel layers. The well has a high production rate with minimal drawdown showing the aquifier has an excellent nitrate mixing capacity. The area is of low population density, and the distance variance under consideration is minor. Water samples are satisfactory. Nitrate level is 0.33 MG/L. If you have any questions or any further concerns please call me at 694-5195. Sincerely, Louis Butera, P.E. ma L,-)hoLQ 0-0-e- -�i 113 ,�I.Q I i - 3Q q -I C? -191 -90 �W z .w-Hac�aoao 4 0 -Z 0-4 zy�Na�.94cq p'o��umv�zoay ' .i ��am4� w a.OE GV to to NU -ca (aN �aV wZ'vZ b �• p� (:� Q ' .H 4�1oy� Ec4u�IyKzOOZWQ H ..w.0 x Z,2Hcn .;z w OP003HH� Z ac cp>;COU co 40 0 �vNz°° HaE�E' uVTw�H zW9,0)'� O.,0OW '4HH.EaaHUUo0aMm H •D4 .90 94 i4011N'NC�Hr-7�.U4s�UUZUUMaS4 C4 H03aNHNagor'rdma4HzHC-4 94 414c73WoUa"14ZZNU�RZazzHzzp.NH3HWaOpRozogHo,00cooZfkrAzQr,c4N C4 u log �•Otq 1: r4 N en •et Ln % r co ON r -I r••I r -I 114 c. - 11 L LQ Z t3 w ♦ 2 Q ILAJ N. 54 i 47' Q N �•: •� Ajp, � N m I . Z m W r co J O I h Iq 1001 . i • yi AI NO`i3n8.LSN03 ON3 j { 90*16b='A313'1 dOl j 3'IOHNVW _ i V 3d11 3j ca co o r W W } 0 i z U) .. I. w a r i r F, t I I 1 t I I 1 1 r / I I I � I I � 1 I { I I I I 1 � 1 I � � r• I 1 ' LL .-IN 1 it ta le ernE—groes ng Se Box rvices Ea le River, AK 99577 AyP�.Wo� 694x5195 7iS7` ,MOO, .r r rap p/: Gr9X/n/ C7 AeAkj Z 3 5 ,2. >v ,ey P,4T.9� 7Z;, WWE-14 141 //3 -5 /,1 / , 8 B /off, 5 /v7,8 Z„ ,,•,cox r°rW- Gf. 4wk /O -,5-4L ' \ V7 35 //e. 0 39-o"45 ! ulH O"r LA 5T 31 f05 6:10,t 0 0 AeAkj Z 3 5 ,2. >v ,ey P,4T.9� 7Z;, WWE-14 141 //3 -5 /,1 / , 8 B /off, 5 /v7,8 Z„ ,,•,cox r°rW- Gf. 4wk /O -,5-4L ' \ V7 CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. 5633 B STREET - ANCHORAGE, ALASKA 99518 - TELEPHONE (907) 562-2343 FEDERAL TAX I.D. #92-0040440 ANALYSIS REPORT BY SAMPLE for Work Order 1 26585 Date Report Printed: AUG 22 90 1 11:14 Client Sample ID:ALDERWOOD SUB LOT 14 PWSID :UA Collected AUG 16 90 1 18:15 hre. Received AUG 17 90 1 17:15 hre. Preserved with :AS REQUIRED Client Name RODNEZ P KINNEY ASSOC. Client Acct RODNEYN P.0.1 NONE RECEIVED Req 1 Ordered By : LOU BUTERA Analysis Completed :AUG 21 90 Send Reports to: Laboratory Super isor :ST,EPREN C. EDE/ 1)RODNE1 P KINNEY ASSOC. Released By G �jy'/'s__ 2)RODNEY P. KINNEY & ASSOC. ................................................................................................................................ Special Instruct: Chemlab Ref 1: 903119 Lab Smpl ID:,1 Matrix: WATER Allowable Parameter Tested Result Unite Method Limits -----------------------------------•--------------------------------------------------------------------------- NITRATE-N 0.33 mg/1 EPA 353.2 10 Sample SAMPLE COLLECTED BY ROD KINNEY. Remarks: ............................................................................... .......... 1 Tests Performed See Special Instructions Above UA -Unavailable ND- None D,tected Soo Sample Remark: Above NA- Not Analyzed LT -Less than, GT -Greater Than o� � �� y ti � .t. m b �• q R e � ,C W A •O b V O Q y � .,, v N H q R� J` J b o v..b ° b c a v �awtmOU°Ebwm aha �� a :-Oy�oma`0io�vma �mN � QQ 4yi WRQ cu c4tS o«?cy¢ ' w c • '� i o a m• c y ¢ Q J 1. N m D r a 0 •l � � 2 a � E W W � W 8 � J C o 5 U o w 19 � T ,E e E z o' 7 _fJ�- .orae ,os• ,00.0E t e o 6 b as ,os'ae ©s'ae a F 3„OQa00k -- b a: '. T M a ~o I c j ( Q 0 4 D �I 2 ;u toads 33-1 -- -- W mLAJ Q Y I C1 0 \ � d Z a Y j �o b U � � Ow Q W 3 cn y p E p a S 2 Lo z _t y r o' 7 _fJ�- .orae ,os• ,00.0E t e o 6 b as ,os'ae ©s'ae a F 3„OQa00k -- b a: '. 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