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Home My WebLink AboutROBIN HILL #3 BLK 3 LT 6Robin Hill #3 Block 3 Lot 6 #017-394-12 On -Site Water System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP131342 Tax Code Number: 01739412000 Work Type: Well Permit Effective Dates: September 20, 2013 to September 20, 2014 Design Engineer: Subdivision: ROBIN HILL #3 Site Legal Address: ROBIN HILL #3 BILK 3 LT 6 G:2838 Owner/Address: GOLICK JOHN D 12961 MOUNTAIN PLACE ANCHORAGE AK 995163188 Site Mailing Address: 12961 MOUNTAIN PL, Anchorage This permit is for the construction of: N Disposal Field N Septic Tank N Holding Tank N Privy All construction must be in accordance with: Lot Size in Sq Ft: 77842 Total Bedrooms: 3 Y Private Well N Water Storage 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received B Issued By: MUNICIPALITY OF Community Development Department Development Services Division 6 On -Site Water & Wastewater Program •'. Phone: 907-343-7904 Fax: 907-343-7997 RUSH! ON-SITE SEWERNUELL PERMIT APPLICATION , Parcel I.D. ©n--�ctq- ia l 7 j Property owner(s) �00Q Day phone Mailing address Site address SAM G Legal description (Sub'd., Block & Lot) LO/ �� B �� -��, Z013W Ola, bL 2 Legal description (Township, Range & Section) Lot Size I . I q. Ft. Number of Bedrooms APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Single Family (SF) Absorption Field ❑ Initial ❑ Septic Tank ❑ Upgrade (w/wo ADU) Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well Pq Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. Permit/Rush Fees: d0jb Waiver Fees: Date of Payment: Ct I I Sd I C&Date of Payment: l3 Receipt Number: dbF��b Receipt Number: Permit No. 13t-ka. Waiver No. Permit App__-: 4A 8 4 s PiRc; ly ti 4 fT1 Z I r 2 F r ca O o 4 �+ 4 C w Z m V, ri p s PiRc; ly ti 4 1 �,.._ NA O LJ N -T-,4n,, i hd U C 0 ()1 OD to 65 F- ,ir9'ZtZ 21'-10 114" L a,GE N O O O , ca v 10' UTaLITY EASEMENT .00'09Z 3 J? U0.00 5 A"em-G/ ........... D i : • •:J OA44 •r ,,. a !irx".C�1";.t,Ff?if4Y'��tlr .Y Cc��tiF[— D wn� � � � ins `�• [.� o � r c v n? Municipality of Anchorage Pana a DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 a Anchorage, Alaska 99519-6650 • Telephone: 3434744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: S49 PID Number: "'meBQIAnL4Dp Wastewater System: gNew 0 Upgrade Address: ABSORPTION FIELD PAO"° of ei0ro°""` 3 0 Deep Trench Shallow Trench 0 Bed 0 Mound 0 cow LEGAL DESCRIPTION $°''"""'° Ta"' DI'': °'r"".'"'" , i6 Lot:/ Block: 9Subdir �1�� ppmbraOOUow"sa i49rWt Gravel OWMber"Mpipe �. Ff. Township: Range:Section: FiUadded ewbopraiW. (irarNlarnpN: NO1%frFt.%L WELL: )(New O Upgrade Gravelwi '' S R. lry �alirw k,re °wane ISFL Clauificauon (Private. A,B,C): PJ214*T6 Total Depth: 8/ Caned To: 8a.SFt. Total abaeption erect: ZO Pipe material: 3034 PVCO Ft. T Driller: M- w Date 11M. IV, $Wc; riaSW ss tiaelelter: Al�ctsr� OeNklelaMad 9 i 12111 lrJ 9 L Ft. Yield: 7 Pump Setal: Gww 3 t cam: TANK GPM !fa FI SEPARATION DISTANCES Xseptic 13Holdinp 13 STEP. To Septic Absorption lin marmucWW.4eri. �yb" �Zso From Tank F*W Station Tank Sever Line agar. Well /SD' Ida, — — 142 Material: STLCL. rwtee"etc�.nmarw Waere — — — — — LIFT STATION– Lot N• I Size In paawie: mommclwe: Line Foundation 6' ZZe P°rr1pWwow at otrW tar "tohMOMf' Mat Curtain PlesptMiaitim EMatriealtirpedbnaperbrmWby Drain Remarks: OVC25j&iV- PTiiC. BENCH MARK N V.LA c t; r Location and Daaaipuarl: Tor op FovaDA-+eN e - T uJALL a"li 1sr %aaw— OR Flo usGIFf a, 41 _I_� Inspections performed by: M- 4pibeRSoAl Data: 1s 9 �° 9°° 2nd 9/ b° i$°Michael E. Anderson +� a `, 13- Department of Health d u anrices approval °°a °°$�°°°°°� Reviewed and approved by. Date. 72-011911ter.IVatl MOA 25 Permit No. SW&01224 Pape Z. of 3 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 0 Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Legal Description: <6 If 3 ledXh //jf5 v M. 72-013 A (Rev. 9191) MOA 25 0 E 4 M f CW /it= SO PID No.: --el -1!12 /7_ I,JQ-L O pAGIN991t SEAL V .,J .1d ad a�ooa` o eae �-- s Michael F,. An decso s A381• c lk'ePROFessl��• Permit No.�� 3 Papp _3 of 3 r Municipality of Anchorage 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 Description: LoT-L BL-ocie-3 PoB1f7IwS J ^i PIDNo.: 9 0 $c4C4 AAAft.1L a .100 •'o/ OF lvu4bA710J Wa�" 4oar1 cw- t444a L 0p Foust; 72-013 A IRw. Y91) MOA 25 'ir !% 063 "JO[0H .v l' -1J EJ/y, V ;� U p�v, OD 6 Irl rte. % em e� �cacuao �a000 aOeoE oo��,°�n ,Michael E. Anderson $ o� 4381 - E 0 CO3B08 F.\. ca �0fy�=�ss�o`'r M -W DRILLING, Inc. P.O. Box 110378 0 10330 Old Seward Highway �-'(907) 349-8535 ANCqORAGE, ALASKA 99511 DRILLING LOG. BRIAN LADDD Domestic Well Owner I of Well Location (address of: Township, Range, Section, if, known; or. --'distance main road Lot 6 Blk. 3 Robin Hills Size of casing 6 epth of Hole 81 feet Cased to --- U -.5 ---feet Static water level 58 `ft. (Abliby"I , below) land surface. Finish of well (check one) open end X a. ' Screen Perforated ( '#1 Describe screen or perforation NIA 7 Ot 2 1007, Well pumping test at OWW) (minute) for __--hours with t. of drawdown from staticYel A nnfn of Auj 7292 Depth in feet from ground surface 0 TO --L- 2 15 To— :15 17 To— 17 20 20 60 TO 60 81 To— TO- TO- TO- -TO- -TO WELL LOG of formations penetrated, size of material, color and hardness ickUD R ECF I VFn Bldg a< t NOV 2 1992 4 MU nlcipala� Ot Anchnrmc1g, Dept.,; altvalth & HUMan Services vic 4V :, Ok Jidl �jes Nw VV MW To- -TO— TO- 0- 3—CONTRACTOR M&W DRILLING TEL Nu.907-345-3287 Mar.18,93 5:37 P.01 M -W DRILLING, Inc. P.O. Box 110378 • 10330 Old Seward Highway r (907) 349.8535 ANCHORAGE, ALASKA 99511 GRILLING LOG BRAT`d LAD'Domestic Well Owner Use of Well Location (address of: Township, Range, Section, if known; or distance main road Lot 6 Blk. 3 :"obin hills Subd. j Size of casing 6 Depth of Hole 22feet Cased to 19 7 feet Static water level 53 ft. (1&8) below) land surface. Finish of well (check one) open end Screen ( }_ ); Perforated ( v). i Describe screen or perforation — r' t� perf'd from 58-63, 83-98, 116-135 v7 4 slots/f� Well pumping test at 1 lro2gallons pet >(~) (minute) fore hours of drawdown from static level. `tote: A 4" PVC csg & screen was Inst-alled Date of completion 05 March 1993 screen from 50•-60' & 145-2001. Annul -L. packed w/ 3/8 minus pea gravel. WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness -4�__TO E1 Existing Well of TO 97 Ueaving Sand D (• Ix/ _87 TO .,7 Flardpan 2 2 1995 07 TO 9Q.5 Small. Vater Gravel `MAK Dept. Health & Human Services _@R,5 TO 10y Hard an 1''16 TO 120 51 ltv Sand • wet 1-?�—TO 13G c`lavev Gravel broom damp - 1 3 r" _To S_ 'dateg Gravel — __12_5__TO 170 - Cl,g ey Nardpan wL small grAvel streaks --no--To 1q9 CnArse ('ravel �I C)-, TO 903 [dParhPrej !Pdrnck -- ---20-:A TO -22 Rerlrortk • grP;g• 1 ` t-nne:..,q*rgij11Le-.- a few wat-er semis in sporadic fractures. _ TO_ TO TO 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:SW920026 DESIGN ENGINEER:ANDERSON ENGINEERING OWNER NAME:LADD BRIAN J & CECILEE OWNER ADDRESS:7501 SOLARSET ANCHORAGE, AK 99505 PARCEL ID:01739412 LEGAL DESCRIPTION: ROBIN HILL #3 BLK 3 LT 6 LOT SIZE: 77842 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: PAGE 1 OF 1 DATE ISSUED: 3/10/92 EXPIRATION DATE: 3/10/93 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: ISSUED BY DATE: /yZ DATE : !7 Dear Technician: I have reviewed information available on lots adjacent to the subject property and have conducted an onsite investigation. Lots immediately adjacent to the property are currently vacant with no onsite systems. Systems located on other properties in the neighborhood are more than 200' from the proposed systems on the subject lot. The terrain of the lot is fairly flat with the center of 4he lot somewhat higher than'• the lot lines. In addition, the following comments pertain to the property: 1. The system, if constructed as designed, will have no adverse impacts on the wells currently in use or to be placed in the future on lots located in the area. 2. The •system, if constructed as .designed, will. -have no --adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserved space either surface or subsurface on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. Sincerely, Michael E. Anderson, P.E. k�Y- doe 0'49 TI4 �6 dada„soaea aa,ddaoa oeodoeG�ae e OaoOd0a,a0ob0 ddo00d Goad oboe, .0 Michael E. Anderson e' 4381 - E ® TF dd,o d,® �� Aw *000000 rn August 18, 1991 o z `a V Municipality of Anchorage ;V Dept. of Health & Human Services g o Environmental Services Division m m 825 "L" Street, Room 502 rm o Anchorage, Alaska 99501 Subject: Lot 6, Block 3, Robin Hills Septic System Design Impacts to Adjacent Properties Dear Technician: I have reviewed information available on lots adjacent to the subject property and have conducted an onsite investigation. Lots immediately adjacent to the property are currently vacant with no onsite systems. Systems located on other properties in the neighborhood are more than 200' from the proposed systems on the subject lot. The terrain of the lot is fairly flat with the center of 4he lot somewhat higher than'• the lot lines. In addition, the following comments pertain to the property: 1. The system, if constructed as designed, will have no adverse impacts on the wells currently in use or to be placed in the future on lots located in the area. 2. The •system, if constructed as .designed, will. -have no --adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserved space either surface or subsurface on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. Sincerely, Michael E. Anderson, P.E. k�Y- doe 0'49 TI4 �6 dada„soaea aa,ddaoa oeodoeG�ae e OaoOd0a,a0ob0 ddo00d Goad oboe, .0 Michael E. Anderson e' 4381 - E ® TF dd,o d,® �� Aw *000000 JOB �Or 51,0 G(- 3, pt o 3 to 14I u-,5 SHEETNO. OF CALCULATED BV DATE CHECKED BY DATE JVNLC .. .. .......... Lot- ET ..... ......... .......... ........... is _ �VAGsl0—T 4 Uy \ O _... _... r z / P�P�SSD ;....._ 1 } ............ ..... %r 7 � . (J� r,OF S� rc �caa A - e eo AV st �pQ .{q : 6J� Q -sad S` � 0 -.. - :....... ...... _... .... �Y aFP' ` 1 e �c l .... v�QC Q398pga4d aQ 0Q ®LQR9eYG@ . c-PTUL AAC p� fftiti®®x'33 oai®aooASFa]`ao o eeoao e.,[/owe E,q Q ;e Michael E Anderson 1-j J on _...4387-E ... ° Qo Q ®��^fa • SHEET NO. U OF .9�, �J.a 40 A, LoC' CALCULATED BY ... . ....... . .. . . . ........ DATE CHECKED BY DATE .. . .. ..... SCALE D15AD5 A L .5"1 . . ....... .. ....... ... . ....... PtM CO LA 7-7 0 j 141 Aj .......... ..... ....... .. .. .......... - 7-/ D f,; -o 6AI- !S- x ]::t. ol 4 Z67 —7. dAr) ... .. . ..... B AV C7 LID rCX T I LC7 i FA ........ . ...... Lb ........ ... . . .......... .... .. .. ........... . ...... ... .. ... ..... . ..... ...... . ........ . - ...... .... ... ... .. A/ .. ... .. . .. .. .. . ......... ....... ...... .... .. .............. T -u uc I -X U .9�, �J.a 40 A, LoC' cr"( ... . ....... . .. . . . ........ cO l ucbaei Anderson 1%i 1,7 .. . .. ..... O�}EN 1�'�S SEAL) yy✓✓ a 4 a Municipality of Anchorage t DEPARTMENT OF HEALTH & HUMAN SERVICES;d' p•i 6 BJP°P 04947 Asaa asCfi° POae° 825 "L" Street, Anchorage, Alaska 99502-0650 1p �t F SOILS LOG —PERCOLATION TESTP_MtchaeleEn Anderson e+oe PERFORMED FOR: ZAt4 ' G,:,A4 Net Drop LEGAL DESCRIPTION: ��t' 1. ^.'f3ltlj. ��II�V, Township, Range, $e L SLOPE g. S 7,) 07 Dl--PZU (F EE^TJ) 9. ZS 37 / !rz 9.L3 8 :17 /0140 .3 / az 2 3 :2 /.SYP .2S '3z 5 ;t .3Z 1:37 /l. z5 .3 4 5 t 11-67 -32- 2. i 6 7 8 v 9 ° 16 17 18 19 WAS GROUND WATER ENCOUNTERED? S �— L 0 E 9/17 ✓! v Ci;% `0oa�0 o°� �G• cJ D _ DATE PERF�'Ef7�' ,_ :tion: SITE PLAN IF YES, AT WHAT DEPTH? Depth to Water After Monitoring? /y0^/C Date: Reading Date Gross Time 20 Net Time Depth to Water Net Drop �� 41 rz:sy--- L g. S 7,) 07 9. ZS 37 / !rz 9.L3 8 :17 /0140 .3 / az S /o. 31 .31 :2 /.SYP .2S '3z 5 /o, .3Z 1:37 /l. z5 .3 1: qL 5 11-67 -32- 2. 20 PERCOLATION RATE 1/ ` (minutes/inch) PERC HOLE DIAMETER ( ET jyTEST RUN BETWEEN v FT AND FT G��T COMMENTS I�I 1SDLC pi AS PkC-50+4rL-6D PR.1a2 PER GALA -'i 0 JJ 'TA`s 7^17~16. n Q �n PERFORMED BY:/ I""'"""�' 4��""`°' CER IFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:�� j- o 0 eye a Municipality of Anchorage .< DEPARTMENT OF HEALTH & HUMAN SERVICES e 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: DATE PERF LEGAL DESCRIPTION: LL/ r" " OXOO W I'1 l �l�<Township, Range, Section COMMENTS 4 pj f15 . Di F. A.Iderson 4381-E SITE PLAN WAS GROUND WATER I, P ENCOUNTERED? UP s IF YES, AT WHAT L DEPTH? P E Depth to Water Aller , I Monitoring? �y Date: DEPTH (FEET) I /�✓ 1 .. 2 3 4 5 /• 6 b 7 8- i 9- 10 10- 11 11 ,q 12 b'' . 13 14- 4 15- 151s 16 17 s1918- 1 9 20 COMMENTS 4 pj f15 . Di F. A.Iderson 4381-E SITE PLAN WAS GROUND WATER I, P ENCOUNTERED? UP s IF YES, AT WHAT L DEPTH? P E Depth to Water Aller , I Monitoring? �y Date: PERCOLATION RATE (minutes/inch) -PERC HOLE DIAMETER 6 y TEST RUN BETWEEN FT AND —Z— FT T'. — LLi� ..Ae' 'P3n.- C,-1 A,, I>.?,ne PERFORMED BY: �/ L-1� I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) Depth to Water .. PERCOLATION RATE (minutes/inch) -PERC HOLE DIAMETER 6 y TEST RUN BETWEEN FT AND —Z— FT T'. — LLi� ..Ae' 'P3n.- C,-1 A,, I>.?,ne PERFORMED BY: �/ L-1� I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) SURVEYORS PLANNERS ENGINEERS TRANSMITTED TO: e z ATTENTION: DATE: 9 - /24- - 2 TIME: _ # OF PAGES (INCLUSIVE) SENT BY,- MESSAGE: Y: MESSAGE• f % `(_.� t ' •l / �_.5 RECEIVER: PLEASE DELIVER THIS FACSIMILE TRANSMISSION TO THE ABOVE ADDRESSEE. IF YOU DO NOT RECEIVE ALL OF THE PAGES IN GOOD CONDITION, PLEASE ADVISE THE SENDER AT YOUR EARLIEST CONVENIENCE, THANK YOU FOR YOUR ASSISTANCE FAX (907) 561-6626 PHONE 562-5291 440 WEST BENSON, SUITE 1 03 ANCHORAGE, ALASKA JJ503 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTHAND HUMAN SERVICES MEMORANDUM DATE: March 22, 1993 TO: Leslie Jordan, Public Works, Permit Counter FROM: Daniel Bolles, On -Site Services SUBJECT: Lot 6, Blk 3, Robin Hills #3, PID #017-394-12 Please be advised that the well and septic system constructed on the subject lot are now in compliance with the requirements of AMC 15.55 and AMC 15.65 respectively. db/205 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTHAND HUMAN SERVICES MEMORANDUM DATE: November 18, 1992 TO: Leslie Jordan, Public Works, Permit Counter FROM: Daniel Bolles, On -Site Services SUBJECT: Lot 6, Blk 3, Robin Hills #3, PID #017-394-12 Please be advised that the well and septic systems constructed on the subject lot do not currently meet the requirements of AMC 15.55 and AMC A.65 respectively. C.O. should be withheld until approval by this department is granted. db/205 Municipality of Anchorage .Development .Services Department Building Safety Division On -Site 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 FOR A SINGLE AFAMILY DWELLING Parcel I.D. 01739412 1. GENERAL INFORMATION COSA# 05G /0 /P.1 a Expiration Date: Complete legal description ROBIN HILL #3; BLOCK 3, LOT 6 Location (site address) 12961 MOUNTAIN PLACE *ANCHORAGE, AK Current Property owner(s) BRIAN LADD Day phone 345-5499 Mailing address Lending agency Mailing address Real Estate Agent Mailing address 12961 MOUNTAIN PLACE *ANCHORAGE, AK Day phone BETH SIMPSON W/ KELLER WILLIAMS Day phone 865-6556 101 W. BENSON BLVD. SUITE 503 *ANCHORAGE, AK 99503 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER Of BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site Individual Water Storage ❑ i Individual Holding tank ❑ Community Class Well ❑. Community On-site ❑ Public Water System ❑ Public Sewer ❑ 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 samples. (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, 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 tiles 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 GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Date Engineer's Printed Name Engineer's Comments: Phone 337-6179 JEFFREY A. GARNESS, P.E. In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the own r --4 d b A 1' ..... ...........� A. G rness; "V ofes /i "y l� l� Q'P�\ e �s e a ove. ny re rance upon or use of 1111S report by any 0000 (t , /trrj other person or party is not authorized, nor will it confer any legal right whatsoever. i 0 r, DSD SIGNATURE �XV`•' '•,y©F: ON-SITE Approved for bedrooms. : '� • WATER AND • K� WASTEWATER Disapproved._ PROt;RAM _ Conditional approval for bedrooms, with the fllowing stipulations: �,o'.. .•'�Q``.t�� • oNT Attachments: COSA Checklist � Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineer's Report Nitrate Advisory Other By: % Original Certificate Date: 9 �v (Rev. 11105) Municipality of Anchorage Gh gv • Development Services Department Building Safety Division On -Site Water & Wastewater Program p T. 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: ROBIN HILL #3; BLOCK 3, LOT 6 Parcel ID: 01739412 A. WELL DATA Well type PRWATE If A, B, or C provide PWSID# N A Date completed 8/21/1992 Sanitary seal (Y/N) YES Total depth 229 ft. Cased to 197 ft. Date of test Static water level Well production FROM WELL LOG 3/5/1993 53 ft. 1.5-2.5 WATER SAMPLE RESULTS: Coliform 6olonies/100 ml. Arsenic: ug./L. B. SEPTIC/HOLDING TANK DATA Well Log (Y/N) YES Wires properly protected (Y/N) YES Casing height (above ground) 12+ in. AT INSPECTION 7/9/2010 57 ft. g.p.m. 0.62 g.p.m. Nitrate ma I mg./L. Other bacteria colonies/100 ml. Date of sample: 7/9/2010 Collected by: GEG Ltd. Tank Type/Material SEPTIC/STEEL Date installed 9/17-18/1992 Tank size 1250 gal Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping -V Pumper ISAAC'S PUMPING C. ABSORPTION FIELD DATA *BELOW ExiSTI cRA�E Date installed 9/17-18/1992 Soil rating (g.p.d./ft2o /bdr 0.8 System type SHALLOW TRENCH Length 20 36'=72 ft. Width 5" ft. Gravel below pipe 3 ft. Total depth *9.58 ft. Eff. absorption area 620 ft2 Monitoring tube YES Depression over field NO Date of adequacy test **7/9/2010 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 9 in. Water added 626 gal. New depth 23 in. Elapsed Time: 120 min. Final fluid depth 21 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date - **WEST TRENCH TESTED ONLY, EAST TRENCH WAS VISUALLY INSPECTED AND FOUND TO BE SURCHARGED. D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N "Pump on" level at in. "Pump off' level High water alarm level at in. Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ Public sewer main N/A On adjacent lots 100'+ Public sewer manhole/cleanout N/A Sewer /septic service line 25'+ Holding tank N/A Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water, Wells on adjacent lots 100'+ 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building, foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION ► 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 JEFFREY A. GARNESS Date 17 h O /) D COSA Fee $ q 10 Waiver Fee $ _ Date of PaymentTT40 Date of Payment On Receipt Number L-/ Receipt Number. (Rev. 11/05) Municipality of Anchorage P.O Box 196550 4700 Elmore Road Anchorage, Alaska 99519-6650 (907) 343-7904 Fax (907) 343-7997 hftp://www.muni.org/onsite Planning and Development Services Department On -Site Water and Wastewater Program On -Site Sewer/Well Submittal Comment Sheet Engineer: GARNESS ENGINEERING GROUP LTD 9/24/2010 Legal Description: Robin Hill #3 Blk 3 Lt 6 Permit: OSC101219 WellSeptic Completed By: J.Poet Report Type: COSA The attached paperwork has been reviewed and is being returned for the following reasons: COSA will not be approved. Inspected system on 9-24-10 and found trenches full. :� l L �l�l�✓�t�lJ✓ �qc ec- G le,4 l2 -CSX J^ 7- L/ I -Vf e LI i P Cil e 1.1 G GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS September 28, 2010 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650, Anchorage, Ak 99519-6650 (907) 343-7904 Attn: Jeff Poet. Ref: Robin Hill S/D #3; Lot 6, Block 3, Mr Poet: Per your request, we re -inspected the septic system on the subject property. A site visit was made on 9/28/2010. Elevation shots were taken to confirm the liquid level in the west trench. It was found that the trench only had 7 inches of standing water (out of 36 inches effective depth). The cleanout in question (south cleanout of west trench) appears to have a slight reverse grade in between the tank and the drainfield. We believe this is a result of poor construction and is the only cause of the standing water in the cleanout. This is corroborated by the fact that the north cleanout of the same trench is dry. In short, the drainfield is functioning correctly. We therefore ask you to approve the C.O.S.A. for the subject property. If you have any questions, please contact us at 337-6179. Thank you for your assistance. Sincerely, r frey, , ,t(�rne ., M.S. 3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507-1259 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.gamessengineering.com Municipality of Anchorage • Development Services Department Building Safety Division S A E 7 Y On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www. ci. anchorage. ak.us (907)343-7904 Water Well Advisory Certificate of On -Site Systems Approval (COSA) # 101219 During a recent COSA on-site inspection and test of the potable water supply well on Block 3, Lot 6 of Robin Hill #3 subdivision, the well's productivity was determined to be 0.62 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 3 -bedroom residence is 0.31 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. SGS Ref.# 1103369001 LOQ Units Client Name Garness Engineering Group, Ltd Printed Date/Time 07/13/2010 17:11 Project Name/9 Robin Hills 43 B3,L6 Collected Date/Time 07/09/2010 14:38 Client Sample ID Robin Hills 43 B3,L6 Received Date/Time 07/09/2010 15:20 Matrix Drinking Water Technical Director Stephen C. Ede Sample Remarks: Parameter Results LOQ Units Method Container ID Allowable Limits Prep Analysis Date Date lnit Metals by ICP/MS Arsenic ND 5,00 ug/L EP200.8 C (<10) 07/09/10 07/12/10 NRB Waters Department Total N itrate/N itrite-N ND 0.100 mg/L SM20 4500NO3-F B (<10) 07/12/10 AYC Microbiology Laboratory E. Coli Negative 1 I OOmL SM20 9223B A 07/09/10 DLC Total Coliform Negative I I OOmL SM20 9223B A 07/09/10 DLC ISAACS PUMPING SERVWI::Cj M -w DRILLING, Inc. P.O. Box 110378 • 10330 Old Seward Highway (907) 349-8535 ANCHORAGE, ALASKA 99511 DRILLING LOG Well Owner BRIAN LADD Use of Well Domestic Location (address of: Township, Range, Section, if known; or distance main road: Lot 6 Blk. 3 Robin Hills Size of casing 6" Depth of Hole 81 feet Cased to 80.5 feet Static water level 58 ft. (awe) (below) land surlface. Finish of well (check cne): open end ( X ); Screen ( ); Perforated ( ) Describe screen or perforation N/A Well pumping test at 7 gallons per (hour) (minute) for 2 hours with 100% ft. of drawdown from static level. Date of completion: August 21, 1992 WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness 0 TO 2 CSG Stickup 2 TO 15 Peat 15 TO 17 Mud 17 TO 20 Gravel: Small 20 TO 60 Grey Silty Clay 60 TO 81 Med Gravel: Water Bearing NWWA Certified Contractor Certificate No/s, 814 & 978 M -W DRILLING, Inc. P.O. Box 110378 • 10330 Old Seward Highway (907) 349-8535 ANCHORAGE, ALASKA 99511 DRILLING LOG Well Owner BRIAN LADD Use of Well Domestic Location (address of: Township, Range, Section, if known; or distance main road: Lot 6 Blk. 3 Robin Hills Subd. Size of casing 6" Depth of Hole 229 feet Cased to 197 feet Static water level 53 ft. (above)(below) land surface. Finish of well (check one): open end ( ); Screen (X); Perforated (X) Describe screen or perforation: Csg perf d from 58-63, 83-98, 116-135 w/ 4 slots/ft. Well pumping test at 1.5 to 2.5 gallons per (how)(minute) for 24+ hours with 120 ft. of drawdown from static level. Date of completion: 5 March 1993 Note: A 4" PVC csg & screen was installed w/ screen from 50-60' & 145-200'. Annulus packed w/ 3/8 minus pea gravel. WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness 0 TO 81 81 TO 87 87 TO 97 97 TO 98.5 98.5 TO 106 106 TO 120 120 TO 130 130 TO 135 135 TO 170 170 TO 192 192 TO 203 203 TO 229 sporadic fractures. NWWA Certified Contractor Certificate No/s, 814 & 978 Existing Well Heaving Sand Hardpan Small Water Gravel Hardpan Silty Sand: wet Clayey Gravel: brown, damp Water Gravel Clayey Hardpan w/ small gravel streaks Coarse Gravel Weathered Bedrock Bedrock: grey siltsone argillite, a few water seaps in MUNICIPALITY OF ANCHORAGE�� • DEPARTMENT OF HEALTH & HUMAN SERVICES dl�j 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. # kp\--) _ .�iI Ll — 1 ra HAA # 0 C�°I ` f-_)-- ?A 1. GENERAL INFORMATION Complete legal description' Location (site address or directions) f zq6 l Aa>� tJ Mm 41 M0u,0-a--Ajj,9 t'4ACC 'A_% Property owner 43 i rk LASDay phone 34)q` 109q Mailing address 7O Z -r "' `1 � ��-- ct Lending agency Mailing address. Agent Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well X Community well Public water Day phone Day phone NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site 3C 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 N21 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. Name of Firm /i,`'f?ice ��,),.J �i�1 �/tJC-L-�,AAJ Phone `Iq- Address ) l Z-4- 6i`- A -a- Engineer's signature _121'1161 '116 Date J� 6. DHHS SIGNATURE _, L Approved for Disapproved. Conditional approval for Additional Comments W M bedrooms. 111Tir c(•.? ;ICF O£i°a C1.Rnderso" ,��' en �{ c'�\°�481 _t °aa1,a4� fe�FCp °peoyoeo°®q° �� 0 Slti\il\\- az. IT Z_ bedrooms, with the following stipulations: 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. Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: r.OT zoo &0U(_ S. 2,1)89/4 f7r Parcel.I.D. elf A. WELL DATA Well type } RRI VAT'G' Log present(Y/N) Total depth Sanitary seal (Y/N) If A, B, or C, attach ADEC letter. ADEC water system number Y Z -9I Y — Date completed 3,& &T Driller IV) _kJ DIZr(-(-fel 6 � 7Z / Cased to /T 7 Casing height / 3 Wires properly protected (Y/N) WATER SAMPLE RESULTS: Coliform o Nitrate Other bacteria D Date of sample: Collected by:1 B. SEPTIC/HOLDING TANK DATA 9 Date installed '?//'7 19 Z- Tank size 1 L`-�® Compartments Ta Cleanouts (Y/N) Y Foundation cleanout 'Y/N1 Depression (Y/N) Iq High water alarm (Y/N) Alarm tested (Y/N) Date of pumping N dW left rJ S,Mu cr/0 1,J Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: r Wei I(s) on lot /SO On adjacentlots '�00 Foundation AIIA To property line /IV Absorption field Water main/service line Surface water/drainage NO A) &- /D / 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE FROM WELL LOG AT INSPECTION C7 (D� c Date of test .316 S j w rn Static water level Xe,g.p.m. Well flow g.p.m. c o roco --- Pump level L) 14,N 10yJIQ 00 ca t'il C o c� SEPARATION DISTANCES FROM WELL TO: <.(Q Septic/holding tank on lot r On adjacent lots >/00 N Absorption field on lot 142- ; On adjacent lots >/-dD M( CCI /A U0 Public sewer main Public sewer manhole/cleanout Sewer service line > 50 Petroleum tank �DJJ C WATER SAMPLE RESULTS: Coliform o Nitrate Other bacteria D Date of sample: Collected by:1 B. SEPTIC/HOLDING TANK DATA 9 Date installed '?//'7 19 Z- Tank size 1 L`-�® Compartments Ta Cleanouts (Y/N) Y Foundation cleanout 'Y/N1 Depression (Y/N) Iq High water alarm (Y/N) Alarm tested (Y/N) Date of pumping N dW left rJ S,Mu cr/0 1,J Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: r Wei I(s) on lot /SO On adjacentlots '�00 Foundation AIIA To property line /IV Absorption field Water main/service line Surface water/drainage NO A) &- /D / 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent(Y/N) High water alarm level "Pump on" level at Meets MOA electrical codes (Y/N) Manufacturer Manhole/Access (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots "Pump off' level at Cycles tested Surface water _ D. ABSORPTION FIELD DATA Date installed T/17`% q Z- Soil rating 6191011 =7 System type Length Width 5 Gravel thickness s Total depth %— /Z' Total absorption area %ZO f=7' Cleanouts present (Y/N) Depression over field (Y/N) Date of adequacy test cw nl sT-Ay c:r,o j Results (pass/fail) PA $.5`` '� for Peroxide treatment (past 12 months) (Y/N) /V If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: o / Well on lot /4 On adjacent lots % 1D� Property line_ To building foundation 71 L To existing or abandoned system on lot bedrooms b® / A10 ni c On adjacent lots 40 fJ L _ C u t b a n k AJp � C- Water main/service line r Surface water 14o JC_ Driveway, parking/vehicle storage area i 5� Curtain drain ^d0 "'iC E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect PiYhe date of1his; inspection. p C Signature i a Engineer's Name 1v` 1C4'1a1-`Z- 1,W,0 C� Uc� �? cc ;p-• 0 00o c i Date 3 Z € "n _1 0060n0 Aflaoo0on0 Oo0 p r "'n G r ; ° rn a10Ci . A CIC, o� HAA Fee $ Date of Payment Waiver Fee: $ Date of Payment Receipt Number Receipt Number Municipality of Anchorage Department of Health & Human Services _ HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description:.' �3, /V g%rJ I ILLS Parcel I.D. CIL , Y�/ /2 A. WELL DATA Well type �� 41_6' If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Total depth Sanitary seal (Y/N) Date of test Static water level Well flow Pump level 0/, _ Date completed €8 1 Z- Driller M' w T)X1 Li4^4b Cased to 1 0 X_ / Casing height— Sanitary eight Wires properly protected (Y/N) FROM WELL LOG lel l C? 9 -p.m i AT INSPECTION SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot 150 ; On adjacent lots Absorption field on lot 41Z ; On adjacent lots Public sewer main NIlk Sewer service line WATER SAMPLE RESULTS: Coliform Date of sample: B. SEPTIC/HOLDING TANK DATA Date installed 11 9 Z_ Cleanouts(Y/N) Y High water alarm (Y/N) — Date of pumping AJQ7 LAJ Nitrate Public sewer manhole/cleanout Petroleum tank Collected by: - > t o o' til+ 1J /A Other bacteria Tank size �� Compartments 0 Foundation cleanout (Y/N) Depression IV/N) 11 Alarm tested (Y/N) /V /A ._L SrAU,A104 Pumper 6f 1A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot /sO On adjacent lots ? /00 Foundation 6 r i To property line /Id Absorption field Water main/service line } Surface water/drainage 1400 eE 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE zm M v a < h'"tM m 0 C)f g.p.m< <„ r c- 1 00 > t o o' til+ 1J /A Other bacteria Tank size �� Compartments 0 Foundation cleanout (Y/N) Depression IV/N) 11 Alarm tested (Y/N) /V /A ._L SrAU,A104 Pumper 6f 1A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot /sO On adjacent lots ? /00 Foundation 6 r i To property line /Id Absorption field Water main/service line } Surface water/drainage 1400 eE 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent(Y/N) High water alarm level /Q/A "Pump on" level at Meets MOA electrical codes (Y/N) Manufacturer Manhole/Access (Y/N) Cycles SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot D. ABSORPTION FIELD DATA Date installed/l-7 /q I Length 7Z Width On adjacent lots "Pump off" level at Surface water Soil rating PI) /:1-T Z. System type�Ma t Gravel thickness Total depth "7 Total absorption area _ Cleanouts present (Y/N) Depression over field (Y/N) Results (pass/fail) Peroxide treatment (past 12 months) (Y/N) �r r �trl(h4 _ Date of adequacy test r`�� `' CK?nJ (r—/?_,Q forbedrooms If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: qz /Q+ Well on lot ` On adjacent lots ' loo Property line To building foundation To existing or abandoned system on lot A On adjacent lots / Cutbank 1'11A Water main/service line Surface water 141,4 Driveway,C/O J parking/vehicle storage area Curtain drain 1,11A E. ENGINEER'S CERTIFICATION certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect plqe date of this inspection. Signature�f� �a ,6a��_ ri r �� Engineer's Name "'14 /7— hC-1ZS,)^� Date ip/e, /I1� HAA Fee $ /7t?( V d Date of Payment / b —.'?,0 ` c --- - Receipt Number Waiver Fee: $ — Date of Payment Receipt Number CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FAX: (907) 561-5301 Chemlab Ref.# :93.1117-1 REPORT of ANALYSIS Client Sample ID :L6 B3 ROBBIN HILLS S/D WELL WATER Matrix : WATER Client Name :ANDERSON ENGINEERING Ordered By :A.H. Project Name Project# PWSID :UA Sample ROUTINE SAMPLE COLLECTED BY: A. HARALA. Remarks: QC Parameter Results Qual. Units ----------------------------------------------------------- NITRATE-N 0.10 U mg/1 Collected :03/18/93 A 13:46 hrs. Received :03/18/93 6 16:50 hrs. WORK Order :64152 Report Completed :03/19/93 Technical Director :S PHEN . `EDEEE Released By Allowable Extract Analysis Method Limits Date Date Init ------------------------------------------------------------------- EPA 353.2/300.0 10 03/19/93 MCE RECEIVED MAR 2 2 1993 muilic. ®ept. Health & Human Services ..................................""----___...--............-.-..__...-.,._........__..._....0.......----------_-_.---.---_ ` See Special Instructions Above UA - Unavailable " See Sample Remarks Above NA = Not Analyzed U - Undetected, Reported value is the practical quantification limit. IT - Less Than D - Secondary dilution. GT - Greater Than 1v�L' E3S Member of the SGS Group (Societe Generale de Surveillance) CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FAX: (907) 561-5301 ANALYSIS RESULTS for INVOICE # 59919 Chemlab Ref.# 92.597.9 Sample n 1 lfatr.i.x:. W WR Client Sample ID : ROBIN HILLS - SWENSEN Client Name :hh'DERSON ENGINEERING PI7SID UA Client Acct :ANDENGR Collected @ hr s. BPO# POn :NONE RECFIVFD Recaived OCT 22 92 @ 15:30 hrs. Req# Prsserved with AS REQUIRED Ordered By Analysis Completed OCT 2.3 92 Send Reports to: Laboratory Supexvisor STEPHEN C. EDE I)ANDERSON ENGINEERING Released By Parnmeteu Results Units Method Allowable Limits NITRATE -N ND{ 10) my/l EPA 353.2/300.0 10 Semple ROUTTINE SAMPLE COLLECTED BY: UA. Rorcatks: saa9�o,_=aLno s _,v=a a................. _ _.. _ _ ........ ........ o._.e_...... 7. Tests Pat:foxmad See Special Instructions Above UA-U;savailable ND- None Dotectea " See Sample Remark's Above NA- Not Analyzed LT -Less Than, GT Greater Than IRNl SGS Member of the SGS Groun (Societe Generale de Surveillance)