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Home My WebLink AboutBRENDLWOOD TR C· Municipality of Anchorage Page DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: ~l~]qOl~/C/ PID Number: 0 Name: Wastewater System: [;~'New [] Upgrade Address: ~ ~~ D~v~ ABSORPTION FI.ELD ~ ~ No. of Bedrooms: ~0~ j ~ ~I ~ ~DeePTrench ~ Shallow Trench ~ Bed ~ Mound ~ Other L E G A L D E S C R I PT I O N so, Rating; Total Depth from original g rede: · ~ GPD/Sq, Ft. ~ ~: Subdlv~ion: Depth to pipe bottom from original gr~e: Gravel depth beneath pipe ~ ~ c Bp~OL WOOD .¢¢BR~ Ft. ~ Ft. Township: I Range: ~ Section: Fill added above original grade: Gravel length: I ~~ · ~ Ft. ~ Ft. WELL: ~ New D Upgrade ~erave, w,dth: Number of lines: lDistanc~etweenlines: ~ Ft. / Ft Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: ~lV~ Ft. Ft. ~ SQ. Ft ~ ~O~ Driller: Date Drilled: Static Water Level; Installer: Date installed: Yield: GPM I Pump Set at: Ft. Icasing Height Ab°v° Gr°und:Ft. TANK SEPARATION DISTANCES ~septic ~ Holding ~ S.T.E.P. To Septic Abso~tion Lift Holding Public/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines ~~ ~ Material: Number of Compa~ments: WelY /~/ /~ / ~ ~ ~ ~E~ Sudace , Water /~ % /~ + - ~ LIFT STATION Lot , Size in gall°ns: I Manufacturer: ~ Line /0 ~ /0 /~ ' F°undati°n 2~' 4~-' ~ _ ~ "Pump on" leve~~ cfr' level at: ~ High water alarm at: Remarks: 2" /~sutnr/o~ pc~c~O ovo-~ BENCH MARK Location and Description: ~o~ oP~,~ Assumed Elevation: E~~AL ~,~ .. ~.. ~. ~ '~ ~'"" '-/.~ Inspections performed by: ~=~e,,-~. a,.,~..sT~ Dates: 1st ~-/N -gq Department of Health and Human Ca,ices approval ,, ~ ........ Reviewed and approved by: ~ . Date: ~E-~q-q4 72-013 (Rev. 9/91) MOA 25 Permit No.5w940199 Page 2 of 2 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 Legal DescriptionS.RENDLwOOD SUBDIVISION; TRACT C PID No.: 05051345 ffCCO' '"3~:;'0' "3g;'O ~Ot 28.5 87.0 02 36.0 94,5 03 47.0 104.6 504 95.0 1.50.C [~TI 92.0 1.48.6 SCALE SEPTl~C TANK 4 BDRM HOUSE TRENCH CO VELL~ 72-013 A (1/93) * · I~ ',C. tO.WAN' :.. CE ,,8,80:! ..., PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW940199 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:BRAENDEL ARTHUR ALFRED & OWNER ADDRESS:2000 WALDRON DRIVE ANCHORAGE, ALASKA 99507-1344 DATE ISSUED: 6/24/94 EXPIRATION DATE: 6/24/95 PARCEL ID:05031345 LEGAL DESCRIPTION: BRENDLWOOD TR C LOT SIZE: 236530 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AACS0). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 (24 HOURS) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: DATE: ROBERT SHAFER, P.E. ROGER SHAFER, P.E. June 11, 1994 CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 'L' Street P.O. Box 196650 Anchorage, Alaska 99519-6650 REFERENCE: Brendlwood Subdivision; Tract C Request you issue a permit to drill a well and install a septic system to serve the proposed four bedro~house on the referenced property. A test hole was excavated and a percolation test performed. The approximate location of the test hole is located on the attached site plan. At the time of excavation no water was encountered and after seven day ground water monitoring water was found at 17.5 feet. This property has enough area for a future septic upgrade which can be seen on the attached site plan. We do not anticipate any adverse effects on neighboring properties by the installation of the proposed septic system. If you have any questions, or require additional information for your rei~~~../~~cOntactA. Shafer, P.E.P US Sin =;/LSU/jk 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 w oZ ~d TOE NYqd 311S Municipality ot Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2O Township, Range, Section: SLOPE WAS GROUND WATER \ A ENCOUNTERED? s L IF YES, AT WHAT O DEPTH? ~' Depth to Water After _ ~ ~ Monitoring? [~"{ ~'~ Date: SITE PLAN Gross Net Depth to Net Reading Date Time Time Water Drop PERCO,ATION RATE TEST RUN BETWEEN -- (minutes/inch) PERC HOLE DIAMETER COMMENTS -- PERFORMED B~): °$.M. p~ d~n J~!a'15'~ ,EOLt ,~~ ~_-._CEF ACCORDANCE WITH ALL STATE A~~IP~I~&INES~~ ON THIS DATE. DATE: / 72-008 (Rev. 4/85) CERTIFY THAT THIS TEST WAS PERFORMED IN O~I-$IT~ WAST~ATE~ DISPOSAL SYST~ CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS ~: Brendlwood Subdivision; Tract C 1. The scope of this project includes the installation of a 1250 gallon septic tank and a leachfield trench to serve the proposed four bedroom residence located on the referenced property. 2. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The contractor shall be responsible for obtaining any necessary underground utility locates. 4. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. On all leachfield mound systems, the property owner shall be responsible for ensuring a satisfactory vegetation growth over the mounded area. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. SEPTIC TANK INSTALLATION: 1. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 3. Ail standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 4. Septic tanks installed with less than 4' of cover shall be insulated. Page Two Brendlwood Subdivision; Tract C June 11, 1994 5. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10' from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. INSTALLATION: 1. Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (roughed-up) before gravel (sewer rock) placement. 2. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. 3. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. 4. Monitor tubes shall be of four (4) inch diameter and installed approximately in the locations shown on the design. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. 5. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. MINIMOI~MATf~IAL SP~CIFICkTIONS: 1. Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. Page Three Brendlwood Subdivision; Tract C June 11, 1994 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe Perforated Solid Cast Iron Yes Yes ASTM D3034 (P¥C) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). 5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 140/N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. 6. Ail leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. 7. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements. Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: 1. The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. 2. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. Page Four Brendlwood Subdivision; Tract C June 11, 1994 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required, especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre-construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractor's activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractor's activities. Final acceptance of the contractor's work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER .............. ??~." APPROVAL FOR A SINGLE FAMILY DWELLING ~ }~.~Complete. l~al description,r T~ CI LocatiOn (site address or dlreofions) i~!; prope~7 '-.Mailing address . r.u Lending agency_ .:.. Agent '" ..... Lb~ Cro~ :: :'EEMAX EAGLE Eagl~ River, AK Day_phone~''''~' 696- 5554 99577 !:!~: ' ':-~'~';~: .......... Day phone Day phone ..... 6 q 4- 4200 ---'-'--::'AddreSS ........ 16600 C~eAfie~d D~Zve E~,qle. ~Zve.,%, '~ AK 99577 ............. Unless otherWise requested, HAA will be held for pickup. ,.,.,m?,~.~,..~:, ~:,~i~:~,'~!,:i,~:;~!:: ' .~,~:'.i-:' . _ 2,: NUMBER OF BEDROOMS: -- ....... 3.-~-.-~-TYPE OF-WATER SUPPLY: ....... :.,.:;,,;:,,.: ,'.;,,, ~.~,,;~-~,,,~.~,-Indlvidual well NOTE: ::' IfCom~u'n. ity.Well system, provide written confirmation from State AOEC attest-. ..... ~.,.:~ ..... ~ . ing to the legality and status of system: ........ ,-.~..4. ~;: TYPE OF WASTEWATER, DISPOSAL: ,? vidual on,site ...,,~: .... .. ;. _,.-;; :.' , :.. ..... j;;,;.' ,.'.;: ? commUni~~on-site' NOTE: system, prOvide Wri~en : a~esting~'to"the legali~ and status.of s~tem. ~.~, ~(R~.1~1) F~I MOA~I~ ' .... ' ' Engineer's signature STATEMENT OF INSPECTION BY ENGINEER .... --. _.~.:.~::_ As certified bY my seal affiXed hereto and as of the v~iida:ti0'n'date sh'o;~'"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 inves.ti_,qation 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 s & s ENGINEERING . Phone -: ~'~{ i ~U~4 E, agie i<iver Loop KO~i No, ~ Address Eagle River, Alaska 99577 -.' , ?..!' .............. ~:.,.-. ::: :-:..~.. - " ' Date .'::/ 6.' DHHS SIGNATURE - .,;~ Approved for Z~-. bedrooms.- .... Disapproved. Conditional approval for ....... bedrooms, with the following stipulations: Additional Comments · ~ t" The ~tu~n~0~pahty of ~.'hchorage Department of Health and Human SerVices'(DHHS) issues Health Ai~thbrity ~'' , '~.Approval ~rtifi0~es'l~s~l only upon the representations given in paragraph 5 above bY an independent f . c°n'~l~JCt 'inspi~flons o[.~:~naly~e data before a certificate is issu~l. The MuniciPality of Anchorage is not Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: '"~~ ~_~ ~DL.,~. c> ¢~, Parcel I.D. A. Well Data Well type Log present (~) Total depth If A, B, or C, attach ADEC letter. ADEC water system number Date completed '"/-~ Driller Cased to tS<J ' b ~ rt-~'. Casing height Sanitary seal ~N) ~ Date of test Static water level Well flow Pump level1 FROM WELL LOG SEPARATION DISTANCES FROM WELL TO: Wires properly protected (J~N) AT INSPECTION Septic/holding tank on lot Absorption field on lot Public sewer main Sewer service line g.p.m, jJ g.p.m. ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank o z WATER SAMPLE RESULTS: Coliform Date of sample: Nitrate o ,~ c, Other bacteria Collected by: B. SEPTIC/HOLDING TANK DATA Date installed Cleanouts~N) High water alarm (Y~ Date of pumping Tank size \ ?...5'-c~ Compartments '7.--- Foundation cleanout ~LN) -.7/ Depression (y~ Alarm tested (Y/N) ~ [,~ ~-~ Pumper ~[~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot \ o5 On adjacent lots To property line ~ ~ . Absorption field Su dace water/drainage ~ ~ ~ Foundation Water main/service line 72-026 (3/93)* Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) Manufacturer Manhole/Access (Y/N) "Pump on" level at "Pu~t High water alarm level C~eef'e-~d Meets MOA electrical codes (Y/N) ~ ~t On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed ~t - Length /-1/~ ~ -~ Total absorption area' Date of adequacy test Water level in absorption field before test Peroxide treatment (past 12 months) ('~. Soil rating (GPD/FF) C), Width · ... ~ Gravel thickness '" ~'¢ ~ ~/:' Cleanout,present(~l) / ~,//k ~ ~_~ Results (pads/fail) System type 7"',e.~_ dC ¢ Total depth /,Z Depression over field (Yf~j) ,,,-/' for 4 Bedrooms After test -~. If yes, give date "~ SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot To building foundation On adjacent lots Surface water Curtain drain On adjacent lots \ '~ c::'~ ~ Property line To existing or abandoned system on lot Cutbank ~'-c~ t~ Water main/service line Driveway, parking/vehicle storage area ~ E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines i.~e~.'~,,.'~.te, of this inspection. Signature ~~ ~ ~~ .~, ................. ~ ~ i~ ."' : .:~?:':': .~:F:::::;. ~...:::::" :. ' ' . Engineer's Name [~, ~ % "~[~: c?:::'cow~..:::.: ~ (~ ,>-~ -~~ - 880] ~ c~ ¢ Date / //~ / ~ ~ '¢~*:';~J% '";*'[~ ~ HAA Fee $ Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number 72-026 (3/93)* Back 81/16/95 15:42 COMMERCIAL TESTING ~ 90?6941211 N0.540 ~02 Drinking Water Analysis Report for Total Coliform Bacteria a~w ~Nsr~ucrm~s o~ ~~ sm* *~soay, cott~crm~ Commercial Testing & Engineering Co. Environmental laboratory Services 5633 8 Street Anchorage, AK 99518-1600 Tel: (907) 562.2343 Fax,. (907) 561.5301 MUST S~- COM~Lg~D' §¥ w^r~ su~P[.~ I I I~ Send R~u~j Iq $snd ,tnvoi¢¢ SAMPLE D.~:TE; ~ Month SAMPLE TYPE: ~- Routine a Repeat Sample (for murine sample ~th lab rcf, no, ) D Special Purpose S~LE LOCATION Day Year D Treated Water a '(Jatrcated Water Time Collected Collected By TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: Satisfactory O Unsatisfactory n Se. topic over 30 hours old, r~suRs may be ur, reliable ' Cl Sample too long ~ transit; samolc should not I~e over 48 hours old at ex~ation to indicate reliable r~sulB. Ple~e s~od new s~mple ~Sa sp~ifl ddiveu msil. DatcReceived ~ ?J ~ T~e atc, iv,d . ~,~ Analy6s Began Analytical Method: ~ M-.mbranc Filter [] MMO-MUO * Number of colorties/100 ,-d. Lab Ref. No. Result* Sent toA.D.E.C. Q Fb~ kant/st J'uJ't Dtt,: [ ~_~., Time; Client notified of unsatisfaetor3' results; Phoned Spol~e ~-ith Time: F~xtd [] Fuzed BACTERIOLOGICAL WATER ANALYSIS RECORD MMO-MTUG Result: Total CoLiform. Membrane Filter: Db"ect Count Verification: LTB ~'ecel Coliform Cou firma BGB £ C~Zi 0 ColonteN100 mi COLIFIRIVl, FL~al Membrane Filter Resets / ..,o.. t/:/& 24_9- Coliform/lOg nd OF TwO TO FOLLOW s~ ~11~ Meml~er of the $G$ Group ($ociita Genirele de Surveillance) ENVIRONMENTAL FACILITIg$ IN ~.LASKA, COLORADO. FLORIDA, ILLINOIs. MARYLAND, N~W JERSEY, OHIO, UTAH. vV~$T VIRGINIA 01/17/95 09:11 COMMERCIAL TESTING ~ 90?6941211 N0.542 QB~ Client Sample ID Matrix CT&E Environmental Services Inc. Laboretory Division ==-_--_--_--j-_--_--_~_--jr_=.'_:___~_- ..... , .010o-1 J./ boratory Analysis Report TRACT C BRENDLWOOD WATER Client Name S & S ENGINEERING WORK Or4er 11964 Ordered By RAY Printed Da~e 01/16/95 ~roject Name collected Da~ 01/12/95 ® 12:30 hrs. Project# Re=aired Date 01/13/95 ~ 08~30 hrs. ~WSID UA Technical Director STEPHEN C. EDE Sample Remarks: ROUTINE SAMPLE COLLECTED BY: RAy. QC Allowable Sxt. Anal Paramoter Reeulte Qual Unit~ Method 5imit~ Date Da~e Init N~trate-N 0,76 m~/L EPA 353.2 10, 01/13/95 CMR * See Spe¢&al ins==uc~&on~ Above UA = Unavailable ** See Sam[~le Re~arka ~ova NA - NQ~ A~alyZ~O ~= Seoondary ~llugton. ~T - ~reater Than 200 W. Potter Drive, Anchor&ge, AK ~518-1605 -- Tel: (907) 562..2343 Fax: (907) 551-5301 ENVIRONMENTAL I;;ACtiJTIES IN ALASKA. CALIFORNIA, FLORIDA, ILLINOIS, MARYlaND, MICHIGAN, MISSOURI. NEW JERSEY, OHI0, WEST VIRGINIA DOC Co. dba SULLIVAN WATER WELLS P.O. BOX 670272, CHUGIAK, ALASKA 99567 * TELEPHONE 688-2759 OWNER OF L~/ND LEGAL DESCRIPTION DATE-Started Ended '7/~ t'~ ...... PERMIT NUMBER I)RAW DOwN FT. GALS. Per HR KINI) OF CASING KIND From . From From . F~6m From C~ Ft. to ~.3I From ..,~ Ft. to 3 ~ OF FORMATION: [~)~ . Ft. to ~ Ft. C./~_g',/O£_, ,~'7:_tC~._/g_~'~ From ~ Et. to ~ "Ft; O C)~ ~~ From Ft. ~4~ ~~ From From Ft. lo .... Ft. Ft. to , Ft, Ft. to Ft~ ;Ft. to__ Ft. Ft. to Fl, From..~t~ Ft. to ~S' Ft. ~-.~.t..t~l ~ ~4~dg.i,. Fr,,m From ~ Ft. to ~ Ft. ~/~ ~e ~ 64~OE4 ..... tg~gE, mm From~F,.,o ~O e,, ~,~ *~o~ _.~'dX ~o,(~~ From , Ft. to Ft.Z~c~'~ aO7~'~ ~~. From Ft. to 13~ Ft. ii&HI ~/~'~ F~om~Ft. to / ~0 Ft. ' ~ 6~ a C ~ Ft. to . Ft. From ...... Ft. to Ft. to __Ft. Ft. to Ft. to~ Ft. to Ft. Ft, Ft. _Ft. Ft. Ft. .Ft. From Ft. to Fr°m 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.~ From Ft. to .Ft. MISCL. INFORMATION: ~13 ~' 6" 7'~7~'- 6:" T'o "~0 Ft DRILLER'S NAME