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Home My WebLink AboutT12N R3W SEC 15 LT 13T12N, R3W, Secti o n 15 BLM Lot 13 #015-112-28 Municipality of Anchorage Page [ of5' Department of Health and Human Services Division of Environmental Services On-Site Services Section 825 "L"Street Room 502 EO. Box 196650 Anchorage, AK 99519-6550 www. cLanchorage.ak.us (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: S~,~C[~ [~ ~-[~ PID Number Wastewater System: ~New ~ Upgrade Address: rD550 ~ ~t~ ' ~C~OC~ ABSORPTION FIELD Soil Rating: Total Depth from original grade: LEGAL DESCRIPTION ~ , ~ GPD/FE I ~ Ft. BJock Lot: Subdivision: Depth to pipe boEom from original grade: Gravel depth beneath pipe: Township:~[~ ~ ~Range:~ ~e~Secti°n: ~ Fill added above o iginal~, ~ rade: Ft. Gravel Length~ Ft. Gravel Width: Number of Lines: Distance be~een lines: Well: ~ New ~ Upgrade ~ Fb [ Ft. Classification (Private, A, B, C): Total Depth: Cased to: Total absorp~n ~ P~pe Material: ~eld: ~ Pump Set at: ~ Casing Height Above Ground: ~: Ft. R. TANK SEPARATION DISTANCES ~ptic ~ Holding ~ S.T,E.P. ~ Other: To~ Septic Absorption Lift Holding Public/Private Manufacturer: ~ Capaci~: Tank Field Station Tank SewerLine ~o¢~ ~C. ~ Gal. I Material: ~ ~ Number of Compa~ments SuHa~Water ~ G~DI ~ Gb5/ ~ ~ LIFT STATION Lot Line ~/ [~/ ~/ Size: Gal. Manufacturer: Foundation ~, ~, ~, "Pump On" level at: "Pump off" level at: I H,gh water alarm at: Pump Make & Mod~h Electrical Inspections pedormed by: Cu~ain Drain Remarks: BENCH MARK Inspections performed by~ ¢~ Dates: 1st [AJ¢~k~~~J Dates: 1st J Department of Health and Human Services approval Reviewed and approved by: ~ ~ ~ Date: ~-2 72-013 (Rev. 01/00)* NORTH PIPE TEST HOLE (TRENCH)I NEW 2,000 GAL. EXIST. SEEPAGE & S-BDRM SYSTEM (PiT ABANDONED FILLED IN, PIPING REMOVED) J TRENCH (10' x 47') --TEST HOLE NO.1 NEW CONST. EXIST. 2,000-GAL. CONCRETE TANK TABLE OF DISTANCES DISTANCE FROM/TO (FEET) NW BLOG CORNER (A) TO TANK CLEANOUT (B) 32.9 NW BLBG CORNER (A) TO ABSORPTION TRENCH CLDANOUT (C) 46.0 NW BLOG CORNER (A) TO MONITOR PIPE (D) 41.7 NW BLOG CORNER (A) TO ABSORPTION TRENCH CLEANOUT (E) 31.2 TANK CLEANOUT (B) TO WELL (F) 116.5 TANK CL~ANOUT (B) TO PROPERTY LINE (APPROXIMATE) 52 ABSORPTION TRENCH C.O. (C) TO PROPERLY' LINE (APPROX.) 15 5% CONST. BLM LOT 13 SECTION 15 PACER PLACE SHELL #1S/O HOUSE SEPTIC SYSTEM AND RESERVED SITE BLM LOT 13, SEC. 15, T12N, R3W, S.M. 1 INCH = 50 FEET DRAWN BY PCR MARCH 2000 NOTE: THIS IS NOT A SURVEYED PLAT. ALL LOCATIONS SHOWN ARE APPROXIMATE. Brown Residence BLM Lot 13, Sec. 15, TI2N, R3W, S.M. Excavating absorption trench. View looking northeast. Excavating absorption trench. View looking southeast. I Test Hole Soils Log -- Percolation Test Legal Description: Date Performed: Performed For: BLM LOT 13, SECTION 15, T12N, R3W, S.M. JUNE 24, 1998 KEVIN A. BROWN 1 2-- 3-- 4-- 5-- 6-- 7-- 8 -- 9-- 10 11-- 16 Perc Description Peat/top soil (PT) Reddish sandy loam (SM Gray fine silty sand with some gravel (SM) Silty sand with gravel an( organics (SM) Silty sandy gravel (GM) Gray silty sand with som{ gravel (SM) Slope I I I -T-F-r- - _L_L_I_ I I I Site Plan See Separate Site Plan Test Hole 2 Type:Date Trench 6/24/981 7/1/98 Area: 3ff by 10ft 30sf (Yx 10') * see site plan Depth: 19 z2 Water Table No water encountered 7th day Mon tot Tube No water present DeltaT Reading Delta H Date Reading/Test # Time (minutes) (inches) (inches) 6/24198 Presoak 7:00 PM End Presoak 7:30 30 >>>>>> 28 T1 - Add water 7:40 14 7:50 10 6 8 T2 - Add water 7:50 14 8:00 10 6.5 7.5 T3 - Add water 8:00 t4 8:10 10 6.5 7.5 T4 - Add water 8:10 14 8:20 10 6.75 7.25 T5 - Add water 8:20 14 8:30 10 6.75i 7.25 T6 - Add water 8:30 14 8:40 107 7 6/24/98 7- Add water 8:40 1~ 8:50 t0 71 7 Percolation Rate (T7) 1.43 MPI Test Depth between 6 ftand 7ft Diameter; 4 inch cedify that this test was performed in accordance with all state and municiple guidelines in effect on this date. Date: MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Renewal Date Issued: Sep 17, 1999 Expiration Date: Sep 16, 2000 Permit Number: SW990340 Legal Description: T'i2N R3W SEC 15 LT 13 Design Engineer: 0804 Paul C. Ramert, PE Owner Name: Kevin A. Brown Owner Address: 10550 Pacer Place Anchorage, AK 99516-6330 Parcel ID: 015-112-28 Site Address: 010550 PACER PL Lot Size: 186040 SQ. FT. Total Bedrooms: 7 Permit Bedrooms: 7 This permit is for the construction of: [] Disposal Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage 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 ( 18AAC80 ). 3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. ' THE SEVEN (7) BEDROOM WASTEWATER SYSTEM SHALL BE COMPOSED OF A MINIMUM OF A 2000 GALLON SEPTIC TANK AND AN ABSORPTION FIELD THAT IS A MAXIMUM OF THIRTEEN (13) FEET DEEP WITH 10 FEET OF SEWER ROCK BENEATH THE PERFORATED DISTRIBUTION PIPE AND A MINIMUM OF FORTYFOUR (44) FEET LONG. Received By: Issued By: MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Renewal Date Issued: Sep 17, 1999 Expiration Date: Sep 16, 2000 Permit Number: SW990340 Legal Description: T12N R3W SEC 15 LT 13 Design Engineer: 0804 Paul C. Rained, PE Owner Name: Kevin A. Brown Owner Address: 10550 Pacer Place Anchorage, AK 99516-6330 Parcel ID: 015-112-28 Site Address: 010550 PACER PL Lot Size: 186040 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: [] Disposal Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapten Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Wet, 3. The engineer must notify DHHS at least 2 hours prior to each insI (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply P 4. From October 15 to April 15, a subsurface soil absorption system must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent fre~ Receiv~~ Date: Date: Rick Mystrom. Ma vor Mtmicipality of Anchorag¢ Department of Health and Human Services $25 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 htlp://www.ci.anchorage.ak.us August 10, 1999 Kevin & Ma~y Brown 10550 PACER PL ANCHORAGE, AK 995166330 Subject: T12NR3WSEC 15 LT 13 Permit # SW980371 PID # 01511228 The subject permit #SW980371, issued by this office for a single family well and/or on-site wastewater system, is due to expire as of 9/18/99. If this is a well permit and you have drilled the well, a well log must be sent to this office for documentation of the installation and to close the permit. If this is an on-site wastewater systm and a licensed Professional Engineer has inspected the installation, the original as-built inspection report must be sent to this office for review, approval and documentation. All inspection reports must be submitted within 30 days of construction completion. A new permit must be obtained from this office for a well and/or on-site wastewater system NOT installed by the expiration date. However a new permit can be issued free of charge for a second year if the application for the renewal is received on or before the date of expiration of the original permit for which a fee was paid. When applying for a new permit after the original permit has expired or for more than a second year, the fees are: $320.00 for an on-site wastewater permit and $120.00 for a well permit. If you have any questions, please call this office at 343-4744. JamesSince~~p~ Cross, PE /Q ' '~ Program Manager On-site Services enc: Copy of Permit MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box ?96650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Sep 18, 1998 Expiration Date: Sep 18, 1999 Permit Number: SW980371 Legal Description: T12N R3W SEC 15 LT 13 Design Engineer: 0804 Paul C. Ramert, P.E. Owner Name: Kevin A. Brown OwnerAddmss: 10550 Pacer Place Anchorage, AK 99516-6330 Parcel ID: 015-112-28 Site Address: 010550 PACER PL Lot Size: 186040 SQ. FT. Total Bedrooms: 7 Permit Bedrooms: 7 This permit is for the construction of: [] Disposal Field [] SepticTank [] Holding Tank [] Privy [] Private Well [] Water Storage 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 (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special previsions. The waiver 0NR940022) granted for the existing crib to well of 90 feet shall remain in effect. The new septic tank and 7 bedroom absorption field shall be installed a minimum of t00' from all private wells. Received By: ./~//~ ~-~2~/~// Date: Issued By: ~ ~'"'~ Date: / September 17, 1998 Ms. Donna C. Mears Municipality of Anchorage Department of Health and Human Services P.O. Box 19-6650 Anchorage, Alaska 99519 RECEIVED Dept. Heal h '?~o,l "qnChoraata t.. human eecv ,Je Septic System Upgrade Brown Residence BLM Lot 13, Section 15, T12N, R3W, S.M. Dear Ms. Mears: Attached for your review and approval is a copy of the revised site plan for BLM Lot 13, Section 15, T12N, R3W, S.M., showing a 7-bedroom septic system and reserve site. The revised site plan is based on our discussions of September 14 and 15, 1998, and replaces Attachment 3 submit[ed to you under cover letter dated August 5, 1998. The septic tank associated with the current 3-bedroom system will be removed when the 7-bedroom system is constructed. The existing seepage pit and associated soil absorption ~ench will be left in place to serve as a 3- bedroom septic reserve. An additional 4-bedroom septic reserve ama is located north of the existing absorption trench as depicted on the attached site plan. If you have questions or comments, please contact me at (907) 563-8102. Attachment Paul C. Ramert, P.E. 270'1 Westwind Cir. Anchorage, Alaska 99516 (907) 563-g102 August 5, 1998 Municipality of Anchorage Department of Health and Human Services P.O. Box 19~6650 Anchorage, Alaska 99519 Septic System Upgrade Brown Residence BLM Lot 13, Section 15, TI2N, R3W, S.M. This letter serves as a request for approval of a septic upgrade and provision of the associated construction permit. The proposed upgrade design is in support of a home addition adding 3 bedrooms for a total of 6 bedrooms. The current system is designed to accommodate three bedrooms and was granted a Health Authority Approval (HAA) certificate May 9, 1994. The upgrade will involve installation of a new independent 3 bedroom system to support the addition including effluent from the new kitchen, and 2-½ new bathrooms. The existing system will continue to be utilized to serve the existing 2 full bathrooms as well as a bar sink. According to documents on file at DHHS, the original septic system was installed in June 1969, and consisted of a 1,000 gallon concrete septic tank and concrete ring seepage pit. As described in an April 1994 letter by Flattop Technical Services (Ted Moore, P.E.), the system was upgraded approximately 19 years ago with the addition of soil absorption trenching extending northward from the original seepage pit. No records describing the design of the soil absorption trenching upgrade are on file; however, based on soil tests on both sides of the trench (Test Hole I and Test Hole 2), the system appears to be constructed in soil that supports a percolation rate of approximately 1.5 to 8 minutes per inch. The original concrete tank and seepage ring are located 79 fi and 97 ft., respectively from the well (i.e. inside the 100 ft offset from the onsite water well). By letter dated May 9, 1994, DHHS approved a waiver request for well separation for the existing system. Test Hole No. 1 was excavated to 14.5 feet deep by Ted Moore (April 19, 1994) in support of the May, 1994 HAA certificate and Waiver. Attachments 1 and 2 are copies of the site plan and soils log/percolation test prepared by Mr. Moore. The soils in Test Hole 1 were dry to the bottom and remained dry after 7 days. The monitor pipe for Test Hole 1 remains in place and was dry when measured on July 7, 1998. Test Hole No. 2 was excavated June 22, 1998 in support of this application. The hole was excavated to a depth of 19 feet at the location shown on Attachment 3. The soils log and percolation test results are documented on Attachment 4. Test Hol~ 2 was absent of groundwater and the monitor pipe remained dry as of July 7, 1998. The soil was tested at a percolation rate of 1.46 minutes per inch. Attachment 4 is a site plan showing the existing 3-bedroom system, the proposed 3-bedroom system addition (for a resulting 6-bedroom system), and the reserved site (6-bedroom system). Attachments 5 through 7 are supporting calculations and elevation drawings for the proposed upgrade and reserve systems. General notes are included as Attachment 8. lfyou have questions or comments, please contact me at (907) 563-8102. Civil Engineer - 8489 Paul C. Ramert, P.E. 2701 Westwind Cir. Anchorage, Alaska 99516 (907) 563-8102 Attachments: Site Plan - Existing Well and Septic System Test Hole # 1 Soils Log and Percolation Test Site Plan ~ Proposed Septic System and Reserve Site Test Hole # 2 Soils Log and Percolation Test Calculations for Deep Absorption Trench Elevation for Proposed 3-Bedroom Septic System Upgrade Elevation for Proposed 6-Bedroom Septic System (Reserved Site) General Notes Paul C. Ramert, P.E. 2701 Westwind Cir. Anchorage, Alaska 99516 (907) 563-8102 TEST HOLE NO.2 PROPOSEO 7-BEDROOM SYSTEM VALVE 10% PROPOSED PIT ,~/ \\ / I 2~ ~__ __x_._ LOT 1 I LOT 3A SHELL O'MALLEY HTS Ii# s/o SHEDS [] -TEST HOLE NO. 1 PROPOSED NEW CONST. NORTH BLM LOT 15 SECTION 15 PROPOSED SEPTIC SYSTEM AND RESERVE SITE BLM LOT 13, SEC. 15, T12N, R3W, S.M. 1 INCH = 50 FEET DRAWN BY PCR SEPTEMBER 1998 NOTE: THIS IS NOT A SURVEYED PLAT, ALL LOCATIONS SHOWN ARE APPROXIMATE. Test Hole # 2 Legal Description: Date Performed: Performed For: 2-- 3-- 4-- 5-- 6 7-- 8-- 9-- 11-- 12-- 13-- 14-- 15-- 16 17-- 18-- Soils Log -- Percolation Test BLM LOT 13, SECTION 15, T12N, R3W, S.M. JUNE 24, 1998 KEV[If A. BROWN Description Peat/top soil (PT) Reddish sandy loam (SM Gray fine silty sand with some gravel (SM) Silty sand with gravel ant organics (SM) Silty sandy gravel (GM) Gray silty sand with som~ gravel (SM) ~.'.; ~ Slope I I I -TT'-f- - I-I-I- - I-I-I- - I-I-I- - LI--I- -I--I--I- _ I_1_1_ -I--I--I- Site Plan Sec Separate Site Plan ~ _/_1.1 I I I I Test Hole 2 Type:Date Trench 6/24/9~:II Area: 3ff by 10ft 30sf (3'x 10') *seesiteplan Depth: 19 ft Water Table No water encountered 7th day Monitor Tube No water present 7/1/98 Delta T Reading Delta H Date Reading/Test# Time (minutes) (inches) (nches) 6/24~98 Presoak 7:00 PM End Presoak 7:30 30 >>>>>> 28 T1 - Add water 7:40 14 7:50 10 6 8 T2 - Add water 7:50 14 8:00 10 6.5 7.5 T3 - Add water 8:00 14 8:10 10 6.5 7.5 T4 - Add water 8:10 14 8:20 10 6.7~ 7.25 T5 - Add water 8:20 t4 8:30 10 6.7[ 7.25 T6 - Add water 8:30 t4 8:40 10 7 6/24/98 'f7- Add water 8:40 14! 8:50 10 7 7 Percolation Rate (T7) 1.43 MPI Test Depth between 6 fi[ and 7 fit 20 Hole Diameter, 4 inch I certify that this test was performed in accordance with all state and municiple guidelines in effect on this date. Date: Foe-. ~ BPe-.q S'~gre~: ', i : 1.) ' All construction shffll 6ompiy with the current editi6~ .of' the Uniform El~ Code and 16cal building codes including the most r~cent 'edition of the ~ ~ f6r otherwise noted. '. :2¥.. 2. ) The maximum sewer p~pe slope shall, b~ .3/4" per fo~t unless otherwise noted on the plans. The minimum sewer pipe slope shell he 1/8" per foot. 4.) All drain field pipe shall be. pieced level {no fell from one end to the other]. Systems installed on hillsides (except mound or b~ systems] ma change elevation from one lateral to the next, but each l%teral' sh~l be la'id level and °'goosenecks" shell he installed on the manifold line at each lateral intersection. The "gooseneck" shall be placed on the manifold line just downstream of the lateral tee. . 5. ] Allpipe is to be 4" d~a. A.B.S. .unless other, wise noted, except -that perforated P.V.C. may ~e used for ora~n laterels risk. P.V.C. pipe requires .great care ouring instaxxation to prevent pipe crushing. : - - .. · ' 6.] Septic tanks shall be'of steel construction unless otherwise noted on the plans. Concrete tanks.ma3. be instelled upon the approvel of the engineer. Unless otherwise note~tanks shall' be ~wo compartment style. 7.) Monitor tubes shall be'installed over each compartment i~ the teak and in the drain field or pit (except in 'the case oz pressure distributed mound s~stems). Drein field monitoring tubes sSall be connected to the draln leterel with a wye and 45 bend or combo and the tube shall extend to the bottom of the septic rock. Perforated pipe shall be installed for the monitoring tube below the connection and solid pipe shell be installed from the connection to the ground surface. 8.) All sewer pipes and structures shall he provided with at least 4' of cover. 1" of rigid styrofoam.insulation may be substituted for 1' of eerth cover to a maximum of 2 of styrofoam. Pipes running under driveways shall have a minimu~of 6' of earth cover or equivalent insulet~on'and earth cover. · 9.) A clean-out shall be installed either inside the building foundation line where the sewer exits the building or within 5' of the outer surface of the fotmdation. Additional clean,outs shall be installe~' every 100' of sewer line run. Clean-outs shell be constructed with wyes and a 45 sweep. Clean-outs installed outs/de of the building must meet current A.D.E.C. well separation reqUirements. 1~.] Septic rock' (sewer rock) shall be a minimum of 3/4" and a maximum of 3" in least dimension, and shall contein no sand, silt or organics. 11.] 10 lineal feet of cas% iron or heavy wall A.B.S. pipe shall be installed on both sides of the septic tank,s) -unless otherwise noted. 12.] ~aterlines shall be installed with a minimum of 8' of cover where not lying under traveled ways or parking areas. ~ater lines installed under treveled wa~s or parking areas shell have e minimum of i0' of cover. 1" of rigia insulation may be substituted for 1' of cover up to a maximum of 2" o~ insulation. 13.) All water outlets intended for use in filling tanks or equip~.d with hose connections inside, commercial structures or multi-fam/ly dwell.lags shell be equipped with backflow preventers. b MONITOR TUBE UPGRADE TRENCH SEEPAGE PiT ! EOT 1 SHELL #1 S/D / SEPTIC TANK BARN SHEDS " ,,' L_TEST HOLE ,, / BLM LOT 13 SECTION 15 T;12N, R3W, S.M. WELL ..... . e~----~-_.~ ~ ~o LOT 3A ' -~ O'MALLEY HTS. - ............ WELL WELL LU LOT 4A O"MALLEY HEIGHTS BLM LOT 13, SEC. 15, T12N, R3W. WELL AND SEPTIC SYSTEM SITE PLAN I FLATTOP TECHNICAL SERVICES I1 INCH = 50 FEET 14530 ECHO STREET I DRAWN BY TFM ANCHORAGE, ALASKA 99516 APRIL, 1994 NOTE: THIS IS NOT A SURVEYED PLAT. ALL LOCATIONS SHOWN ARE APPROXIMATE. TEST HOLE LEGAL DESCRIPTION: DATE PERFORMED: PERFORMED FOR: DEPTH (feeQ 1- 2 3- 4- FLATTOP TECHNICAL SERVICES 14530 ECHO ST. ANCHORAG E, ALASKA 99516 SOILS LOG -- PERCOLATION TEST BLM LOT 13, SECTION 15, T12N, R3W, S.M. APRIL 19; 1994 Y[JDY RECKHORN PT SM REDDISH SANDY LOAM SM GRAY SILTY SAND DENSE, DRY, SOME COBBLES SLOPE SEE SEPARATE SITE PLAN 15-- 16-- 17-- 18-- 19-- 20-- COMMENTS: Depth to Groundwater Date No groundwater 4/i9/94 Monitor tube dr? 4/26/94 Clock Net Time Percometer Net Drop Date Reading Time (minutes) Reading (inches) B.H. ' ; - 4/19 12" presoak 12:07 ~': I 27 3/8 _.%,../~. c/ 12:21 [ 23 1/4 Add warm' 12:22 27 1/4 12:38:30 23 3/8 #1 12:48:30 10 22 1/16 1 5/16 Add water 12:49 23 1/2 #2 h00 11 22 0/16 '"1 1/2 Add water 1:00:30 I 23 9/16 #3 1:10:30 10 I 22 1/8 1 7/16 PERCOLATION RATE 8 (minutes/inch} PERC HOLE DIAMETER 6" TEST RUN BETWEEN 5.5 FTAND 6.0 FT · Soils test was done to provide documentation for existing soil absorption trench. PERFORMED BY FLATYOP TECHNICAL SERVICES. I_~ ~ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECTON THIS DATE. DATE; /7// ~.~ ,/<~ ~