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Home My WebLink AboutSEIDLER #2 BLK 5 LT 1idl r' lock Lo1' I 050-131 R ANCHORAGE AREA BOF ~'GH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM ADDRESS SEPTIC TANK: DISTANCE '~/~''~' %£' ~'¢ MATERIAL /~/]~/~ NUMBER OF FROM WELL ---- MANUFACTURER COMPARTMENTS. / _ INSIDE LENGTH INSIDE WIDTH__ LIQUID DEPTH __.LIQUID CAPACITY ~ ()¢g5 GALLONS. SEEPAGE PIT: NUMBEROFPn'S~ D~AMETER__ORWlDTH /-2-- LENGTH/2~ DEPTH g'"" LINING MATERIAL O~~" CRIB SIZE: DIAMETER__DEPTH DISTANCE FROM: WELL BUILDING FOUNDATION NEAREST LOT LINE . ABSORPTION AREA (WALL AREA) ~ 2 _SQ. FT, ADDITIONAL ABSORPTION WELl-: ] ' ~ CONSTRUCTION_ '~'~ TYPE ) £'//?" ; ~ NEAREST NEAREST BUILDING FOUNDATION LOT LINE SEWER LINE CESSPOOL IV/14 OTHER SOURCES_ APPROVED DISAPPROVED REMARKS DEPTH DISTANCE FROM: SEPTIC //g) ~-' SEEPAGE TAN~ SYSTEM DISTANCES: INSTALLED BY: /~/J4~('~¢ PIPE MATERIAL: /2)// ~: £0~, LOT SLOPE: REMARKS: Form No. EQ-031 DIAGRAM OF SYSTEM G,A.A.B. [/K~ ~'~ ~ ~o "c- s'r~F-~,~:~C ', · /4. /.,wrf?~ (~/~,~, , , ' · 'lc L ~)~Jd b~[/~'J~ ~AWAG~ DISPOSAL SYSTEM -~ APPLICATION AND NOT VALID WITHOUT SOIL TEST ' 2-0 f GI~AVEL BAC, I{F ILL T.H.'~I 7-23-75 0.0! SANDY GRAVEL TRACE SILT~ SO~ COBBLES (GW) NOWATER TABLE 14.0~ToD. Log represents Lot 1 Block 5 Sidler Subdivision No.2 Engineering ~5 Geological Consultants Inc, ANCHORAGE FAIRgANKS ALASKA JuN[~u DAi~5 7-24-75 Gordon ltoyt Property Log of Test Hole Anchorage, Alaska M-W DRILLING, Inc. f,,J. Box4-1224 /. 1310CInternationalAirport Hoad (907) 274-461] ANCHORAGE, ALASKA 99509 Well Owner. Gordon Hoyt DRILLING LOG _Use of Well Location (address of: Township, Range, Section, if known; or distance main road ~lk~;41, Se!dler Bub., No. 2 Size of casing 6 Depth of Hole ~0 feet Cased to }2 Static water level 150 ft. (J]{69~) (bqlow) land surface. Screen ( ); Perforated ( ). None Describe screen or perforation Well pumping test at ~- gallons per of drawdown from static level feet Finish of well (check one) open end ( X (minute) for l hours with Date of completion_ 16 August 74 WELL LOG Depth in feet from ground sm'face Give details of formations penetrated, size of material, color and hardness 0 ~0 _~ Grawl P~ll 4 TO 27_ ~7 TO ~ TO. .TO. .TO. ____TO ____TO .TO TO __TO TO TO_ ft. Organics Silty Onbb]m G.nve] l_igh_t_t~ d~aBr.-~r%,; fe~cattered £r~ctu?~ wiih very small water.seaps 1 -- CUSTOMEF Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196050 Anchorage, AK 995t 9-6650 www. muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D.O.CO - ~5 t -6' '7_ GENERAL INFORMATION Complete legal description LoCatiOn (site address) Current Property owner(s) COSA # ~('~) Expiration Date: Mailing address Lending agency Day phone ................. Mailing address Real Estate Agent; 1~4~ /z~,,~d. ro~- l Re ~ Day phone Unless othe~is~'re~uested, ~OSA will be held by DSD for pickup. ¢ 1¢~¢ ~-¢ ~, NUMBEROF BEDRO,OMS: TYPE oF' WATER SUPPLY: Individual WelJ ' [] Individual Water Storage [] Community Class ~ Well [] Public Water System [] 7Z7 -3300 TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding Tank Community On-site Pubiic Sewer [] 'lq [] [] 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 sample results. (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 files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(ara) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm. ~(~(-,4c,/~ 7-~-~;'¢~,/ ._~e,,-e,,e ~.~ Phone "Address Iy~ '~c'~ ~~ ~A~~ ~ ~t~ Engineer's Printed Name ~~ ~o~ ~ ./~oa~ . Date DSD SIGNATURE ~ Approved for ,~ Disapproved. Conditional approval for bedrooms. ...¢,, ~,~ ~/~ I_ .~ :~".7:~.~:'~ bedrooms, with the following stipulations: Attachments: COSA Checklist Septic System Advisory Well .Flow Advisory Nitrate Advisory (Rev. 11/05) X Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Elmore 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: A. WELL DATA Well type ~,'/' If A, B, or C provide PWSID # M./I,. Well Log (Y/N) Y' Date completed ~/! 0"/7¥ Sanitary seal (Y/N) ~' Wires properly protected (Y/N) Total depth 35-0 ft. Cased to ,'~ 2_ ft. ('.~'~,.~ ~_) 'Casing height (above ground) FROM WELL LOG AT INSPECTION Dateoftest ~/ I~' I'/'/ 3/I /Zotl Static water level t ,5'O ' ft. ~ ft. Well production ~.,~ g.p.m. I,~, g.p.m. WATER SAMPLE RESULTS: Coliform E) colonies/100 mL Nitrate ,~O~ ~ mg/L Arsenic: ~ Ug/L date of sample: ~/~' B. SEPTIC/HOLDING TANK DATA Tank Type/Material .~'e~;c // F,/~d~' ]~'-~ Tank size I00~ gal. Number of Compartments j Foundation cleanout (Y/N) N w uepression over tank (Y/N) __ Date of pumping ~ / Z.~- / t~ Pumper .7' r{ £ ~ tx ~,, ~ / ~ ~It C. ABSORPTION FIELD DATA Date installed ~0 ~Z~ ,/75" Soil rating (g.p.d./ft2 or ft~/bdrm) Length I ~ ft. Width I ~ ft. Total depth lo, S-ft. Eft. absorption area;;~ ft2 Monitoring tube Date of adequacy test ~/g'/20t I Results (Pass/Fail) J~ Fluid depth in absorption field before test O in. Water added(~?¢) gal. Elapsed Time:l 1 2. min. Final fluid depth i~,¢, in. Any rejuvenation treatment (past 12 mo.) (Y/N & type) IV Other bacteria -'-- colonies/lO0 mL Collected by: /:'[,~f'/~,,'- 7~c~ Date installed I~ / ?.P/75" Cleanouts (Y/N) 'i" High water alarm (Y/N) System type /-¢,~' Cr',~ Gravel below pipe ~K' ft. Depression over field k,/ For '~ bedrooms New depth 1 7,,~n. Absorption rate >= q~C~3 g.p.d. If yes, give date tJ. aL. D, LIFT STATION /~J'. A-, Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at __ in. "Pump off" level at ~ in. High water alarm level at in, Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SePtic tank/lift station on lot Absorption field on lot Public sewer main SEPARATION DISTANCES FROM WELL ON LOT TO: Sewer/septic service line Animal containment areas 5"0~/ On adjacent lots On adjacent lots Public sewer manhole/cleanout Holding tank ~J- /~. Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation '~, 3-' Property line '~ YE ' Absorption field Water main I~'.. /I-, Water service line "> /~ ' Surface water Wells on adjacent lots '~ ~'~ ' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line '~ ?-¢' ' Building foundation "'~ ~'/E ' Water Service line "~ ~ "' Surface water ~ ~'~' ' Curtain drain ~o,~// _~ ~,,',~ Wells on adjacent lots '> I ~, ' Water main fJ- ~-, Driveway, parking/vehicle storage F. COMMENTS G. ENGINEER'S CERTIFICATION I 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. COSA Fee $ Date of Payment Receipt Number (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number oi 30' 2 8,7'55'25" W 150.00' 7 DRIVE DAvF__. WINDSOR 99-L-SalA 562-5291' AS--E)UILT 0;".' t/GaL LOT 1. BLOCK 5. SEIDLER SUBD. 9I :01 m/u'um e/c....O s/u* ~ 0 NO. 2 SGS ReL# 1112270001 Client Name Flattop Technical Srv. Printed Date/Time 06/10/2011 16:06 Project Name/# Lot 1, Blk 5, Seidler #2 S/D Collected Date/Time 06/06/2011 12:00 Client Sample ID Lot 1, Blk 5, Seidler #2 S/D Received Date/Time 06/06/2011 15:40 Matrix Drinking Water Technical Director Steohen C. Ede PWSID 0 Sample Remarks: Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init Metals by ICP/MS Arsenic ND 5.00 ug/L EP200.8 B (<10) 06/07/11 06/08/11 NRB Waters Department Total Nitrate/Nilyite-N ND 0.100 mg/L SM20 4500NO3-F C (<10) 06/07/11 AYC Microbiolog~r Laboratory E. C01i Total Coliform Negative 1 100mL SM20 9223B A 06/06/11 DLC Negative 1 100mL SM20 9223B A 06/06/11 DLC SEP-l-8011 10:IG FROM:JR'S SEPTIC PUMPING 90T5449821 T0:5451555 Pol~I J'Rs Pumpin~ PO l~ox 773415 Eagle ~,i¥~r.. AK 99577 (907) 694-645a IBlllin.g_!nformation Tom Nouser 11922 Devils End Eagle River, AK 99577 (907) 696-2541 ~_(~b Site Information. Tom 11922 Devils End Eagle River, AK 99577 (907) 696-2541 269.4813 AclditJonal Location Comments: ~lst house on left - Gra~, house w/#'s on dw, no dogs, 3bdrm septic in back(viable) - single access tank down hill behind house Job Description; P,O. Number: Tetma: Selesrep: Map Book: Cross Streets: Job Comments: 1250g Service Agreement Number~ 033549 Order Date: 06-Jun-2011 Service Date: 08-Jun.2011 Technician:* Dan Net 30 .' Tax %: 0 Dawn-Dawn Job Type: Repeat Map Grid: 86 Birch Hills Drive Last Se~ ;08/25/2010" 12509 · Gallons Planned: 1250 tank levels normal back flushed 1 time t¥ib' levels Iow clean out ok Diagram; ~_ :~Diao rams~.,! 7358,1;~ma Gal, Actual: ., , Hose Leis§th: 2 DOuble Tank: [] ......_ Pump System: ~ -. Baffles Inlet: [] ~ Baffles Outlet: [] ......_ Service Type Qty Price Each Tax? SepticServ 1250K 1 $185.00 No Extension ActUal $185.00 NonTaxable Total Estimated Charge~;: $I 85,00 Taxable Total $0.00 Tax Total Grand Total $000 $185.00 Actual Cha~ges: Customer agreea to the terms and coAti[lions shown. THiS IS A BINDING AGREEMENT. - ILl - i I ~ I ' ~c~te~ by JR~ Pu~ ' f . ~ Date Ac~pted F~ y~r added~n~ ~ a~ept: Di~ver. Visa and Maste~ Card pa~ents over the phone. Aher 30 Days a~ount w~ll ~ turned over to CO~E~IONS. $30.00 For NSF Che~s Returned. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES 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 GENERA[. INFORMATION Complete legal description Location (site address or directions) 'Property owner '~¢ bO r~.~ Mailing address Lending agency Maili n.g address Day phone Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: ~ Day phone o~, :5 ?- TYPE OF WATER SUPPLY: Individual well Community well Public water 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 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. 72~25 (Rev. 1/91) Front MOA ~21 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 Address Engineer's signature $ & $ ENGINEERING 17034 Eagle River Loop Road No. 204 Phone Date DHHS SIGNATURE 'P~ Approved for Disapproved. ,H¢EE. bedrooms. Conditional approval for bedrooms, with the following stipulations: Additiona4 Comments 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 courtesyto 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. Mumcq)ahty of Anchorage ~' ' ./~ DEPARTMENT OF HEALTH & HUMAN SERVICES ~,c~ Environmental Services Division OCT c~ 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343~.~7,4~ Health Authority Approval Checklist Legal Description: /--Z)',r- /J ~Z:~r~' .~','~:~,/,~LE~-~ ~//~-~. &~/..O_ Parcel I.D.:__ ~;)/,-,~¢) ¢-/,~/ A. WELL DATA Well type _/3/~ ~ v,q r"L If A. B. or C. attach ADEC letter. ADEC water system number Log present ~N) '¥ & -~ Date completed ~/)6/'7 ¢ Total depth '~ 5"'O Cased to ~ ;;;)' ~- ~ fi, ~, Casing height (above ground) Sanitary seal ((~N) y 8 5 Wires properly protected i~f/N) Date of test Static water level Well production FROM WELL LOG AT INSPECTION /'"~- g,p,m. "~ ~ o g.p,m. WATER SAMPLE RESULTS: Coliform (~ Nitrate Date of sample: Jo / ~/,~ (1 B. SEPTIC/HOLDING TANK DATA Date installed /o ~-~/'? 5- Tank size Foundation cleanout (Y~) ~'~ -4-~ Depression (Y~_~ Date gf Pumping ~/~1~ _Pumper ;T~ -~' C, oliected by:_ Other bacteria s & s ENGINEERING 17054 kagle River Loop Road No. ~ Myer, Alaska 99577 ) o o 0 Number of Compartments ] Cleanouts ('~/N). Ye ,~- High water alarm (Y,~¢ ,,¢ o C. ABSORPTION FIELD DATA Date installed Io/~ 0 / 7 5- Soil rating (g.p.d./ft~ (J~(Jr_r~ g Length ) 3- Width ~ ~ Gravel thickness below pipe System type. Total depth Effective absorption area ~ g ~'~ Monitoring Tube present (~/N) Y~:'¢_ Depression over field (Y,~ ,~ 0 Dete of adequacy test /0// ,/¢1~ Results~.~Fail)_ I)~$ ,~ For ~ bedrooms Fluid depth in absorption field before test (in.); /o Immediately after/'/?~- gal. water added (in.): ;)'~ Fluid depth ~'~ I/'~ (ins) Minutes later: ~ ~,/O Absorption rate = ~ S"O -J- g.p.d. Peroxide treatment (past 12 months) (Y/N) ~J o,v4 ~,~o~,¢¢v If yes, give date 72-026 (Rev. 3/96)* D. LIFT STATION Date installed . Size in gallons ~ Manhole/Access (Y/N) "P~ "Pump off" level at* High water alarm level at* / *Datum E, SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot ~'? ' ~-~R ~o0.¥'6 ) On adjacent lots /OO "--/ Absorption field on lot / ~) O -/-- On adjacent lots .) o ¢ -4- Public sewer main /J/,'¢ Public sewer manhole/cleanout Sewer/septic service line ~..5- /-/- Lift station 7o SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation ~'~ '/-' Property line ~'- d--- Absorption field Water main/service line /0 t..~ Surface wateddrainage /00 ~- Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line /O -f- Building foundation ?0 -)- Water main/service line Surface water !~ o -/- Driveway, parking/vehicle storage area ~> ch Curtain drain /~,)~,,L ~,~o~..,~J Wells on adjacent lots ?O0 -/- F. ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal records tJ~l'~.~...~.,..c~...e~s are In conformance w/th MOA HAA c~uldel nes m effect on this date. -- .. ~ /_ ~ Signature ~ d-, ~ ~ Engineer's Name ~ ~ ~.¢~ ~. ~-o ~,~ ~,, HAA Fee $ Waiver Fee $ Date of Payment t(._'~/F~ ~'/q ~ Date of Payment Receipt Number ~ '~'~(',,'2 ( '-~'~''~ ) Receipt Number 72-026 (Rev, 3/96)* Address · ' APPLI(" NT FILLS OUT UPPER HAr ONLY Phone Zip Code ZipCode ~/;. /L~- Zip Code Ihone Type of Residence Single Family ~J~ Multiple Family No. of Bedrooms ~ Other Water Supply ~ Individual ATTACH WELL LOG. A well Icg is required for all wells drilled since June 1975. ~ Community For wells drilled prior to Ihat date, give well depth (attach Icg If available). [~ Public Utgity Sewer Disposal .... ~ Individual Year Individual Installed:__ ]'~' ~ [~ Public Utility When Connected to Public Utility: [] Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Date Date Date Datce,.:> ,~. Inspector Inspector Inspector Inspector ~,- O, ~ ,'~un!~ipality of Anch0rag0" Time Time APPROVED BEDROOMS3 DISAPPROVED CONDITIONAL APPROVAL' 'CONDITIONS OF ~[q~l~oni~l Protoction" Soils Rating Date S~wer Installed Well To Absorption Area / C3 ~2.0 ''7 ~'~" Well to Tank --'{ e o IWell Log Received /~' Septic Tank Size Tom Fink, Mayor / Iunicipality of Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 October 12, 1989 Lou Butera, P.E. Eagle River Engineering Servcies PO box 773294 Eagle River, Alaska 99577 Subject: Waiver Request for Lot 1 Block 5 Seidler S/D #2 Waiver Request ~WR890056, PID #050-131-62 Dear Mr. Butera: Your request for waiver of the required 100 foot separation of a septic system to a private well has been approved. The approved separation distance is 80 feet (well to tank). This waiver approval applies to the existing septic system to well separation only. Any future upgrade to either will require all separation distances be met or another approval from this department. Sincerely, Daniel J. Civil Engineer On-site Services DJR/ljw96 EAGLE RIVER ENGINEERING tCUNiCtPALIiY OF ANCI IOR/",G~i 11~ IiNVII4ONM[NiAL SE&ViCES DIVISION SERVICES Leu Butera, P.E. P.O. Box 773204 Eagle River, Alaska 00577 Telephone (907) 694-§195 September 6, 1989 Mr. John Smith Municipality of Anchorage Pouch 6-650 Anchorage, AK 99502 RE: Lot 1, Blk 5, Seidler No. 2 RI CEIVED Dear Mr. Smith, On behalf of my client, Mr. Gordon Hoy't, I am submitting the information necessary for your determination of a waiver of well to septic tank, to 80' for the above reference lot. The septic system was installed in 1975 by municipal inspection. The well, drilled in 1973, was located on the inspection report with no reference to septic 'tank distance. Our measurements and an asbui].t survey show the 'tank to be 80' from the well in question. The well is located up gradient of the septic tank on a 25~ slope. The existing home is located directly between the tank and well. Any possible surface or immediate subsurface seepage would flow downhill away from the well. It has been established by previous studies that the bedrock plane slopes downhill from the tank away from the well. The well is a bedrock type well of low yield. The static water level in the well is recorded as 44' below ground surface. Soil in the area is a GW type sandy gravel. The area in question has a low population density. If you have any further questions or concerns please call me at 694-5195. Sincerely, Louis Butera, P.E. / BIRCH HILLS S. 02 DRIVE ' 05~ E. TO EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 EAGLE RIVER, ALASKA 99577 Phone 694-5195 WE ARE SENDING YOU '~Attached [] Under separate cover via [] Shop drawings [] Prints [] Plans [] Copy of letter [] Change order [] the following items: [] Samples [] Specifications conIEs DATE NO. DESORInTION THESE ARE TRANSMITTED as checked be[ow: REMARKS [] For approval [] For your use ~ As requested [] For review and comment [] FOR BIDS DUE [] Approved as submitted [] Approved as noted [] Returned for corrections [] 19 [] Resubmit [] Submit [] Return __copies for approval copies for distribution corrected prints [] PRINTS RETURNED AFTER LOAN TO US SIGNED: ~""~'~ '~'""'-'- CltEMICAL & GEOLOGICAL LABORATORIES~tt~.~I~ ,~.~. ,, DEPT ~ ' ' ~:,~ 5633B STREET ANCHORAGFEDERALE, ALASKATAX ID #9951892.0040440TELEPHON~(~9'~h"gf;~%~'~ pROTECTION OCT 5 t98.9 REC[IVED Date Report P~inted~ REP L4 89 ~ 09:04 Collected REP 11 89 ~ 16:00 Recetyad REP 12 89 ~ 14:00 Client Acer ; EAGLZRP P.O.$ NONE RECEIVED Ordered By Analysis Completed :REP 13 89 Hand Reports to: Special Imtruat: Chemlab kef S: 7487 Lab Smpl ID: 5 Matrix; WATER Allowable Parameter Tested Result/Units ~ethod Limits IHTRATE-N HD[0,10) mg/l EPA 353.2 i0 Sample SA~PLER COLLECTED BY RUSSELL HARRINGTOH. Remarks: i Tests Parfosmo~ ' See Special Inst~uctions ~bova ~A.Unavallable ~D- ~one Detected "See Sample genarks kbove ~ HA- Not Analyzed ','l: ET-Less Than, GT-Greater Than EMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. TELEPHONE (907) 562-2343 5633 B Street · Anchorage, ~lanka 99518 ~.~ Drinking Water Analysis Report for Total Coliform Bacteria PRIVATE WATER SYSTEM Nerne EAGLE RIVER, AK 9957 :~0. U, OX 773294- Mailing Address 694-5195 City / stere Mo. Day Year SAMPLE TYPE: ~ Routine Check Sample (for routine sample with lab ref, no ...... [] Special Purpose SAMPLE NO. LOCATION MUNiC!pAUTY OF ANCHORAGf~ DEPT, OF HEALIH ~ ENVIRONMENTAl- pROTECTION dC"[ 5 1989 RECEIVED Zip Code [] Treated Water ..~ Untreated Water Time Collected Coliealad By lib5o_ _~_~__.~ READ INSTRUCTIONS BEFORE COLLECTING SAMPLE_ TO BE COMPLE'rED BY LABORATORY Analysis chows this Waier SAMPLE to be: _,~atlsfaetory [] Unsatisfactory [] Sample too long in transit', sample should not be over 30 hours old at examination to Indicate reliable results, Please send new sample via special delivery rn~ll, O~te Received _ ~' ~?'~? Time Received Analytical Method: Membrane Filter No, of colonies/100 mi, t.ab Ret, No. Result* I L-l-] I __l r'T-I L ] KI-1 BACTERIOLOGICAl,. WATER ANALYSIS RECORD Membrane Filler= DIreal Count Verlllcatlnn: LTB _.-- 0 ~'~' BGS Final Membrane Filter flo~ulI~ Repealed Time: _ Analyst CoIItormllOOml _ Cclltorm/lOOml TNTC = Too Numberous To Count OB = Other Bacteria K.~AGLE RIVER E~GINEERING sL~k~ICES'' P.O. BOX 773294 EAGLE RIVER, ALASKA 99577 (907) 694-6195 TEST RECORD LEGAL: LOT / , BLOCK OWNER: ,A'5W* DATE: TYPE OF TEST: SUBDIVISIOb rIME METER LEVEL LEVEL LEVEL FLOW . LINE NOTES READING IN IN IN RATE PRESURE (3~A-T~ MONITOR WELL TANK G. P.M. P. S. I. ,v,~ r~,~ o~.* TUBE i~.,~ ....................... ~/~/~ MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION OCT u lg~g RECEIVED