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MANN BLK 2 LT 5B
Mann Lot 5B Block 2 #020-041-28 Municipality of Anchorage Page Department of Health and Human Services Two DivisioR of Environmental Services On-Site Services Section 825 "L" Street Room 502 ~'~ch~, P.O. Box 196650 Anchorage, AK 99519-6650 www. ci.anchorage.ak.us (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: 5V~O00 141 PID Number 0~0~0~/ N~e: Wastewater System: ~ New ~Upgrade Address: i~ {OO E~/ZA~ETI4 5~, A~ ABSORPTION FIELD Phone: Number of Bedrooms: ~ Deep Trench ~ Shalrow Trench ~Bed ~ Mound ~ Other LEGAL DESCRIPTION so. Rating: O, 5 GPD/F¢ ~O~HT°tal Depth ~ ~3~fr°m origi.al,~grade: Ft. BIo~k ~ Lot: Subdivision: Depth to pipe boEom from original grade: Gravel depth beneath p~pe: Township; Range; Section: Fill added above original grade: Gravel Length: Upgr~~ Gravel Width: ~ Fl. Number of Lines:~ Distance~ 5 ~be~een lines:Ft. Well: New Total Depth: Cased to: Classification (Private, A, B, C): Fetal De,b: ~ fetal absorption area: Pipe Material: '~M;~P ~t at:: Ft. ] Casing Height Above Ground:Ft. TANK ' SEPARATION DISTANCES ~s~¢c ~ Holding ~S.T.E.P, ~Other: ~ TO: Septic ~ Abso~tio~ Lilt Holding Public/Private i Manufacturer: ~ Capacity: Material: 3te~lJ Number of Compa.ments Sudace Ware, ~ ~¢~. k / LI~ STATION Lot Line ~0 ~0~ ~ Oah "Pump On" level at: ~t: ~ High water alarm at: Foundation ~' )~ / ~ A in~ ,n. Cu.ain Drain ~ '~ "~ ~ / ~ ~ filoctdcal Inspec,ions pedormed h,: 1 Location and Description J ' ' Engineer's Stamp Inspections performed by: .5,H~/~ Dates:Dates: lstlSt ~/Z) ~/~ ~/~r:' "e"a--nt°'"ea""a''"umanSer--s'r°va' Reviewed and approved by: O~/~2. ~ate: ~-2/-0~ "~:~;~~¢~ 72-013 (Rev. 01100)* IO-FT UTILITY EASEMENT, TYP 1"=50' CONSTRUCTION ASBUILT LOT 5A, BLOCK 2 MANN SUBDIVISION EXIST. CONNECTED NEW LINE TO EXIST LINE INSTALLED CLEANOUT AT CONNECTION. LOT 5B~ BLK 2 MANN SUB. EXIST TRENCH ABANDONED IN PLACE GROUND SURFACE DISINFECTED WITH BLEACH -- ORIENTATION OF TRENCH ADJUSTED TO TAKE ADVANTAGE OF ADDITIONAL NATURAL GROUND COVER AND TO REDUCE EXCAVATION IMPACT ON FOUNDATION OF EXIST. SHED TH-2 FILLED COMPLETELY AND TAMPED SILTY SOIL ALLOWED GOOD SEAL AGAINST SHORT CIRCUITING OF EFFLUENT TO GRND WATER LOT 4, BLOCK 2 MANN SUBDIVISION SKLH CONSULTANTS MANN SUBDIVISION LOT 5B, BLOCK 2 SEPTIC SYSTEM UPGRADE -- PLAN VIEW JUNE 2000 PREPARED FOR: DARRELL ARNOLD (907) 345-1593 PAGE 1 / 2 CONSTRUCTION 60 FT ASBUILT 4-IN. SOLID HEADER (~ ............... -t --,~ ....................... -PJ?-~ ...... -~ ..... 1'- 10.5 ~, ~ SINGLE 4-1NCH MT.'~ 3' - 9", TYPICAL (~ ...... o- ............... J- .................................... MIN. 56.25 FT OF 4-IN. PERF. PIPE. PIPE LAID LEVEL W/PERF.'S DOWN., TYP. OF 4 4_-INC CLEt TOW SEE NOTE1 NOUT ~RDS TANK MT. PERFSIN GRAVEL GRND ELEV. 99.0 FT FILTER FABRIC OVER G BED PLAN 32FT ELEV. g5.8FT 17INCHES / 7604 NOTES: 1. TWO ADDITIONAL CLEANOUTS INSTALLED BY CONTRACTOR. ONE SWEEP TOWARDS TANK, OTHER TOWARDS FIELD. 2. NO INSULATION INSTALLED. DEPTH OF NA- TURAL SOIL COVER MINIMUM OF 3 FEET. MOUNDED FOR SETIELEMENT. FILTER FABRIC INSTALLED OVER GRAVEL. ELEV. 4.gFT I~ 94.4 FT INLET <'>f 8~._5 FT ELEV 1034 OUTLET ELEV. gS.SF] ELEV. TANK INVERT 924 FT · ED DETAIL TANK ELEVATION DRND ELEV. 1022 SKLH CONSUL TANTS MANN SUBDIVISION LOT 5B, BLOCK 2 SEPTIC SYSTEM UPGRADE --ABSORPTION BED DETAILS JUNE 2000 PREPARED FOR: DARRELL ARNOLD (907) 345-1593 PAGE 2 / 2 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Roam 502 P.O. Box 'i96650, Anchorage, AK 995'i9-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Jun 01, 2000 Expiration Date: Jun 01,2001 Permit Number: SW000141 Legal Description: MANN BLK 2 LT 5B Design Engineer: 0002 SKLH Consultants Owner Name: Darrell Arnold OwnerAddrass: 16100 Elizabeth St. Anchorage, AK 99516-5046 Parcel ID: 020-041-28 Site Address: 016100 ELIZABETH ST Lot Size: 44943 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 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 Chaptem 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 dudng freezing weather must be eithei': A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. THE SAND USED IN THE FILTER LAYER MUST BE A CLEAN COARSE SAND WITH 4% OR LESS PASSING THE #100 SIEVE AND 2% OR LESS PASSING THE #200 SIEVE. A SIEVE ANALYSIS MUST BE PROVIDED ON THE SAND USED OR OBTAINED FROM AN APPROVED SOURCE. Date: Date: SKLH Consultants ~400 Rabbit Creek Road Anchorage, AK 99516 FAX: 987-348-7456 e-mail: shenslee@juno.com Tuesday, May 30, 2000 Municipality of Anchorage Dept. of Health and Human Services Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref.: Sewer System Upgrade Mann Subdivision, Lot 5B, Block 2 Gentlemen: The three bedroom house of the referenced property is served by a private well and septic system. The septic system is an undocumented failed system. The purpose of this submittal is to obtain an approval to abandon the existing system and construct a new system in its place. Details of the proposed design are provided below. SUBSURFACE CONDITIONS: Attached are soil logs for two test pits excavated on the property for the purpose of characterizing the subsurface conditions. Percolation test results are shown on the logs. Ground water was encountered in both excavations. The water level was measured after being allowed to stabilize after seven days from the date of the excavation. This final elevation is also shown on the soil logs. 2. DESIGN SUMMARY: a. System type: Absorption bed b. Percolation rate: 5 to 11 minutes per inch. c. Application rate: 0.5 gpd/sf d. Design flow: 3 bdrms x 150 gpd/bdrm = 450 gpd e. Min. absorption area: 450 gpd/0.5 gpd/sf~- 900 sf f. Width: 15 ft / g. Length: 60 ft h. Possible sand filter depth: 12 inches. 3. SURFACE WATER: There are no surface waters within 200 feet of the proposed septic system. 2004_O01.1Wp SKLH Consultants / MOA On-Site Services SAS Upgrade. Mann Subdivision, 5B/2 May 19, 2000 Page 2 of 2 TOPOGRAPHY: The lot is generally comprised of two benches. The single family house is located on the first and higher bench and the second bench, approximately 20 lower is where the proposed replacement septic system will be installed. This area has a shallow slope of less than five percent. A grade break (<25 % slope) is located just beyond the new drain field. The grade brake is shown on the attached design drawings. To the best of my knowledge, the proposed installation does not adversely impact the development of adjacent lots. If you should have questions, please do not hesitate tO contact me. Sincerely 2004_001.1wp I',I MANN S/D '~"='~oo' il', " .~. ~.',..t.",r.~.', /~ i' ', CEC 7604 , , ~ ~. ., I '" ~-" ....... ,, , .~C~oF~ss~ L2, B2 ', " MANN 8/D i:i '~'~'~'~ ' ' I LSA, B 2 /' R 100 FI i , I EXIST, SEPTIC , ,~ / ,/ '~, / -- "'-, I I SYS, ~ / %' , I', ~ / ,,",, R10[ F,¥ I"" R100FT ,,, X,--~ ,, / ,, , ,, ,, , MANN S/D [A~_~', ', ', ~ PROPOSED : ~ ', ~'~_---', ~', SEPTIC SYSTEM ~ I ... ,,,/ .. ....... ..- /-..., ~ ,, , ,,,~ , , t, I , , , R 100 FT r '[' ' ' i I ,,,,, SKLH CONSULTANTS MANN SUBDIVISION LOT 5B, BLOCK 2 SEPTIC SYSTEM UPGRADE -- SITE PLAN MAY 2000 PREPARED FOR: DARRELL ARNOLD (907) 345-1593 PAGE 1/3 10-FT UTILITY EASEMENT, TYP 1"= 50' LEGEND DRAINAGE ARROW LOT 5A, BLOCK 2 . .-" MANN SUBDIVISION .." EXIST. SEPTIC TANK AND DPt, INFIELD TO BE COMPLETELY NEW 4-IN LINE APPROX. LOT SB, BLK 2 MANN SUB. RIOOB EXIST. 'I~STALL SWEEP CLEAN- OUTS EVERY 40 FT, SWEEP T~WAROS TAN~-, ONE NEW 1COO-GAL ' '. SEPTIC TANK '. 5-ft INLET PIPE. ' ' 4-IN. CLEANOUT ENO OF EACH LINE LOT 4, BLOCK 2 MANN SUBDIVISION SKLH CONSUL TANTS MANN SUBDIVISION LOT 5B, BLOCK 2 SEPTIC SYSTEM UPGRADE -- PLAN VIEW MAY 2000 PREPARED FOR: DARRELL ARNOLD (907) 345-1593 PAGE 2 / 3 - 60 FT - 4-IN. SOLID HEADER /~ SINGLE 4-INCH MT. 3' - 9", TYPICAL ~ 4-INCH SWEEP 56.25 FT OF 4-IN. PERF. PIPE. CLE/NOUT i PIPE LAID LEVEL W/PERF.'S DOWN., TYP. OF 4 TOW NRDS TANK SEE NOTE 3~ NOTES: SEENOTE1-- ~ '~ 1. NATIVE SOIL BACKFILL MIN. 24 INCHES OVER 2qNCH INSULATION. NO INSULA- TION REQUIRED IF BACKFILL 3 FT OR ~-- THICKER. FILTER FABRIC REQUIRED IF iNSULATION NOT INSTALLED. MOUND 2-INCHES BACKFILL FOR DRAINAGE & SETTLEMENT. APPROVED 2. FOUR-INCH PERFERATED PIPE WiTH 2 INSULATION INCHES GRAVEL COVER AND 9 --~"- INCHES BELOW THE PIPE. TOTAL ooK~o°~ .... . .oo o 15 INCHES GRAVEL THICKNESS OF 15 INCHES. °~ ' ~ -- ~f- MOA APPROVED SEPTIC ROCK ONLY. CENTERED IN BED. PERFORATED IN ~ E 2 GRAVEL SECTION, SOLID ABOVE GRAVEL. 4. SEE ATTACHEMENT FOR SOIL LOGS ~ ELEV. 4.25FT AND PERCOLATION TEST RESULTS. 3~'~ 93.78' SEE PAGE 2 OF 3 FOR LOCATION OF ,. /% >6FT TEST HOLES. 5. ALL WATER ELEVATIONS SHOWN ! ARE AS OF 5/13/00. ~ © ! 89.48' 6. BOTTOM OF BED TO BE CONSTRUCTED ~- WITHIN 2 INCHES OF LEVEL OVER ENTIRE SURFACE. r NO IMPERMEABLE LAYERS FOUND WITHIN 6 FEET OF THE BOTTOM OF THE PROPOSED SEEPAGE BED SKLH CONSULTANTS MANN SUBDIVISION LOT 5B, BLOCK 2 SEPTIC SYSTEM UPGRADE --ABSORPTION BED DETAILS MAY 2000 PREPARED FOR: DARRELL ARNOLD (907) 345-1593 PAGE 3 / 3 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERPORMED POR: D,/~R/4OLD OATEPERFORMED: 0 F. GA k~C~/~OOT 1 2 3 4 7 .5.&MDy .SILT FO OF 150LILOF:_.~-~ '4- 9 87, Z" 10- 11 13- T"OI° OF . 15- ~7- 18- 20 -- Township, Range, Section: SLOPE WAS GROUND WATER ENCOUNTERED? SITE PLAN I- N S IF YES, AT WHAT ! OL DEPTH? .....~ p E Depth le Water ADer " Menitoring? '7',, / Oale: Gross Net Dept h.~o' op~ Net Reading Date Time Time Water Drop I ._rtl 20: 17 0~/~/ /, z~' ¥ Z ,,,~/ 20 '. 47 I als '¢ '7~" .3 ~'Y/ ZI : /7 -.~ I Vz 4 '/z" 4 Y 21~47 / lYz 4Vz" PERCOLATION RATE ~, ~ (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN '~' FT AND '-~ FT I /~',~¢/¢~/ , CERTIFY THAT THIS TEST WAS PERFORMED IN PERFORMED BY: ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT/ ON THIS DATE. DATE: .~/~/~ O 72-008 {Rev. 4/85) Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PER~ORMEO ~OR: D. ARHOLD 10- 11 13- 14- 15- 16- 17 18 19 2O COMMENTS DATE PERFORMED: Township, Range, Section: SLOPE WAS GROUND WATER ENCOUNTERED? SITE PLAN < © S OEPTH? /0 P Oeplh l0 Water A~er o,, Monitorino? ~ ,ate: ~/~ Reading Date Gross Net Depth ..t~'~:Net Time Time Water Drop , . i~,°/ z/:~ ,~..;../ z~+" .~,/+,, 2 ~F~ 2/: ~ 4 ~" / ~/~." J ZZ;o~ ~ J ~/4 . 2~/4.~, PERCOLATION RATE /~)~7 (minutes/inch) PERC HOLE DIAMETER TEST RUN ~ETW.EN ,5 ;"~ ~T AND g '/~ FT PERFORMED BY: ~-~'J~_~P,,V'd~_./~/f'PJT'J'~/'L'~'~' I z' , CERTIFY THAT THIS TE:ST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES iN EF~FECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) Municipality of Anchorage Department of Health and Human Services Division of Environmental Services On-Site Services Section 825 "L" Street Room 502 P.O. Box 196650 Anchorage, AK 99519-6650 www. ci.ancho rage.ak, us (907) 343-4744 Parcel I.D. (C3.,.~) -- (~.'.'.~/ / 1. GENERAL INFORMATION Complete legal description CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Expiration Date: Location (site address or directions) Current Properly owner(s) Mailing address ~ ~V~ Lending agency .~ ~¢ Day phone Mailing address Real Estate Agent ..-/¢¢r ¢ ~_ <¢¢~ //~ '- O~: ~,¢,/¢/'/~ /"¢'¢/~, Day phone Mailing Address Unless otherwise requested, HAA will be held by DHHS for pickup. HAA picked up by: NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Public Water System Well TYPE OF WASTEWATER DISPOSAL: Individual On-site [] Individual Holding Tank [] Community On-site [] Public Sewer The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) on properties served by a single family on-site wastewater disposal and/or water supply system. DHHS also issues HAAs upon request to home owners. Certificates of Health Authority 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 less than 30 days old. Certificates are valid for one year for propedies 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. 72-025 fRev 01/001' 5. STATEMENT OF INSPECTION BY ENGINEER 4 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 Health Authority Approval Guidelines for the Health Authority Approval application show 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 applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ,~/-¢~,,/-/ Engineer's Printed Name DHHS SIGNATURE Approved for __ Disapproved. bedrooms. Date ~ / ENGINEER'S ¢¢.% bedrooms, with the following stipulations. Conditional approval for Additional Comments Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other Expiration Date: Original Certificate Date: Reissue Date: 72 025 iRev 01,00 ' Municipality of Anchorage Department of Health and Human Services Division of EnvirOnmental Services On-Site Services Section 825 "L" Street Room 502 P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-4744 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: //~_,7" ,J~'~ /~/_J~'2 /4~/tJ'/LJ ~'/-/J~/~'~, Parcel I.D.: A. WELL DATA Well type Date completed Total depth /4~,E' ft Cased to FROM WELL LOG Date of test Static water level /~/~j' fCCord¢~ ft Well production WATER SAMPLE RESULTS: Coliform O colonies/100 mi Date of sample: lB. SEPTIC/HOLDING TANK DATA Tank Type/Material ~ ~'.~_~ / If A, B, or C provide PWSID fi, __ Sanitary seal ,~/ ft Bedrock g.p.m Well Log Wires properly protected Casing height (above ground) /~- AT INSPECTION ZZ 2,,5" g.p.m Other bacteria Nitrate /,~ mg/I Collected by: ,~,/L/¢/2,.5'/C C_, Date installed ~ - ~/--O~:~: - Tank size /~ gal Number of Compartments Cleanouts ,2 Foundation Cleanout ~ Depression over tank Date of pumpi,ni~.'_'.E(,U: ~:~)?,~. Pumper C. ABsoRPTiON FIE~Lp~D.~A -' /V/EMJ ~'(.,J.5-/L~fY) Date installed' ~ '~ c~ ~C~O Soil rating O/ft2 or ft2/bdrm) ~,~<' System type Length ~ i~ ft Width ,/C'~ ft Gravel below pipe /~. ~ ft Total depth .,~ ff GEffect,ve abs0rpt,on area,~ fF Monitoring tube Date of adequacy test ./V.(/~J. Results (Pass/Fail) /tJ/~ colonies/100 mi Z High water alarm Fluid depth in absorption field before test (~) in Water added__ Elapsed Time: /(/~ rain Final fluid depth /(//~ in Any rejuvenation treatment (past 12 mo.) (Y/N & type). /(~/ · Depression over field For' ~ bedrooms 0 gal. New depth. (~ in. Absorption rate >= /[/~ g.p.d. If yes, give date -- 72-026 (Rev. 01/00)* LIFT STATION Date installed Size in gallons __ Manhole/Access "Pump on" level at in "Pump off" level at __ ~n High water alarm level at · in Datum Cycles tested. Meets alarm & circuit requirements E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on let Absorption field on lot / 7',~, ' Public sewer main Sewer/septic service line On adjacent lots On adjacent lots Public sewer rnanhole/cleanout Holding tank .//,4 SEPARATION DISTANCES FROM SEPTiC/HOLDING TANK ON LOTTO: Building foundation Water main _ Drainage j.) I/~ ~' Property line 4¢~ ' Absorption field Water service line ~/~.,..4- Surface water Wells on adjacent lots ~F~F~_~/ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line ,/('/" Water Service line Curtain drain Building foundation /2-.5- ' Water main /¢-~2" Surface water/~l/d'/' /0~I/_ Driveway, parking/vehicle storage Wells on adjacent lots O//d/"/04 / 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 HAA guidelines in effect on this date. Engineer's Printed Name ,~-/L~V(~/~ Date HAAFee $ ~Z~(~).~(.~ Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev. 01/00)* D~te Drilledl Static Water Level fee t Gallons Per Minute Draw Down ~/'~ feet Total Feet of ~&sing Type Material Drilleds 0 ~eet to to to to to to Hefty Drilling S.R.A. Box 1553 H Anchorage,Alaska 99507 Certified' Well / /'%= , '~ Depth of well .................. ' .~.....~.... ...................... Size of casing...~: ....... ~.. .............................................................................................. Distance to water.....~....,~,.. .............................................................................. = ......... Distance to water while pumping .............................................................. at rate .,i of ........ .~...,~.... ...................... gnllom per hOur Description of Formation - from to ·" ! ceftin/the aI~)~'~e a~ ~Jnller ....................... SWafford Drilling. 3401 5penard Road sP~nard, Alaska We advise you to attach this certificate to your deed. ~t~mm~ CT&E Environmental Services Inc, CT&E Ref.# 1002978001 Client Name Darrell Arnold Project Name/# Lot 5B, Blk 2 Client Sample ID Lot 5B, Blk 2 Matrix Drinking Water Ordered By PWSID 0 Sample Remarks: Client PO~ Printed Date/Time Collected Datefl'ime Received Date/Time Technical Director 06/19/2000 8:32 06/14/2000 20:33 06/15/2000 10:40 Stephen C. Ede Released B~ Unitm ALLowabLe Prep AnaLysis Method Limits Date Date Init WATERS DEPT Nitrate-M 1.69 0.500 EPA 300.0 lO max 06/15/00 SCL MICRO LAB TotaL CoL(form cok/1OOmL SM18 9222B 06/15/00 KAP