HomeMy WebLinkAboutCOLONIAL PARK BLK 3 LT 3 S2Colonial Pa k
Block 3
Lot 3 $1/2
#050- 301 - 13
CHUGIAK, ALASKA
688-3199
~';RILLING CO. ~S~
WE SERVE ALL ALASKA
POST OFFICE BOX 42 - CHUGIAK, ALASKA 99567
OWNER OF LANn ...E~.'.:.L..:.'iL~,~..~.V. ...........................................
ADDRESS ..L?.'..C.m~.2.2.~- ]~L"..C!.~....~.~.:.'..q E...~.!:.:. .......................
DATE - STARTED ...... [.~..':.~ 3.::"~.!, ........................................
DATE - ENDED .......... .1,..0..~.~.~..-...~..1. ...............................................
KIND OF FOP~IATION:
FROM .......... O. ...... FT. TO .....~.?.-. ......... FT. ~~.~...~...{..~..~..,.q..~:~.? !
DEPTll OF ~ELL, '~ r,~
STATIC LEVEL OF WATER
~,.~ ., .~.. ., ~:.'~'...::.,.
DRAW DOWN FT ......................................................................
GALS
· ,. :' ..~'..:.
FROM ~ TO~;" *. "'
FROM ......~ ./.~: ........ FT. TO ...~.'.q. ........ FT....t..~ ~. ?.-.~ ! _t ~?. ~ .............
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FROM ...Z2!'.. ....... FT. TO .~,~.6 .......... Fr....~...?.::.'.!_ ...................
FROM· ...~?..~: ........ FT. TO ..3:L'?. .......... FT. _.Z= :2 ~._ :Z ..:.L~.'.~.'.::.? 1
FROM ....3.3.2 ...... FT. TO _'3..52 ........ tr../..'v.':.."..YJ:..L.~.~.~ ~.F
FROM ............... FT. TO ..~..:~ .....~. FT. --, ' ..... :,...:. .'.-, -
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FROM .................. FT. TO ............ ET ........................... . ,...:; .:. :. :.
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FROM ..................... FT. TO .................... FT ..........................
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MISCL. INFORMATION:
FROM ................. FT. TO ................. FT ....................... ._, ' [
FROM ................FT. TO .......... FT ................... =, ~
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: (907)343-7904
On -Site Water & Wastewater Section Fax: (907)343-7997
Parcel ID 050 -301-13
Certificate of On -Site Systems Approval
OSC261203
Expiration Date: 6/3/2027
Legal description COLONIAL PARK BLK 3 LT 3 S2
Site address 19907 FIRST ST
Current property owner(s) BARTO TIMOTHY A& KRISTIN
X The On-site system(s) is/are approved for 6 bedrooms
Conditional approval for bedrooms, with the following stipulations:
Comments or conditions:
No comments
By:,; ` e Original Certificate Date: 6/26/2026
This,Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject
system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage,
�' Development Service Department (DSD) issues COSAs based upon representations provided by an
independent professional engineer. The Municipality of Anchorage is not responsible for errors or
omissions in the professional engineer's submittal.
ATTACHMENTS:
COSA Checklist X Well Flow Advisory
Absorption Field Advisory Nitrate Advisory
Tank Age Advisory Arsenic Advisory
Other
MUNICIPALITY OF ANCHORAGE
Development Services Department _� Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval Application
1. GENERAL INFORMATION
Parcel I.D. 050-301-13
Complete legal description Colonial Park Block 3 Lot 3 S2
Location (site address) 19907 First St.
Current property owner(s) Timothy & Kristin Barto Day phone
2. ON-SITE SYSTEMS SIZED FOR 6 BEDROOMS
3. TYPE OF WATER SUPPLY: ❑■ Private Well serving # 1 dwelling units
❑ Other Non-public well as regulated by MOA ❑ Water Storage
❑ Community Well or Public
4. TYPE OF WASTEWATER DISPOSAL: ❑ Private Septic ❑ Private Septic serving 2 dwelling units
❑ Holding Tank ❑■ Community Septic or Public Sewer
5. SEPTIC TANK: ❑ Steel ❑ Plastic ❑ Concrete ❑ Fiberglass
Age - See advisory if steel or fiberglass older than 20 years
6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench ❑ Wide Trench ❑ Seepage Pit
Waiver request for:
Expedited review requested: ❑
Distance:
By applying for this entitlement, this property is subject to inspection by municipal On-site staff
to verify the accuracy of the information provided.
COSA Fee Waiver Fee $
Date of Payment
COSA # -O S C E 6 2 0 3
Date of Payment
Waiver #
COSA Application_Apr2025.doc
Legal Description:
COSA Checklist
Colonial Park Block 3 Lot 3 S2
Parcel ID: 050-301-13
If more than 1 well and/or septic system on tot, provide separate checklist. Structure served by this system
A. WELL DATA
W Well log is filed with Onsite (or attached)
Date drilled 10/27/81 Total depth 357 ft
Cased to 357 ft
Q Sanitary seal is functioning correctly
W Wires are properly protected
Casing height (above ground) 24 in.
Date of flow test for COSA 6/15/26
Static water level at beginning of test 297 pt.
Comments
DATA
Measured operating uft i tic tank „_,�,
Date of pumping
❑ Required maintenance completed, if AWWTS
Comments:
POSAL FIELD DATA
Which em tested (date installed)
❑ ALL standpl present per record drawing
Total measured depth grade ft (max)
Measured depth to pipe inve m grade ft (min)
❑ N/A -- pressurized field.
❑ Per record drawings, field is insulate .
❑ Monitor tubes go to bottom of effective.
If not, state depth into effective
❑ Presoaked required if
(Required if house vacant or field not used for more
than 30 days prior to date of test)
Gallons introduced gallons date
Any rejuvenation treatment (past 12 months)
If yes, enter date
Comments/Deficiencies;
COSA Cneddist_May2025.docx
Well production at time of test 6.0 gpm
Water storage tank volume None gallons
Well disinfected for coliform test? [] Yes Q No
0 Coliform bacteria is Negative
Nitrate 1.08 mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L Arsenic less than MRL (ND)
Collected by Arcterra Consulting
Date 6/3/26
C. LIFT STATION
❑ Required maintenance completed
6 e of lift station years
Lift station
Comments:
Adequacy test date
Results L, Pass
Fluid depth prior to test in
Water added gal
New fluid depth in
Elapsed time min
Final fluid depth in
Absorption rate gpd
hKD STATUS -- POST RECOVERY
(per record drawings) in
Effective depth d in
Effective depth remaini in
E. SEPARATION DISTANCES
From Well on Lot to: (Please enter distances if less than required)
Septic Tank/Lift Station on Lot > 100' Sewer Manhole/Cleanout > 100'
❑ Yes if No NA ft Q Yes if No ft
Neighboring Tank > 100' Q Yes if No ft Sewer Service/Septic Line > 25' ❑ Yes if No 15'* ft
Disposal Field on Lot > 100' ❑ Yes if No NA ft Holding Tank > 100' 0 Yes if No ft
Neighboring Disposal Fields > 100' Animal Containment > 50' Yes if No ft
F,/� Yes if No ft
Manure/Animal Excreta Storage. > 100'
Sewer Line/Main > 100' ❑ Yes if No 45'+* ft Yes if No ft
❑ N/A — Served by Community Well (not on lot) or Public Water
Fro a tic/Holding Tank and Disposal Field(s) on Lot to: (Please enter distances if less than required)
Tank to Foundation ? ❑ Yes if No ft Surface Water> 100' ❑ Yes if No ft
Field to Foundation > 10'
❑ Yes i ft,
Tank to Property Line > 5'
❑ Yes if No ft
Field to Property Line > 10'
❑ Yes if No ft
Water Main/Service Line > 10'
❑ Yes if No ft
F. ENGINEER'S COMMENTS
*Waiver #WR010059 Approved 8/17/01
Wells on Adjacent Lots:
> 100'
Community Wel s �.. '
❑ Yes if No ft
❑ Yes if No ft
If tank or field is under driveway comme
G. CERTIFICATION & 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, indicates that the on-site water
supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation, unless noted otherwise.
Mame of Firm Areterra Consulting Phone (907)-696-6111
Engineer's Printed Name Kenneth Duffus Date
Engineer's Comments: This investigation was completed in compliance with ADEC and
MOA regulations. The assessment of the condition of the well and septic applies only to the
conditions as of the day tested. The flow and absorption rates may change due to
subsurface conditions that may not be observed from the surface, changes inland use, local
soil characteristics, groundwater levels that may fluctuate during the year and the water
usage of the family being served by the system. The operational life of all well and septic
systems are subject to these various and dynamic characteristics and are outside the
control of the evaluator of the well and septic system. Therefore, ArcTerra can not give
any estimate of how long a system will function satisfactory for current or future occupants
or can ArcTerra guarantee that no unseen encroachments, deficiencies or discrepancies
exist.
COSA Cheddist_May2025.docx
*MA"'a��INyIN
* OF
A*
ii7 P.
KENNETH N 6UFFu a
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7.1
6
S 1/2—LOT 3
15,115 SQ.FT.
PORCH
S89'56'00"E 112.00' (R)
CONCRETE
DRIVEWAY-' I
10' UTIL ESMT
ASPHALT
PARKING
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SURVEYOR CERTIFICATE: AS -BUILT
--------------
I HEREBY CERTIFY THAT I HAVE PERFORMED AN AS -BUILT
SURVEY ON THE PROPERTY SHOWN HEREON AND THE
IMPROVEMENTS EXIST AS SHOWN. FIELD SURVEY:
05/13/2026
PLANTER pwck'
5/23/2026
TAYLOR L. DOSCH, PLS 189892
OWNER, BLUE ARROW SURVEYS, LLC
20' 10' 0' 20'
1 "= 20'
1\10j1 -v
*:.49TH ...
_C;;�......`........
Taylor L. Dosch : x
No 1898925/23/26
Jai
til®eROf SSpNAI�.P��� r
1. RECORD DATA SHOWN HEREON IS PER PLAT P-688,
COLONIAL PARK SUBDIVISION, ANCHORAGE RECORDING
DISTRICT,
2. ONLY PROMINENT TREES INCORPORATED INTO LANDSCAPING
SHOWN HEREON.
3. DIMENSIONS FROM THE BUILDING TO THE BOUNDARY
SHOWN HEREON ARE MEASURED FROM THE FOOTPRINT OF
THE MAIN STRUCTURE.
4. THIS SURVEY WAS CONDUCTED WITHOUT THE BENEFIT OF A
TITLE REPORT. ADDITIONAL EASEMENTS MAY EXIST THAT
ARE NOT SHOWN HEREON.
5. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE
THE EXISTENCE OF EASEMENTS, COVENANTS, OR
RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED
SUBDIVISION. THIS AS—BUILT SURVEY SHOULD NOT BE
USED FOR CONSTRUCTION,
6. THIS SURVEY IS IN ACCORDANCE WITH ASPLS MORTGAGE
SURVEY STANDARDS.
7. THIS SURVEY IS NOT A BOUNDARY SURVEY AND IS
SUBJECT TO ANY INACCURACIES A BOUNDARY SURVEY MAY
DISCLOSE.
,41 ,
ol
itl;�9 x.•
„i
Sf is F
LEGEND
S U R V E Y S
STREET — — —569'56'00"E (R)— - — - — - — -- LOT BOUNDARY
WOODEN FENCE
6421 ANDOVER CIR, ANCHORAGE, AK 99516
PHONE: (907) 230-1225 EMAIL: TAYLOR®BLUEARROWSURVEYS.COM
— — — — ADJACENT LOT BOUNDARY
BUILDING
AS -BUILT. S2 LOT 3, BLOCK 3,
— - — R/W CENTERLINE
--------
DECK
COLONIAL PARK SUBDIVISION
------------- UTILITY EASEMENT
--------
BUILDING OVERHANG
ANCHORAGE RECORDING DISTRICT
---- —EDGE PAVEMENT
-,r„}
UTILITY POLE
DRAWN BY:
DATE:
FIELD BOOK:
M 7=_ = CONCRETE
lgWELL
PIPE
JES
5/23/2026
26-05
0 CHAINLINK FENCE
T
TELEPHONE PEDESTAL
CHECKED BY:
SCALE:
PROJECT #:
TLD
1° = 20'
26-068
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program
4700 South Bragaw SL
P.O. Box 196650 Anchorage, AK 99519-6650
www.cl.anchorage.ak.us
(907) 343-7904
CERTIFICATE OF HEALTH AUTHORITY A, PPROVAL'
FOR A SINGLE FAHILY DWELLING
Pa l LD. 0 o- 01-1 HAA./'J
1. GENE~LINFORMA~ON ~pimfion Date:
Completelegaldescdptlon COLONIAL PARK SUBDIVISION; LOT 3, BLOCK 5, SOUTH 1/2,
Locatlon (site address or directlons) 19907 FIRST STREET * EAGLE RIVER, AK 99577
Current Property owner(s)
Mailing address
Lending agency
Mailing address
MICHAEL PIERCE Day phone (509) 288-1152
c/o KATHI OLMSTEAD w/ REMAX PROPERTIES
Day phone
ReaI Estate Agent KATHI OLMSTEAD w/ REMAX PROPERTIES
Mailing address
Day phone. 694-4200
16600 CENTERRELD DR~E * EAGLE RIVER, AK 99577
Unless othet,Mse requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 4
3. TYPE OF WATER SUPPLY:
Individual Well []
Individual Water Storage []
Community Class Well []
Public Water System []
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
Individual Holding tank
Community On-site
Public Sewer
The Municipality of Anchorage Development Services Department (DSD) 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 A~aska. Certificates of Health Authority Approval are required for the transfer
of title (except between spouses) for properties served by a single family on-sita wastewatar disposal and/or
water supply system. DSD also issues HAAs upon request to homeowners. 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 may be reissued for a pedod 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.
Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $885.00 at, or prlor
to dosing for the engineering sa~fces provided.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I vedfy that my
investigation, based on procedures outlined In the Health Autho/fiy Approval Guidelines for this applicaEon,
shows that the on-site water suppty and/or wastawater disposal system is(are) safe, functional and adequate
for the number of bedrooms and type of sfl'ucture indicated herein. I further vedfy that based on the
Information obtained from the Munidpali!y of Anchorage files and from my investigatton and inspection, the
on-site water suppty and/or wastevtatsr 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 ALASKA WATER & WASTEWATER CONSULTANTS, INC. Phone
Address 6901 DEBARE ROAD. SUITE 2B * ANCHORAGE. AK 99504-
Engineer's Printed Name JEFFREY A. CARNESS. P.E.
Engineer's Comments:
In conducting this evaluation, AWWC, thc. attempted to pn~fde a thorough,
conscientious englnsedng analysis of the system In accordance wfth ADEC and MOA
DSD Guidelines & Regulations. The reported results described the peffonwance of the
system under the conditions encountered at tho Eme of the test. and separation
dis~ences measured to roadi¥ Identifiable features. The operational life of all wells and
septic systems depend on the local soils condition, groundwater levels that may
fluctuate dudng the year, and the water usage of tho farni~, being san~d by the system.
These conditions are outalde the contr~ of the evaluater of the system..Satisfactoo, test
results do not guarantee future performance of the system, nor do they guarantse that
there are no hidden defects or encroachments. AWWC, Inc. can therefore not provide
any warranty or future estimate of how tong the system will continue to reset the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the owner listed above, Any reliance upon or use of this repol~ by any
other pereun or party is not authorized, nor ~11 It confer any legal right whatsoever.
Date
337-6179
5. DSD SIGNATURE
~ Approved for ~ bedrooms.
Disapproved.
Conditional approval for __
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
bedrooms, with the fllowing stipulations: .tttl{{.[(_l~rff(tr~
~! WiTERAND ~m
- _....FROG~M .'. ~
...
Manitenan~ Agreemen~ '~)))/11
Supplemen~l Engineers Reo~
O~er
Odginal Certificate Date:
Municipality of Anchorage
Development Services Department
On~e Water & Wastewater Program
4700 ~ou~ 8ragaw 8L
P.O. ~ 1~~, ~1~
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal DescflpUon: COLONIAL PARK S/D; LOT ;3, BLOCK 5, SOUTH 1/2, Parcel ID:
WELL DATA
Well [~. PRIVAT[ If A, B, or G provide PWSlD# N/A
Date completed 10/27/81 ~allllmy~eal(Y/N) YES
Totaldepl~ 357 It. Casadte 357 fL
FROM WELL LOG
10/27/81
Date of test
Static water level 54
Well production 20
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 mL
Date of sample: 7/5/01
B. SEPTIC/HOLDING TANK DATA
g.p.m.
Well L~g (WN)
rares propee/protected (Y/N)
Casing height (above ground)
AT INSPECTION 7/4/01
302 ,fL
5.34 g.p.m,
Nl~te 0.5 mg./L. Other bacteda
Collected by: AWWC, INC.
PUBLIC SEWER
050-301-13
12+ In.
1 colonies/100 mL
Tank Type/Material Date Installed
Tank alze gal. Number of Comparlm~
· ~°aundati°n dean°~ (Y/N) High water alarm (Y/N)'
C. ABSORPTION RELD DATA
Date Installed Soil rating (g.p.d./It=or ~/txlrm) System ~ ~- /
Total deplh _ ft. Eft. absorption ama It= ~ Dapresalon ov~r fi. eld_
Date of .d.uacy test /~R~u....p]~j,~'~Ts/Fall) _ _For...bedrooms
Flulddeplh In:bsmption~ In. _Wateradded_. g,L . New*. in.
uvenation treatment (past 12 mo.) (Y/N & type) If yes, give date
D. UFT STATION
Oete installed Size In gallons ~~ _
'Pump on' level at in. "Pure n. 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
Absorption field on lot N/A
Publlo sewer main *¢5'+
Sewer/sepfio eewloe Ilne * 1
On adjacent lots 100'+
On adjacent lots lOO'+
Publlo sewer manbela/cleanout
Holding tank N,/A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Prope~y line Abeerptlon field
Water een~ce line. Sun'ace water
Wells °n adjacem lote ~~'"'"""-~
SEPARATION DISTANCE FROM ABSO~O:
F. COMMENTS
*AWWU IS CURRENTLY APPLYING FOR WAIVER.
G. ENGINEER'S CERTIFICATION
I cer#fy ~hat I have determined through field Inspe~ons end
review of Mtlrdclpal recolTle that the ebove systems em In
conformance wlgh MOA HAA guidelines In effect on this date.
Englnem's Printed N~me
Date ~.~_~01
JEFFREY A. GARNESS
NAA Fee $ $ OO.
Oate of Payment
Receipt Number
(Rev.
Waiver Fee $
Date of Payment
Receipt Number.
' ' .1UL-II-01 21:11' Fi~4-CT&E ENVIRiIitiKTAL
'~I'Ko CT&E EnvironmenGll Services Inc.
9075515301 T-858 P.02/03 F-057
CT&£ ReLA~ 1014104001 Client Pi ~#
Client Name AK Water & Wastcwafer Consultants Inc. Prtnted If)ii,Time 07/11~1 ]9:36
Project NIm~N Colonial p~ ~ CoJ~ed Daf~lme 07~5~001 8:30
Cleat Sampb ~ ~3 Bl~k3 R~v~ Olte~ime 07~5~001 13:43
Matr~ ~g Water Tecknlcal D~rector Stephen ~ Ede
Ordered By
EP300 Nitrate: LCS recovered outside control {imits(124%). Sample was non-detectable, n,, further action taken.
Allowable Prep Analysis
Pai'mmefcr Resulu ~OL Units Method ~miu D~ D~t~
Nihatc-N O.500 U 0.500 ~g/L EPA 300.0 (<I 0) 07/05/O1 SCL
Init
To~a{ Coliform
I OB, No Coil
col/100mL SMI8 9222B
(<1) 07/05/01 SKW
Municipality. of Anchorage
G__~e.,orge P. Wuerch, Mayo~
P.O. lh~x 196650 * 4700 S. Bragaw Strcct
Anchomgc, Alaska 90519-6C~50 * (007) 3~3-8.301
h ttp://x~.a'w.cl.anchoragc.ak.us
08/17/01
Frank D. Rast, PE
R & M Consultants Inc.
9101 Vanguard Drive
Anchorage, Alaska 99507
Subject:
Waiver Request for Colonial Park Subdivision Block 3 Lot 3 S 1/2
Waiver Request #WR010059
Parcel ID/1050-301-13
Health Authority Approval Certificate Number WR010405
~epartment o~
Public Works
Dear Mr. Rast:
Your request for a waiver of the required 75 feet horizontal separation from the
public sewer trunk to private well has been approved. The approved separation distance
is 45.0 feet. This approval also waives the subject well to the private sewer line which
requires 25 feet separation to the actual separation of 15 feet.
This waiver approval applies to the existing public sewer trunk to private well separation
only. Any furore upgrade to the on-site wastewater disposal system will require all
separation distances be met or another approval from this department.
If there are any further concerns or questions regarding this waiver, please call our office
at 343-7904.
Sincerely,
Daniel J. Roth
Civil Engineer
On-Site Water & Wastewater Program
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650 Anchorage, AK 99519-6650
wv, w.ci.anchoragc.ak.us
(~07) 343-7904
Waiver Review Worksheet
WR#: I}t1~059 PID~: 9~1.301-13 HA~: ~ Permit~:
Dale Received: 7123/01
Legal Description: Colonial Park BIk 3 Lt 3 S1/2
Engineer:. ~
R&M Consultants Inc. 9101 Vanauard Dr. Anchora.e. AK 99507
Applicant: AWWU
Waiver Requested: 45 - 50 ft ~eoaratlon from well to sewer line
Criteria:
Geology
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
Points:
Total:
Waiver is Granted: ~ Waiver is not Granted:
List Conditions or Reasons for above: ~ ~'~ ,~r',,g~/4'~'J~)
Oate: O--IT-Or Sy: Pl lO
Name of Reviewer
Recg: Amount: $920.00 Date Paid:
I
~. of ~9. R £. C. 5. P. w. Ct. £o~ 5. £. R. O.
~2£ ' /L-. = ~
¢./
If ' ..
zY'
bROvO 'rOrbL1'1.8
__CT&E EnvlronmentalServiceslnc.
1016069003
R & M Consultants Inc
N/A
L3 SI/2 B3 Colonial Pk I'LtD
Drinking Water
CT&E Ref+# Client PO~
Client Name Printed Date/Time 09/11/2001 15:36
Project Namem Collected Date/Time 09/07/2001 8:27
Client Sample ID Received Date/Time 09/07/2001 9:40
Matrix Technical Director Stephen C. Ede
Ordered By
PWSID 0 Released By
Sample Remarks:
Allowable P~'p Analysis
Pammeler Results PQL Uni~ Melbod Limits Date Date Init
Wa~ers Dep&r~ment
Nicrat~-N 0.$00 U 0.500 mg/L £?A 300.0 (<10) G9/07/01
SCL