HomeMy WebLinkAboutHIGHLAND TERRACE #5 TR 1-CHighland
Terrace
Tract ! C
#050- 311 - 25
Municipality of Anchorage ..:' ~..
Bu ding Safety Division ~,~
On-$ile Water and Wastewater Program, 4700 S. Bragaw St.
P.O. Boxt96650 An~omge.~ 995t9-6650 Page J of~
~.cLan~o~age.ak.us (907) 343.7904
ON-SITE WASTEWATER DISPOSAL SYSTEM ANDIOR WELt. INSPECTION REPORT
Permit Number: ~ 000
"'' 5~Ve M~O~ WastewaterSystem= ~New OUogrede
I~'~S04;,.ff~ ~;~tC. ~K ~qS 77 ABSORPTION FIELD
SEPARATION DISTANCES ~s,p~ic U HoUing ~ S.T.E.P. U Other:
Septic Absorption L~ Ho~ing
"~" BENCH MARK
5 & 5 ENGINEERING
Inspections performed by: .......... ~ :
P£R.~II? i~O. SW000475
PAGE 2 OF 5
Mumicip. oLi~ oF .A.n._c hqr ~g.e'
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.a. Box 196650 ·Anchorage, Alaska 99519-6650·Telephone: 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
LEGAL LOT I-C, HIGHLAND TERRACE #5 P.I.D. NO. 050-511--25
PERMIT NO. SW000475 PAGE 3 OP 3
Municip. o.!.i-t o? .A.n._c h.o,r' a g.e.
DEPARTMENT OF HEAl. TH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P,O. Box 196650 OAnchorage, Aiasko 995i9-6650o Telephone: 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL iNSPECTION REPORT
L£CAL LOT l-C, HIGHLAND TERRACE #5
P.I.D. NO. 050--511--25
~ ST1 ST2 /- 99.0'
FINAL G~N SU LATi~NN
94'0'-/ ~ ~- 93.7'
FINAL GRA~E/
/
MT1 = 86.4' ._/
MT2=8~.4'
NO
CO1 =99.6'
A B
FCO 54.5' 57.0'
ST1 40.0' 46.0'
ST2 41.0' 49.0'
DBL1 42.0' 51.0'
OBL2 42.5' 51.5'
,C01 67.0' 64.0'
MT1 61.0' 65.0'
C02 25.0' 81.5'
MT2 28.0' 78.0'
FC02=99.0'
CO1 =93.4'
C02=93.4'
·
WATER FOUND
~'o jl-' B.O.H.
NOU--27-2001 17:08
6IITH ENUIROr,~IENTAL
Job No,:
Pcrmit 1%.:
P.01
M-W Drilling, ]:nc.
· P.O. Box 110378*Anchoroge. A)C 99511e
e907*-34.%4000 · 907-345-3:~57
As°Built Log
· Welt
e Legal D~Cdl~tlon:
· ,Site of C~sing:
· Static ~t~er level
S,~ve Matxson · Use of Wctt:.
Hi~hland Te~ace #5 Tract 1-C
~-? Rivex- Alaska
6" · Dept& of Hole: 307' · Ce.~ed 2'0:
30.7' I~egow top of c~lng.
Domesti~
62A1'
· P/elt f2nbho
OpenmdX~ Screen Perforated
· Screen/Perforation de~crl~tlen: None
· P/eUpttmpfng te~t at, 2 g~liontper mlnutefor I hout~ with 100%
of drawdown from static level.
· Notes: Well dryj:romLnl with one (I) sack bentonite granuals.
e Date of completion:. 11-27-00
Well Log
2 .,,TO 6
6 TO 22 ~veI ~d cobbles
~ TO 25 Bo~der
25 TO 32 Sil~ve!: ~p .... . _
32 TO 65 Sm~l ~vel: ~y, ~ sil~, s~dy, comp~t . .
65 TO 122 Be~k: ~yblaek, silt~one~llite
~22 To _2os F~ct~e zone,'
205 TO 207.' ~ layer
TO
TO ~ ~ ~_~
TO _.. '- _
TO
TOTAL P.O1
ROBERT C. COWAN, RE.
ROBERT A. SHAFER. RE.
Dater
ClVTL ENGINEEFIS
(907) 694-2979
FAX (90?) 694-! 2 t !
8(~ TEST
IESr
Municipality of Anchorage
DEPARTMENT OF tlEALTH AND IIUMAN SERVICES
825 L Street
P.O. Box 196650
Anchorage, Alaska 99519-6650
REFERENCE
The septic inspectiqns for ~he_referenced property were
performed on 6-J%-~'1 and 6 J~ O~ · Prior to submitting
the On-site Wastewater Disposal System and/or Well Inspection
Report we are waiting for the ~-b~'J~ E~fu~ to be
completed.
If we may be of further service please contact us.
Sincerely,
Robert C. Cowan, P.E.
t
7034 NORTH EAGLE RIVER LOOP * SUITE 204 ' EAGLE FdVER, AL, AS, KA 99577
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 WASTE'WATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT
Initial
Date Issued: Nov 09, 2000
Expiration Date: Nov 09, 2001
Permit Number: SW000475
Legal Description: HIGHLAND TERRACE #5 TR
Design Engineer: 0003 S & S Engineering
Owner Name: Steve Mattson
OwnerAddrass: PO Box 233
Willow, AK 99688-
1-C
Parcel iD: 050-311-25
Site Address: 019750 CICUI-rAWAY
Lot Size: 59631 SQ. FT.
Total Bedrooms: 4 Permit Bedrooms: 4
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 ( 18MC72 ) and Drinking Water Regulations ( 18MC80 ).
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.
Received By: //~/'~ -'
Issued By: ~'-~1~ ~ ~~
Date:
October 26, 2000
ROBERT C. COWAN, P.E.
CML ENGINEERS
(907) 694-2979
FAX (907) 694-1211
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
P.O. Box 196650
Anchorage, AK. 99519
REFERENCE: Tract lC, Highland Terrace//5
It is requested that you issue a permit to install a well and a septic system to serve the
proposed four bedroom dwelling on the referenced property.
A test hole xvas 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, 10/20/00, water
was not found. After ground water monitoring, the tube was dry.
We do not anticipate any adverse effects on neighboring wells, septic systems, reserve
areas or drainage patterns by the installation of the proposed septic system. The
construction of this system will not prevent any future development on any of the adjacent
properties.
If you require additional information, please contact us.
Sincerely,
Robert C. Cowan, P.E.
Rcc jj
Enclosure
17034 NORTH EAGLE RIVER LOOP '* SUITE 204 * EAGLE RNER. ALASKA 99577'
DRAINFIELD
9.0' DEEP
7.0' EFFECIIVE
2.5' WIDE
54' LONG
~"~ TRACT lC, I'IIGIII,AND
B.J.J.J R.C.C.
DESIGN CRITERIA:
4 BDRM = 600 GPD
SOILS = 0.8 GPD/SQ.FT.
600/0.8 = 750 SO.FT. REQ'D.
?ERIA:
l--q,
CICUTT~ WAY
TERRACE
6-5-01
#5
J.~,~.u: 1 OF
CONTRACTOR IS REQUIRED TO
OBTAIN UTILITY LOCATES
PRIOR TO ANY EXCAVATION
WORK.
sE.~TRACT lB
LOT 5
LOT 5
ALL LOTS SERVED BY
PUBLIC WATER & SEWER
LOT 10
LOT 11
rring DESIGN CRITERIA:
4 BDRM = 600 GPO PRIOR TO ANY EXCAVATION
SOILS = O.S GPD/SO.FT. wo.~.
600/0.8 = 750 SO.FT. REQ'D.
DRAINFIELD~ C; :ITERIA:
9.0' DEEP I
7.0' EFFECTIVE
2.5' WiDE
54' LONG [ ~m
LOT 4
~T _
.
~,o~ -
Mu,,lclpallly ol Ai,cho,age
bEPAR*rMENT OF ILEAL1 I & I UMAH SERVICES 825
SOILS LOG ~ERCOLATION TEST
6
7
8
§
Io
II
13
IG-
18-
19
2U
SLOPE
SITE PLAN
I'EI'ICOLAIlOlt I'lXl E
tESt RU~I BETWEEJl
COLIMEI41$
ROBERT C. COWAN, P.E.
CML ENGINEER~
(907) 694-2979
FAX (907) 694-1211
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION PRACTICES
and
MATERIAL SPECIFICATIONS
REFERENCE: Tract lC, Highland Terrace//5
October 26, 2000
GENERAL:
The scope of this project includes the installation of a ! 250 gallon minimum
septic tank and a drainfield trench to serve the proposed four bedroom
residence located on the referenced property.
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.
The contractor shall be responsible for obtaining any necessary underground
utility locates.
Unless specifically agreed otherwise, the property owner shall be responsible
for final grading areas subsequently depressed from soil settling.
Contractors installing wastewater disposal systems must be certified by the
Municipal Health Department for system installations. O~aaers installing their
own systems must also receive prior approval from the Municipal Health
Department.
SEPTIC TANK INSTALLATION:
A septic tank is to be constructed by a certified septic tank manufacturer.
Construction shall include two 4" cleanouts for pumping access.
The septic tank shall be sufficiently bedded to prevent settling or shifting of
the tank.
¶7034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER. ALASKA 9951/'
Page 2
Tract lC, Highland Terrace #5
October 26, 2000
All standpipes on the septic tank shall extend a minimum of 12 inches above final grade.
Septic tanks installed with less than 4 ft. of cover shall be insulated.
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
un effluent pumping system exists within the septic tank). These cleanouts shall be
located on undisturbed soil not more than 10 ft. 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.
Final grading over the septic tank shall be such that a positive slope exists away from the
septic tank.
ABSORPTION TRENCll/DRAINFIELD INSTALLATION:
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 (ruffed-up) before gravel (sewer rock)
placement.
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 ofcover over the pipe.
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.
Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations
shown on the design, and extend a minimum of 12 inches above final grade. 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.
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.
Page 3
Tract lC, Highland Terrace #5
October 26, 2000
MINIMUM MATERIAL SPECIFICATIONS:
Any septic tank proposed for installation must be constructed by a Municipal approved
septic tank manufacturer.
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 (PVC) 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.
Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical
Company Styrofoam HI or equal).
Septic tank inlets and outlets shall be fitted with watertight couplings (Caul&r, Femco, or
equal).
A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed
between the final leaclxfield gravel layer and the native soil backfill.
All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3%
passing the #200 sieve.
When sand is being used as a filter material, its gradation specifications must conform to
current M.O.A. or D.E.C. requirements, which ever requirement applies.
INSPECTIONS:
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:
I~aga 4
Tract lC, Highland Terrace #5
October 26, 2000
The first inspection must be conducted after the excavation of ditches, pits,
trenches, or beds and before the installation of any grovel. A septic tank may be
set in place, but may not be backfilled before this inspection.
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.
3. The final inspection is to occur upon final grading of the property.
Often there will be more than these 3 iuspectious 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 contractors 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 contractors
activities. Final acceptance of the contractors 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
cato' 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
DEPARTMENT OF HEALTH & HU,~At
January 10, 1986
TO: Permit Applicant
Subject: Permit # 850268
Tract lC Highland Terrace Subdivis~
A permit issued by this Department for an in
sewer system has expired as of December 31,
Permits are issued on a calendar year basis
Ordinance. A new permit must be obtained fr
well and/or on-site sewer system not install
If you have drilled the well, a well log ne
Department for documentation of the installa
If a private engineer inspected the installa
the original as-built inspection report(thre
this office for review and approval,and for
If there are any further questions, please
Sincerely,
Susan E. Oswalt
Program Manager
On-site Services
SEO/ljw
enc: Copy of Permit
P.O. BO;< 6659
AtqCHORAGE, ALASKA 99502-0650
('907) 26a-4II 1
I SERVICES
on #5
Jividual well and/or on-site
[985.
Dy authority of Municipal
Dm this Department for any
~d by the expiration date.
~ds to be sent to this
:ion and to close the permit.
:ion of the on-site sewer system
part form) must be sent to
ocumentationo
c~ll this office at 264-4720.
BOILS LOG
PERFORMED FOR:
LEGAL DESCRIPTION:
MUNICIPAI. ITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVI RONMEN rAL P¢~OTECTION ,~! PERCOLATION
(~TEST,
82§ k. Straet, Anchorage, Alaska ~50~ 204-4720 ~ ,
SOILS LOG - PERCC)LATION TEST
'~ * ~X DATE
........ 2.; .J ~ ,.... d /
/
10
11
12
13
14
15
16
17,
18-
19-.
20--
COMMENTS
WAS GROUND WA'rER
ENCOUNTEF1ED?
IF YES, AT WEIAT
DEPTH?
Reading Date
"
PERCOLATION RATE
'rEST RUN BETWEEN
Gross
Time
L: ~: /:~
_ ,_..':~:._.',_
Net Depth to
Time Water
t, i~%-'
Net
Drop
(minutes/inch) ~-.}
PERFORMED BY: ~R1~ 1~ __
72-008 (6/79)
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchora ge.ak.us
(907) 343-7904
CERTIFICATE Of HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. O~'o-3lt-~.~"
1. GENERAL INFORMATION
Complete legal description T rac t
Location (site address or directions) 19 75 0 C i c u t t a Wa y
Expiration Date: "~- ~'-'- O ~
lC; Highland Terrace #5
Eagle River, AK 99577
Current Property owner(s) S t e v e M a t t s o n Day phone 5 2 2- 7 29 3
Mailing address 19750 Cicutta Wa~- EaRle Rivert AK 99577
Lending agency
Day phone
Mailing address
Real Estate Agent
Day phone
Mailing Address
Unless otherwise requested, HAA will be held by DSD for pickup.
NUMBER OF BEDROOMS: 4
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 Deve!opment 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 Alaska. Certificates of Health Authority 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 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 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 er a public
water system. The Municipality of Anchorage is not responsible for errors er 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 vedfy that my investigation,
based on procedures outlined in the Health Authority 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 an 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(are) in compliance with all applicable Municipal and State codes, ardinances,
and regulations in effect at the time of installation.
Name of Firm S & S ENGINEERING
Address ~le River, Alaska 99577
Engineers Printed Name ~0~ ~,
5. DSD SIGNATURE
V" Approved for
Disapproved.
Conditional approval for
L/... bedrooms.
bedrooms, with the following stipulations:
Additional Comments
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
X
Maintenance Agreements
Supplemental Engineer's Report
Other
Original Certificate Date: /~L. - ~ 0 1
M. nicipality of Anchorage
Development Services Department
Building Safety Division -
On-Site Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.cLanchorage.ak.us ·
(SO~) 343-?9O4
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: ""'~:~ - C i / r ~"~.5" Pa~l ID: O~)-~JIl' 3g
A. WELL DATA
Well b/pe ~;~'4,~C If & B, or C provide P~/$1D # ~ ~' eil L~ ) ~ 5
To. depth ~07.. C~edto 6~...:': ....
FROM WELL LOG
-.' /,
Date of teat ~ I
Static water level "~ I ,, It.
Well production '~ g.p.m.
· WATER SAMPLE RESULTS:
Coliform c~ coJonies/100 mi. NilTate ~'-~ mgJl.
Date of sampte: JIl~'~ /0 I (~ilectedby;
B. SEPTIC/HOLDING TANK DATA
Casing height (above ground) ~t.j{ In.
AT INSPECTION
/;_~: ·
i,-,~"'~ lt.
,~ g.p.m.
Tank Type/Material ~=~~1~
Tank size ~ ~CIC) gel. Number of Compartmente
Foundation cleanout ('~1) yl.$ Depression over tank (Y(~
Date of pumping ~ Pumper
C. ABSORPTION FIELD DATA
Date i,steil~ &'l ¢l"01 Soil raU.g (g.p.d~ or ferodrm) 0,.__~
=u',~ ~ lt.
Length .,.~T ~ fl. Wklth
'rote~depth ¢~ lt. E..a~so,p,on=.?S~,~ Moo,o,ngtu..l~=-<
Fluid depth in absorption field before test '""" in. Water added ~ gal.
Elapsed Time: '--' min. Final fluid depth -' in. Abso~:pfion rate >=
Any rejuvenation treatment (past 12 mo.) (Y/N & type) /~
Other'b~--tezia O colonies/100 mi.
17034 Eagle Ri.aw Leap Road Ne. 204
.~.3.~le RI'yin', Aiasica
Date Installed ~ '-- ~/"{~1/
High water alarm (Y/I~ N o
System type ~
Gravel below pipe '~ ft.
Depression over field ~
For ~ bedrooms
New depth~ in.
"'"'-' g.p.d.
If yes. give date ~
D. UFT STATION
Date instailed __ $~Ze
'Pump on' level at ~.~..i jm ~.~ 3 · T~'g~e.~. ~ ~_
Datum nts?
E. SEPARATION DISTANCES
· in.
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot J J~ I .... On adjacent lots l ~)O~d'
Absorpfion field on lot J T0' OnadjacentlotsIOO"r'
Public sewer main 7 g ~ Public sewer manhol~cteanout
$..r,sep.¢.e ,ine :..bldingtan
SEPARATION DISTANGE$ FROM SEPTIO/H~IIIIB-TANK ON LOT TZ '
Water Service line
Curtain drain ~__
Building foundation J '~
Water main .~
Wells on adjacent lots.
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Building foundation ;~
Surface water J ~)
Wells on adjacent lots
properly line ,~'Itt
Water service line
Absorption field
Surface water I ~0 ~'
Water main ~
Driveway, paddng/~ahicte storage
F. COMMENTS
ENGINEER'S.CERTiFICATION
I certi~/that I have determined through field inspections and
review of Municipal records that the above systems are in
conformance wfth MOA HAA guidelines in effect on this dale.
Engineer's Printed Name ~'~
· / /
Date;, '.: I~. ~ O f ".
· Waiver Fee $
Date of Payment
Receipt Number '
DEC-04-O1 O1:2~Pl,I FROM-CT&E EflVIRONI, EHTAL
~,~n~,sm,A~-~"' ,, CT&E Environmental Servtcel Inc.
9075615~01
T-748 P.02/03 F-644
CT&£ Ret#
Client Name
Project Name/#
CHeat Sample ID
,Matrix
Ordered By
PWSID
Sample Rem=ks:
1018142001
S & S Engineering
Tract l-C HiRMnnd Ten*acc #5
Tract I-C Highland Tcnace #5
Dr/~d~ Water
Client PO#
Printed DatuTlme 12/04/2001 8:i4
Collmed Date/Time 11/27/2001 16:20
Received Date/Time 11/28/2001 16:55
Technical Dirtctor Stephen C. Erie
PQL
Unie Method
AJlownbte P~ep Analys~$
l.lmtts Date Date Init
Ni~=e-N
2.28 0.$00 mg/L EPA 300.0 (<10) I 1/29/01
SCL
M:Lcrobl ology Laborato:~'
To~d Cohforra 0
~l,'lOOmL SMI8 9222B
(<1) I 1/28/01 KAP