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Home My WebLink AboutT12N R3W SEC 25 SW4SW4NW4NW4TI2N W tion 25 SW4 SW4 NW4 NW4 #017-421-01 Municipality of Anchorage Development Servlces Department ( Building Safety Division On-Site Water & Wastewater Program, 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Poge 1 On-Site Wastewater Disposal System and/or Well Inspection Report PermR Number:. SW010015 PID Number:. O17--421--01 N°me:GARY DALTON Wastewater System: · New [] Upgrode 525 JORDY CIRLCE * ANCHORAGE, AK 99504 ABSORPTION FIELD Ph°ne:(907) 553 --7414 4 · Deep Trench ri Shallow Trench n Bed [] Mound [] Ot~er LEGAL DESCRIPTION ~' ~ 0.45 ~o~,~ 9.98 UAX. SW4, SW4, NW4, NW4 - 2.98 MAX. e. 7,0+ To,,n. hlp: T12N Ronge: R3W S.cUo.: 25 ~ ~ ~ ~ me- ~ ~ SEE DWO. ~t 96 (20 48)r~ WELL: · New [] Upgrode 2.5 r. 2 Om4meetton (Pdvet~ ,~.B,C): To~ Dqm~ i C4me ~,~: T~d abeoq~o~ ama: P~e PRIVATE 485 .. tm ~o. oc~),t 1544 s~. e. D 3054/ F-810 HEFTY DRILUING 4/9/2001 40 .. COLONY BUILDERS 9/10-18/2001 0.25 ~ UNKNOW~ ,~ 2 ,, TANK SEPARATION DISTANCES .s,.~ []Holding [] S.T.E.P. []Other TO ~pUCTonk Abso~tflon St~UonLIft Holdin~Tonk~/~'~' ANCHORAGE TANK 1250 Well 100'4- 100'+ -- -- 25'+ STEEL 2 ;.,o:. wot,r ~oo'+ loo'+ - - - LIFT STATION ~emorks: BENCH MARK 1. BOTI'OM OF' SEPTIC TANK 2. TOP OF FCO UD Inspections performed by: AWWC, INC. Dates: 1st 9/10/01 ~*O'J'"'~[~[]~d, i~ '""?*q 5Ih 10/8,/01 ~ '~Jelfreb A. O~:P.~ss.: Department of Health and Human Services.approval .h:~ ',. ..' R~viewed SWOIO013 017-421-01 A T~ INSIALLED F1.0W I~T4 ?0.47 55.45 ~DB~ ~ ~ 3 ~D8[1 /~N~ 1250 ~0N ~ -~ -~. / ~v~ ~~ ~:~' :.:?1 A ST1 9,.~1 23.85 ST2 42.50 41..35 DBL1 44.35 42.22 DSt.2. I 45.66 4,1.07 FS 46.~3 4~.58 C01 7,3.25 80.10 MT1 72.87 79.79 C02 49.75 38.60 MT2 ~0.28 35.46 CO3 91.~0 95.71 C04 65.47 ~8.B9 MT4 70.47 \ ,,,, ,,/' ALASKA WATER & WASTEWATER Z.T.G. GARY DALTON (907) 333-7414 2 OF II2N, R3W, SECTION 251 $W4, $W4, NW4, NW4 AS-BUILT P~N OF SEPTIC SYSTEM pERblFr NUMBER: AS--BUILT DRAWING PARC[LID NUM~E~: SW010015 017-421-01 t~.~ (x~.) ~P OF~K AT~m= m = ~ OF T~K AT I~ oF eum SEP~C TANK I~ Or B~G AT WEST TRENCH ~ST TRENCH ~S~ WATER & WASTE~TER T12N, RSW, SECTION 25; SW4, SW4, NW4, NW4 AS-BUILT PROFILE OF SEPTIC SYSTEM '~A%~ WATER WEt. L RECORD STATE OF AI. ASRA · DEPARTMENT OF NATURAI..'RE$OURE$ Dlvlllon Of GiOIOjfGol A Giophyilcel $urve~l <~ 0 rY L.d (u) (M) 49.78' LOT 1 Xx LOT 2 · (M) N 89'59'45" W 279.15' ~%'t-..'..'" ¢'.r.? 49TH'~~' '....-7~vl~ ; ~....~ ~...';7.,,,,, .......... :...:~. ~_ *. DaSd M. Oreyer ...' ,,~;..,,.,,;; ............. ..;;,,,5,;,~,~- 0 ""' SWl/4, SWl/4, NWl/4, NWl/4 OF SEC. 25, T12N, RSW, S.M. "' o ~ ~ / c/ z 151.7 (M) S 89'51'31" E~.278.53' / LOT 1 " LOT 2 ASPEN Municipalit3, ,of Anchorage George P. Il uerch, Mayor · Buildh~g Safety Division P.O. Box 1OGC~0 * 4700 $. Bragaw Strcct Anchorage, Alaska 90519-C'C~0 * (007) 3~3-8301 h t t p://www.cl.m:chorag¢.akus December 1 I, 2001 Public Works Gary Dalton 525 Jordy Circle Anchorage AK 99504 Subject: On-Site Water and/or Wastewater Permit. Permit Number: SW010013 .',Legal Description: TI2N R3W Section 25 SW4 SW4 NW4 NW4 Dear Gary Dalton: An On-Site Water/Wastewater Permit, number SW010013, issued by this office for a single-family system, ~vill expire on January 30, 2002. This permit was valid for 365 calendar days. sent to this office for spection report must be sent to an report must be signed by ?stem. As-built inspection ~e system. install a well or wastewater ~ermit for a second year may 0 after January 1, 2002. The ate ofthe original permit. :ermit and $150.00 for a well l,, anager On-Site Water and Wastewater Program 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 196650, Anchorage, AK 99519-6650 (gO7) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT Initial Date Issued: Jan 30, 2001 Expiration Date: Jan 30, 2002 Permit Number: SW010013 ~egal Description: T12N R3W SEC 25 SW4SW4NW4NW4 Design Engineer: 0041 AK Water & Wastewater Consultant Owner Name: GARY DALTON Owner Address: 525 JORDY CIRCLE Total Bedrooms: 4 ANCHORAGE, AK 99504- Parcel ID: 017-421-O1 Site Address: Lot Size: 108900 SQ. FT. Permit Bedrooms: 4 This permit is for the construction of: r~ Disposal Field [] SepticTank [] Holding Tank [] Privy [] Private WeII [] Water Storage All construction must be in accordance with: 1. The attached approved design. 2. Ail 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 inspect[on. 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. NOTE: Applrcation must be titled out ccm~etely Property Owner Name Mailing Address Legal Description f,qS, ~oo Lot Size MUNICIPALITY OF ANCHORAGE Department of Health & Human Services On*S.e Sewer~e. Per=.Ap..ce.on 0 I 7 -- 4 2 I- O I SINGLE FAMILY DWELLING Parcel IdenliflcaI~on Nu~lber ~-----~ ~,~'/' O.~-'r'Og Day Phone 12/,,] Number of Bedrooms Inspections will be conducted by: ~ApprovedEngineedngFirm I-I Municipality (permit fee inciuded) Does your house contain any of the following: [] Hot Tub [] Swimming Pool [] Therapy Pool [] Jacuzzi [] Water Softener Unit This application is for: [] Sewer Only ~;~,.Sewer and Well [] Sewer Upgrade [] Well Only [] Water Storage I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and in accordance with applicable Municipal Codes. Receipt it Waiver Fees: Receipt #. 72412 (Rev. 4~J8)' Permit Waiver # ALASKA WATER & WASTEWATER CONSULTANTS, INC, ~ January 26, 2001 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Reft Septic System Design for TI2N, R3W, SEC 25; (SW4, SW4, NW4, NW4) To whom it may concern: The proposed 4 bedroom house will be served by a private well and septic system. Two test holes were excavated in the area of the proposed septic upgrade. The proposed septic system will be designed within the 30 foot radius of test hole #1. We propose that a 1250 gallon septi6 tank be installed outside the 100 foot well radius and dual deep trench type drainfield. Comments regarding the proposed design are summarized as follows: 1. SOILS: See the attached logs which shows the soil classifications, groundwater monitoring, and the percolation test results. It is our opinion that due to the overall appearance of the soils, an a 2 pplication rate of 0.45 gallons/day/ft should be used. 2. TRENCII DESIGN: a. Percolation Rate: 30 minutes/inch b. Allowable Application Rate: 0.45 gallons/day/ft2 c. NumberofBedrooms: 4 d. Design Flow: 600 gallons per day e. Minimum Absorption Area: 1333 ft2 f. Total Depth: 10 feet (max.) g. Effective Depth: 7 feet h. Width: 2.5 feet i. Reduction Factor: N/A j. Minimum Length: 96 feet total length (2 ~ 48 feet long each) k. Effective absorption area = 1344 ft~ 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed upgrade. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: a~vxvc.com 4. TOPOGRAPItY: As can be seen on the attached topography site plan, the average topography of this property is a 5 to 20 percent running from approximately northeast to southwest; in short, there are no slope concerns. The trenches are to be installed parallel to slope contours. I am una~vare of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. ~ ' I(tam&~, P.E., M.S. Pres 'iY~ t' NOTE: Attached is a site plan drawing, a design drawing, a topography site plan, two soils logs, and a 7page construction specification letter which are all part of the design package for this septic system. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akxvxvc.com I I ' I I I , I I ~ I ~ROSTAD SUBOMSlON I I FROSTAD SUBDMSION~ LOT 2. I I I ~ DOES NOT [NCROACH ON t~N. PRK. EST $~DI ~ I ENCROACH ON OTHER LOT~ LOT 3 BK 1 I I OTHER LO~ ! NO CONCERN I I I , LOT 4, BK I. i * X_ PROPOS~ $£1:~1C NO CONCERN i I /~ SYST[M. SEE PAG£ 2 Il ~ // , OF 2 FOR DETNI.S. I / ! I ' PROPOSED FOUR NO CONC[RN II // "%'\ ERNI:ST SMALUNC HOME~TT. AO I , A~PEN HIGHLANDS; ~2 I; I I · I ALASKA WATER & WASTEV %.TER K.D.W. 6901 DeB~d~ ROAD. $UI1~ L*B * ANCHORAGE. A~ e950/. * PHONE 1:907)357-6rTe * F~X 1[<~07)~$11-$Z&6 1" = 100' PREPARED FOR PHONE NUMBER: PAGE NUMBER: ~/~. GARY DALTON (907) 535-7414 1 OF' 2 T12N, R~W, SECTION 25; SW4, SW4, NW4, NW4 SITE PLAN FOR PROPOSED WELL LOCATION ND SEPTIC SYSTEM INOT[: THE CONTRACTOR MUST HAVE '(HE NORTH PROPERTf UNE AND THE: WELL RADII FLAGGED BY A REGISTERED LAND SURVEYOR PROPOSED DRNNFIELDS. EXCAVATE-- PRIOR TO ANY CONSTRUCTION. I 'IWO TRENCHES 11~AT AR£ 2.5 ~ ~ WIDE. BY 10 FEEl' DEEP, BY 48 Ft~.l LONG EACH, ADD ? F[['F OF' \ CLEAN, WASHED SE~/ER DRNNROCK. \ INSTALL TRENCHES PARALLEL TO ~ SLOPE: CONTOURS. Co,,,? '~,,~ / ~pRoPO~ ,,,o / ,, -%%, / / / / x~ / ...... '- . · ~ ~oED NO'( E~C.OAC. UPO. ~r~ s~m~c / \\ / ~ ~/2,/2ooo CONSULTANTS, INC. 1" ---- 40' PREPARED FO~ PHONE NUMBER: PAGE NUMBER: OARY DALTON (907) 333-7414 2 OF 2 A. Oarness: T12N, R~W, SECTION 25; SW4, SW4, NWl, NW4 DESIGN FOR PROPOSED SEPTIC SYSTEM AND WELL LOCATION ALASKA WATER & WASTEWATER CONSULTANTS, INC. ISOIL LOG - PERCO~TION TESTI LEGAL'DESCRIPTION: T12N. RSW. SEC 25; SW4. SW4. ~4. NW4 .......... ~ ''J ~'' .......... PERFORMED FOR: ~ D~TON " OR~ICS J TEST HOLE ~1 J mom HOrn) I I AIS~ITE ~ GW ~ ORG / I' = P~O0 ~ GP ~ HL GM CL GC OL SW HH ~ SP CH ~ s~ OH sc l',j DEPTH TO GROUNDWATER DATE D~ ~ 2/~ ~/00 / D~ ~ 2/~/0o cu/su 10 11 DATE RE. lNG CLOCK NET TIHE ~ WATER LEVEL ' NET DROP TIHE (HINGES) RE'lNG (INCHES) 12 12/14/0a PERC. HO~ W~ PROOFED 4+ HOURS PRIOR TO TE~NO 15 I 2:54 6' 2 ~:24 50 5" 1' 14 ~ 5:24 -- 15 4 ~:54 ~0 5 ~:54 -- 6- 16 6 4:24 ~0 5' 1' 17 18 19 PERCO~TION ~TE 50 .(HIN./INCH) PERC. HOLE DIA. 6 (INCHES) 20 TEST R~ BETWEEN 9.0 FT. ~D 9.5 FT. COHHENTS: PERFORMED BY A~ WATER ~ W~A~R. I, JE~E~ ~ G~NESS, CERTI~ ~T W~ PERF~RU[D IN ACCORD~CE W~ A~ ~ATE AND MUNICIPAL GUIDEUNES IN E~L~ ON DATE: I1~1~ I DEPTH TO GROUNDWATER DATE DRY 12/13/00 DRY 12/22/00 ALASIC~ WAT~.~ & WASTEWATER CONSULTANTS, INC. PHONE (907) ~57--6179 * F~ (907) ~-3246 . ISOIL LOG - PERCO~TION TESTI PERFORMED FOR:, C~ D~TON DATE PERFORMED: 12/13/2000 f OR~I~ TEST HOLE ~2 (so~ UO~) I IN ~~TE P~ ~GP ~ML 6M CL 6C OL S~ MH ~ml~ ~ SP CH ~ SM OH ~ sc DEPTH TO [ DATE GRO~DWATER 10 11 DATE RE. lNG CLOCK NET TIHE WATER LEVEL NET DROP TIHE (HINgeS) RE. lNG (INCHES) 12 12/14/0C PERC. HO~ W~ PRESO~ED 4+ HOURS PRIOR TO TE~NG 13 1 2:55 6' 2 3:25 30 5' 1 14 ~ 3:25 ~ 6- 15 4 3:55 30 5' 1" 5 3:55 ~ 6' 16 6 4:25 30 5' 1" 17 18 19 PERCO~TION ~TE 30 .(MIN,/INCH) PERC. HOLE DIA, 6 (INCHES) 20 TEST R~ BET~EN 8,5 FT, ~D 9.0 FT, COMMENTS: PERFORMEB BY A~ WATER ~ W~ATER, I, JE~ A, OARNESS, CERTI~ ~T ~IS W~ PERFORMED IN AOCORD~CE WffH ~ ~ATE ~D MUNIClP~ CUIDEUNES IN EF~CT ON DATE: t I~ 191 DEPTH TO GROUNDWATER DATE DRY 12/13/00 DRY 12/22/00 Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAHILY DWELLING 017-421-01 Parcel I.D. 1. GENERAL INFORMATION Expiration Date: .Completelegaldescription rT12N, RSW, SECTION 25, SW 1//4, SW 1~/4, NW 1/4, NW 1,/4~' ' Location (site address or directions) HILLSIDE DRIVE '~ ANCHORAGE, AK 99516 GARY DALTON Dayphone 333-7414 525 JORDY CIRCLE * ANCHORAGE~ AK 99504 Day phone Day phone Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address Unless otherwise 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 J~] Public Water System II 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 4 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 samples. (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. Note: Alaska Water and Wastewater Consultants, Inc. shall be paid S J .z~:~O ~ at, or pdor to dosing for the engineering services 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 outiined in the Health Authodty Approval Guidelines forthis application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adeqqate for the number of bedrooms and type of structure indicated herein. I furfher vedfy 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(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 &: WASTE'WATER CONSULTANTS, INC. Phone Address 6901 DEBARR ROAD, SUITE 2B * ANCHORAGE, AK 99504 Engineer's Printed Name JEI-i-I<EY A. GARNESS, P.E. Date 337-6179 Engineer's Comments: In conducting this evaluation, AWWC, Inc. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of ali wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate durfng the year, and the water usage of the family being served by the system. These conditions are outside the control oft he eva/uator of the system. Satisfactoq/ test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. AWWC, Inc. can therefore not provide any warranty or future estimate of how long the system will continue to meet 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 report by any other person or party is not authorized, nor will it confer any legal Mght whatsoever. 5. DSD SIGNATURE ~ Approved for L../. bedrooms. Disapproved. Conditional approval for Attachments: HAA Checklist Septic System Advisory Well Flow Advisory bedrooms, with the fllowing stipulations: ..(((((ffrrr~,- ..... " Manitenance Agreements · Supplemental Engineers Other (Rev. t2.~1) Original Certificate Date: ._0.. _ ~ ~ _ cO ~ Municipality of Anchorage Development Se lces Department BulMIng Safety Division On-Site Water & Wasfewater Program 4700 ~ Bmgaw St. P.O. Box 196650 Anctmrage, AK 99519-6850 www.ct.enchorage.ak.us (S07) 343-79O4 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: T12N~ RSW~ SECTION 25~ SW4~ SW4, NW4, NW4~ Parcel ID: 017-421-01 A. WELL DATA *CASED TO BEDROCK Wellt~e PlaVATE ffA, B, orCpravidePWSIl~ N/A Date completed 4/9/2001 Sanitaxy seal (Y/N) YES Total depth 485 It. Cased to *32 ff. Well Log (Y/N) YES Wires pmpedy protected (Y/N) YES Casing height (above ground) 24-~ in. Date of test Static water level Well production FROM WELL LOG 4/g/2oot WATER SAMPLE RESULTS: ATINSPEC~ON *0.25 . g.p.m. ,-- g.p:m. *INST.~IIr'n 500 GALLONS OF STORAGE IN CRAWLSPACE Coliform 0 colonies/100 mi. Amenic: N//A mg./L Nitrate ,I-.27 mg./g Other bacteria 0 colonies/100 mi. Date of sample: 2/14//2002 Collected by: AWWC~ INC. 9. SEPTIC/HOLDING TANK DATA Tank Type/Material STEEL Tank size 1250 gal. Number of Compartments Foundation deanout (Y/N) YES Date of pumping' * NEW C. ABSORPTION FIELD DATA 2 Depression over tank (Y/N) NO Pumper Data installed 9/10-18/2001 Cleanoute (y/N) YES High water alarm (y/N) Date b~stalled g/lO-lS/2ool Soil rating ~ fl~xlrm) 0.45 System type ' ' DON. TRENCH Length 96 (2 O 48) lt. Width 2.5 lt. Gravel below pipe 7.0+ fl.' Totaldepth*11.2-t2.3ff. Eff. absoq3tlonarea 1344 fl2 Monltoringtuba YES Depmssionoverflald NO Date of adequacy test NEW Results (Pass/Fall) - For 4 bedrooms Fluid depth in absorption field before test - in. Water added - gal. New depth - in. Elapsed Time: - min. Final fluid depth - in. Absorption rate >= - .g.p.d. Any rejuvenation treatmem (past 12 mo.) (Y/N & type) N//A If yes, give date. - D. UFT STATION Date installed Size in gallons M~~ '_ 'Pump on' level at. in. 'Pump off' . 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! 00'+ Absorption field on lot 100'+ Public sewer main N,/A Sewer/septic service line 25'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/deanout Holding tank N,/A N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5°+ Properly line 5'4- Absorption field Water main N/A Water sewice line 10'4- Surface water. Wells on adjacent lots 100'+ 5'4- 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line. 10'+ Building foundation. 10'+ Water sen, ice line 10'+ Sudace water 100'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'4- Water main N/A Driveway, parking/vehicle storage 25'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections end review of Municipal records that the above systems are/n conformance with MOA HAA guidelines in effect on this date. Engineer's Printed N~me Oate dP..PPKEY ~ GARNESS HAA Fee $ ~7~, Date of Payment Receipt Number (~ev. ~2~o~) Waiver Fee $ Date of Payment Receipt Number FEB-18-02 I1:17.~U FI~,-CT&E EflVll~l,l~KTkL SRV ,~l&~__.. CT&E Environmental Services Inc. 9075615~01 To418 P.02/0~ F-915 CT&T' Ref.# 1020845001 Client PO# Client Name AK Water & T~/nstcwater Consnlt~Tts ~¢- Printed Date/Time ~] 8~2 ]1:05 Project Name/N TI2N ~W Sec25 SW4 SW4 NW4 NW4 Co]leet~ Date~lme 0~14~2 12:50 Olent Samp~ ID TI2N ~W Sec25 SW4 SW4 NW4 ~4 ~telv~ Dal~me 0~14~2 14:10 Drinking ~atcr Technical Dilator Stephen ~ Ede Sample R~marks: Allowable ~ AnalysL~ Rcs~tts PQT. Unit~ Mct~od t.h~its Datc D~e Init Nitratc-N 4.2'/ 0.200 m8~. £pA 300.0 (<10) 02/14/02 IDT To,at Coliform 0 co~/lO0~L S.MI8 9222B (<l) 02/14~0~ KAP