HomeMy WebLinkAboutKNIK VIEW BLK 4 LT 3Knik View
Block 4
Lot 3
#0§1-031-59
Development Services Department
Building Safety Division "~
On-Site Water and Wastewater Program, 4700 S. Bragaw St.
P.O. Box 196650 Anchorage. AK 99519-6650 Page
wv,~v, cLanchorage.ak.us {907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: .~L~ OIOIOO PIDNumben
"'"'~'~'~J 5~.ht/y.t.~,j~C,.,~- WastewaterSystem: ~New DUpgrade
Well: ~New ~ Upgrade
SEPARATION DISTANCES ~s~,~ic DHolding DS.T.E.P. DOthen
To Septic AbsorpUon Lift tlolding
Tank Field Station Tank S~r t~e m / ~ ~
s.,--w,. IO0'P 100~ ~/ LIFT STATION
"~"' BENCH MARK
Inspeclions performed uy.~~ Dates: 2~ J- ~- O~
Devel6pme~t Seryl~s Department Approval
P£R.~IT NO. SWO 101 O0 PAG£ OF
P ........ Hu_n~ipgti .t y_o. ¢
bPAN1MbN/ Oh HbAL/H AND HUMAN SERVICES
ENVlRONHENTAL SERVICES DIVISION
P.B. Box 196650 OAncho¢~ge, Al(lskn 99519-66500Telephone, 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
L£CAI., LOT $, BLOCK 4, KNIK VIEW S/D P.I.D. NO. 051-051-59
· . .
Mumctpal,ty of Anchorage .,~;.-,,,...?J ^...~{,
Development Services Department
Building Safety Divisioa
On-Site Water and Wastewater Program ;,~o.
4700 Sou~h Bmgaw SL
Soils Lea - i-,ercola[ion/est
Legal ~Description: Slope Sit. Plan
1- 6,'¢
2-
3-
5-
6-
9-
10-
11-
12.
13-
14-
15-
16-
17-
18-
19-
20-
Depth to Water A~ter / p
Monitoring? ¢ E
Reading Date Gross Time Net Time Depth to Water'Net Drop
1. /o lq.d-' /o"
/o /?" /~"
/_t//z ~ hol, F"
PERCCf. AT~ON RATE (m,nutes,',nch) · / PERC HOLE DIAMETER
TEST BE'DNEEN FT AND F'~
./'-~/ ,~ / ~' '"' -'/
/~// ~/¢p ~--~.~~-"~ CERTIFY THAT THIS TEST WAS
PERFORMED BY: -
PERFORMED IN A"C~6RDANCE WITH ALL STITg~NO M~MNES IN EFFECT ON TH~$ DATE. DATE:
SULLIVAN WATER WELLS
P.O. BOX 670272, CHUGiAK, ALASKA 99567 · TELEPHONE 688-2"/50
OWNER OF LAND:
ADDRESS:
LEGAL DESCRIPTION:
-oT
DATE: / ~
PERMITNUMBER:~#O/oO Date of lssue ~ -_~'~
TAX IDENTIFICATION NUMBER.. ~.
Is well located at approved peri, it location? ~ rj NO
Method of Drilling: ~,~.e~'rotary :j cable tool
Depth of well: /.o /
Ca.sing Type ~.~Z~_Z~.Wall Thickness * ~ ~ inches
~' / feet
Diameter ~ .,e Inches, depth
Liner Type:
Casing St~ckup Above Ground:_..o~
Static Water Level:
Recover Rate: ~ O gpm
Method of Testing:
feet
J-. e?O~T. ~ feet
Wel ntake Opening Type' ta'~n end O open hole
;I Screened; Start feet Stopped feet
;'~ Perforations Sta~l .. feet Sto~e~ [eet
Gro~ Ty~e: ~~ Volume '
~th:~m ~ feet, to ~O ~ f~t
Well Disinf~t~ Upon ~mpletion? ~ '~ NO
Met~ of Disinfection: ~ H~,~
~mmen~:
BORE HOLE DATA
Driller's Name
oj,,eI. 4.,J O
ATTENTION: It is the responsibility o! the property owner lo submit a copy of the well log to the proper authority. Municipality
of Anchorage: Department of Health & Hum, an Services and/or Department of Envlronmental Conservation. MatSu Borough:
Department of Environmental Conservation.:
E0 3~d N~AI-F~S 6g::889 ~g:00 666I/~0/Z0
r{OBER[ C. COWAJJ,
ROBERT A. SI IAFEI%
CIWL ENGINEERS
(907) 694-297§
FAX (907) 694-1211
Municipality of Anchorage
DEPARTMENT OF IIEALTII AND IIUMAN SERVICES
825 L Street
P.O. Box 196650
Anchorage, Alaska 995~9-6650
The septic inspections for the_referenced property were
performed o. I'g- 0~ end I-% 0~.. Prior to snb=~tting
tbs On-site Wastewater Disposal System.and/~r Well Inspection
Report we are waiting for the ~5-~4~'~¢~. to be
completed. '
If we may be of further service, please contact Us.
Sincerely,
Robert C~ Cowan, P.E.
· t?034 NORIII EAGLE RNER LOOP & SUIt'E 204 * EAGLE iwErl. AI.ASKA99577
MUNICIPALITY OF ANCHORAGE
Development Services Deparlment
On-Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON.SITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT
Initial
Date Issued: May 07, 2001
Expiration Date: May 07, 2002
Permit Number: SW010100
Legal Description: KNIKVIEWSUBDIVISlON BLOCK4 LOT3
Design Engineer: 0003 S & S Engineering
Owner Name: TED SCHMELZER
Owner Address: PO BOX 999
NACHES, WA 98937-
Parcel ID: 051-031-59
Site Address: NHN BIRCH CREEK DRIVE
Lot Size: 48390 SQ. FT.
Total Bedrooms: 4 Permit Bedrooms: 4
This permit is for the construction of:
[] Disposal Field [] Septic Tank [] Holding Tank [] Privy
[] Private Well [] Water Storage
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 DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 ( 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:
Date:
Date: ~'--' 7-- ~/
Municipality of Anchorage.
Development Services Department
Building Safety Division '"
On-Site Water end Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 A~chorage, AK 99519-6650
www.cLanchorage.ak.us
(907) 343-7904
ON-SITE SEWEPJWELL PERMIT.~p. PLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 0-~'/- 031 - 5'~/
Permit Number
Property owner(s) 'TI[. O
Mailing address (1) p.e. P~o~ q'l~/
Legal description (Lot, Block & Sub'd.) ~o m
Legal description (Section, Township & Range)
Lot Size ~ .Acre~
4o, o
THIS APPLICATION IS FOR:
Sewer Only
Sewer and Well
Sewer Upgrade
THIS PROPERTY CONTAINS:
Hot Tub
Swimming Pool
Therapy Pool
Day phone ~ ~' ~ - (~ '~ Y
c,,,~ ~' ~,,~ $ 7
Zip Code
1<~ v~.~ ~/o.
Number of Bedrooms
Water Storage
Jacuzzi [~]
Water Softening Unit
I certify that the above Information Is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit Fees:
Date of Payment:
Receipt Number:
(Rev. t ?J00)
o o3 s''~3
Waiver Fees:
Date of Payment:
Receipt Number:
ROBERT C. COWAN, P.E.
July 7, 2000
CMLENGINEERS
(907) 694-2979
FAX (907) 694-t2t
~tTJ~CTtJ~J~. &
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
P.O. Box 196650
Anchorage, AK. 99519
REFERENCE: Lot 3, Block 4, Knik View S/D
It is requested that you issue a permit to install a nveil and a septic system to serve the
proposed four bedroom dwelling on the referenced property.
A test hole was excavated and a pemolation test was performed. The approximate location
of the test hole is located on the attached site plan. At the time of excavation 8/1/95 water
was found at 6.0 feet. After ground water monitoring, water was found at 6.0 feet.
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.
Ifyou require additional information, please contact us.
Sincerely,
Robert 12. Cowan, P.E.
ccro. ij
Enclosure
t7034 t~)RTH EAGLE RN~R LboP ~ SUITE 204 ~ E.&GLE Fh'VER, A~KA 99577
~ "~'~ LOT 3, BI,OCK 4, KNIK VIEW
~ ~,, ,,. ~,~,,~ ~.
~ N B J J [ R.C.C.
mn mrrrin9 DESIGN CRITERIA:
~/ SOILS = 1.O ~PO/SO.[T. / //~
..x,,:o.,..._,., ~7
DRAINFIEI D CRITERIA: .~
0.5' EFFECTVE ~,~rq'~.~, ~/~/ / / / o
LONG {2 0 60' EACH) /~o~
/LOT 9
X / ~1~'.,'.~1.,/ ,.0~~
- ,
~~~/ X // /
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 'L" Street. Anchorage. Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
PERFORMED FOR:
LEGAL DESCR,PT,O.~ t--~, :~ ~'-~-~
5-
6- ~Z g -t.~'
7
8
9
12
~0-
COMMENTS '-r'.~l -~ 3A
DATE PERFORMED
Township, Range, Section:
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH? /
SLOPE SITE PLAN
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE
TEST RUN BETWEEN
Im,nute$/incll~ PERC HOLE DIAMETER
FT AND *'~'~' FT"
$ & S ENGIN£ERIN~3
PERFORMED BY; ..... ~_ at.--, t ~ De:~ ga, ~ ~"'Z~I/I[A,. ~ ~ CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE W,T. A~'~.r~;D~L,NES,. EFFECT ON TH,S DATE. DATE-'
72-008 (Rev. 4/85)
SiTE
I:x'S,'K~ S','ST EiJ
ROBERT C. COWAN. P.E.
CML ENGINEERS
(907) 694-297g
FAX (907) 694-t21 t
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION PRACTICES
and
MATERIAL SPECIFICATIONS
REFERENCE: Lot 3, Block 4, Knik View S/D
July 7, 2000
GENERAL:
The scope of this project includes the installation of a 1300 gallon Premier
polyethylene 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 wastewatcr disposal systems must be certified by the
Municipal Health Department for system installations. Owners 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" clcanouts for pumping access.
Thc septic tank shall be sufficiently bedded to prevent settling or shifting of
the tank.
J7034 kloRTH F...~GLE RNER LOOP; SUITE 204 & EAGLE RNER. ALASKA 99577
I~age 2
Lot 3, Block 4, Knlk View $/D
July 7, 2000
3. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade.
4. 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
an 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 tint 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 TRENCH/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 (rafted-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 coven 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 ofthe 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 U'ench must be mounded to prevent the formation of a depression
after settling.
Page 3
Lot 3, Block 4, Knlk View $/D
July 7, 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 Pi~e perforated [;olid
Cast Iron Yes Yes
ASTM D3034 0aVC) Yes Yes
ASTM F810 0tDPE) 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 (Caulder, Femco, or
equal).
A permeable nontoxic silt barrier ¢rypar 3401, Mirafi 140N, or equal) must be installed
between the final leachfield 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:
Page 4
Lot 3, Block 4, Knlk View $/D
July 7, 2000
The first inspection must be conducted after the excavation of ditches, pits,
trenches, or beds and before the installation of any gravel. 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 inspections 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 ofthe 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
carry 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
Municipality of Anchorage
Development Services Delmar[men[
Building Safety Division
On-Site Water and Wastewa~er Program
4700 South Bragaw St.
P.O. Box '196650 Anchorage. AK 99519-6650
www.cLanchorage.ak.us
(907) 343~7g04
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
ParcelI.D, 051-031-59
1,
GENERAL INFORMATION
Complete legaldescripUon'. Lot 3; Block 4;
.: \
Location {site addre~s'6r diii~cfions)
Expiration Date:
Knik View Subdivision
NHN Knik Vista Dr.
Current Property owner(s) .' Ted Schmelzer
Mailing address PO Box 999 Naches, WA 98937
Lending agenby
Day phone
Day phone
227-6749
Mailing address
Real Estate Agent
Mailing Address
Unless otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF 13EDROOMS: 4
Day phone
3. TYPE OF WATER SUPPLY:
Individual Well
Individual Wa[er Storage
Community Class ~ Well
Public Water System
TYPE OF WASTEWATER DISPOSAL:
Individual On-site ~
Individual Holding., tank
Community On-sRe
[] Public Sewer
The Municipality of Anchorage Developrnen[ Services Depadmenl (DSD) Issues Certificates of Health Authorily
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 ~ransfer of
title (except be[ween spouses) for propedies served by a single family on-silo wastewater disposal and/or water
supply system. DSD also Issues HAAs upon request Io homeowners. Certificates of Health Authorily 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 wilh
new water sample results less than 30 days old. (Cedificates may be reissued for a period of up to one year with
valid water samples.) Cedific'~[es 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.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as o~' Ihe validation da{e shown below, I verify that my Invesilgaiton,
based on procedures outlined In Ihe Health Authorily Approval Guidelines for this application, shows Ihat Ihe
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 {ha{ based on the information obtained from the
Munlclpalify of Anchorage files end from my Investigation and Inspection, the on-site water supply and/or
wastewater disposal system is(are) In compliance with all applicable Municipal and Stale codes, ordinances,
and regulations In effect at lhe time of installation.
NameofFirm S & S EnRineerin~
Address17034 N. Eagle River Loop Eagle River,
Engineer's Printed Name Robert C. Cowan
DSD SIGNATURE
u."'" ^pproved
Disapproved.
Conditional approval for
Phone 694-2979
AK 99577
Date
........... ,.
bedrooms, wi[h lhe following stipulations:
Additional Comments
By:
Allachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
Maintenance Agreements
Supplemenlal Engineer's Report
Other
Original Cedifica[e Date:
Municipality of AnchOrage
Development Services Department
Building Safety Division
On-Site Water & Wastev~ter Program
4700 South Bmgaw SL
P.O. Box 196650 Anchorage, AK 99519-6650
vnvw.ci.anchorage.ek.us
(907) 343-79O4
HEALTH AUTHORITY APPROVAL CHECKLIST
LogalDescripflon:L.e7 ~) ~c~( q ~'~ ¥)Lk/
Parcel ID: O.C/-O f / - ~
A. WELL DATA
Date completed to/z/e i
Total depth G / ff.
If A, B, or C provide PWSID #
Sanitary seal (~/N)
Cesed to ~1
FROM WELL LOG
Date of test
Static water level O
Well production ~-o g.p.m.
WATER SAMPLE RESULTS:
Coliform 0 .colonies/100ml. Nitmta 0-.,~' rog Jl.
Ameni(~: , ~../t. Date of sample: 7/~,/~ z
D. SEPTIC/HOLDING TANK DATA'
TankTy.pe/Mate'dal~ &~/',C /
Tani~lae /.30o 'gal.', :/-. Number of Compertrnents
F~undation cleanout ~N) ~;J Depression over tank (Y~ ~'~
Date of pumping ~/~ -- ~' ~' ~ Pumper
c. A;SO. nO, F,a. DATA'
· Soil rating r ~/bdrm) )- 0
Well Log ~N)
Wires property protected (~N).
Casing height (above ground) J ~' + in.
AT INSPECTION
g.p.m.
Other bacteria O colonies/100 mi.
Collected by:S & S GIGINE~'RING
17034
Da~ i~ll~
C~no~)
High ~r ala~ (Y~
System type
Gravel below pipe ~. 5-
Total depth
Data of adequacy tast ,v/~- ,,,4. v Results(Pess/Fai_l~...----'''~ For ~
Fluid depth in absorption field before Wst~,..~,~Watar added gal. New depth
Elapsed TIme: ~,,,,,~al fluid depth in. Absorption rate >=
Any rejuv~l_......~.a.a.a.a.a.a.a.a~.~"e~lment (pest 1.2 mo.) (Y/N & type) If yes, give date
· ft. Eft. absorption area (~eo ~ Monitoring tube )~65 Depression over field ~ o
bedrooms
in.
g.p.d.
O. LIFT STATION
Date installed
"Pump on" level at
Datum
Size in gallons
in. 'Pump off' level at
Cfc~-~ tes~,d
Manhole/A_ _,'~"ess (Y/N~ ~
~level at
Meets alanw & circuit requirements?
in.
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tenk/lift station on lot / oo
Absorption field on lot /~o
Public sewer main
Sewer/septic sewice line ~- 3- If.
On adjacent lots
On adjacent lots
Publlo s~t~r mnholo/cleanout
Holding tank
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation
Water main /v/~} Water service line /0 "/'-
Wells on adjacent lots / 0 0
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line I
Water Sewlce line /O
~ *': .~-;., ~-...* Curtain drain/~
F, COMMENTS "'~ -"
Building foundation
Surface water /00
Wells on adjacent lots
Absorption field ~'
Surface water ) ~,o
Water main ~/A
D~eway. partdng/vehicie storage
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.
/~r C. C~,~.~
Engineer's Pdnted Nama
Date '7/ ~Lq/OZ--
HAA Fee $
Date of Payment
Receipt Number
(Rev. 12m~1)
Waker Fee $
Date of Payment
Receipt Number
5'O ~
30.8'
JU[-25-02 03:ISPM FROM-CTI£ ENVIRON~NTAL
,~tK CT&E Environm.n[,I Servlce~. hlc.
90?5615101
T-204 P,02/O~ F-394
CT&E Re f./~
Client Name
Project Name~
Client Sample ID
Matrtt
Ordered By
PWS[I)
1024527001
$ & S Engineerint
Lot 3, Block 4, Ki~cview
Lot 3. Block 4, Y, nikview
Dri~dng Walc-r
0
All Datea,q'ime~ are Alaska Standard Time
Prtnted Date/Time 07/26/2002 13:29
Collt~ed Date/Time 07/22/2002 15:30
R~el~ed Date/Time. 07/22/2002 16:30
Technical Director Steph~
Released By ~~
Nit~te-N
0.200 U
Units Med~xl
Limits I~te l~te Init
0.200 mg/~ EPA 300.0 (<101 07/22/02 .IDT
litcrobiologT Laboratorl~
T0~l Coliform 0
eolll OOmL SMI8 9222B
(<11 07/22/02 lOP