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Home My WebLink AboutEAGLE CREST #2 BLK J LT 4 Municipality of Anchorage Page, DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report LEGAL DESCRIPTION so,, ,,.~: WELL: ~ ~ew ~ Upgrade ~ I SEPARATIONDISTANCES 0 s;pt~ O~M,~ / 0 S.T,E.P. SuHace . ~ ~ , Remarks: ~ ~.., ~ Zot,, / BENCH MARK ENGINEER'S SIAL Inspections performed by: Dates: 1st ~ ~ ~ffH 2nd Department of Health and Human Se~ices approval ~.~.~. CITA T:OiY N 89'59' EXISTING EDGE OF ASPHALT .." -" . ~NCE WELL PROTECTION ........ RADIUS ............... / / /' I ~ ....... ~ ~" ," ~I ~ ~ ~... ~ ,. 205~ s.~. ~ ~ ~SEMENT ~ RECOVERED Al o 0 p.p. 0.7 ~ RECOVERED MON., S 89'58' E u.c. UT'S FENCE I ~ ENCROACHMENT · ~ LOT 8 A ~ ~ ~ LOT 8B '*2~?, .o.72~s-s.,.~ SW 9~0268 ~ [ I /~5 93-09.02 lO0' W£LL PRO1[CIlON RADIUS WELL RECOVERI: D Al AION. EXISIING EDG~ or' ASPIIALT " / 151.92 / \'- / / LOT 4 20,597 S.F. 152.39 0 S 89'58' E u.c. UT'S 10' UTILITY F_.ASrcAfENT FENCE -- £NCROACHMENT ...: ~ RECOVERED SULLIVAN WATER WELLS P.O- BOX 670272, CHUGIAK, ALASKA 99567 · TEL£PHON E ~ ST.ATIC'LI'VM.OF WATrR H. . PERMIT NUMBER ..... KIND O~ CASIXC ~) ~ U~ 'T'. C. J KIND OF FORMATION: From .0 F~, to---A...--Ft.-.r'-'t~8~; ..g_~"~.c~OP__. From.o~ F(.IO'~ , Ft. DOE~'~I~O~''~ Frmn~ ...... / . ~T~~ ..... ~ .... From .FL Io. From~ .FI. to... Ft ....... Front ~* Fr~m .. . Fl. lo. . Fr. From .... FL ~o .... FL From~ Ft. lo ..... FI Ft. lo FI. to I'l. lo ~ FI. Ill I'1. I()__ Fi- From ..... FI, to~ . ~FI...: .... I:rom~ FI. 1o _FI.. From . FI. to ..... Fl:.'. ~ From Ft. I- .... FI. From ..... FI. lo . FI .............. From ..... FI. Ih .. FI.~. From__. mFI. to .. _Ft._ ........ From ..FI. lo_. From_ . FI. lO._ . FI .... From .... FI. lo .... FI.. From... FI. lo ..... Ft., . Front , .FI. lo_.. ~FI, MISCL. INFORMATION: tTb /-/ PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL SYSTEM PERMIT PERMIT NUMBER:SW930268 DESIGN ENGINEER:DUMMY COMPANY OWNER NAME:CADMAN THEODORE M OWNER ADDRESS:lB736 CITATION RD EAGLE RIVER, AK 99577 DATE ISSUED: 8/04/93 EXPIRATION DATE: 8/04/94 PARCEL ID:05029323 LEGAL DESCRIPTION: EAGLE CREST BLK J LT 4 LOT SIZE: 20757 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: WELL SYSTEM 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 (18AAC72) AND DRINKING WATER REGULATIONS (ISAACS0). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4329 OR 343-4681 AFTER BUSINESS HOURS 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: PROOF OF CONNECTION TO THE PUBLIC SEWER STUB-OUT MUST BE PROVIDED TO THIS OFFICE BEFORE THIS WELL IS PLACED INTO SERVICE. RECEIVED B~K~ ~%A~'~%~)~ ISSUED BY: ~~, DATE CZ~,4 N 89'59' E ,..... . ....___~m ....:---...-... "... I " .... ]-~ ,,~,¢,',,,, ...... ".:... .......... ~ '". ........ '.... ........ .... ::...,., .............. ".. ::: ..... · . , . ".: , , ,. ~*,~ .s~ ~5 x ~ "..."".. '"'.. "~'.51-'.'9 2 :.. ................. "::. ................. ~': ':.,. '.... '"... '"...~'".,. ........ ~! '"... ":'.. wru. ,~O~CT/O¢/'. .......... '"..L i '"". =, ,~'~ "". ~.'". F.. ,,o,u~ .. _ ..... .... ,...'i % .I, ~.~. ... ,.q .... %. ~.." '...i"-.. : '% !"... i ~.': ~ ,~-'-IJ '".. .:' i.". '".~. ~ "'... '..'',. :~". ...'"' '"'.. '"'... PROPOSED .'" .... '... ~. '"".. 1-STORY WOOD .." ....... 2. o ". FRAME HOUSE ". .~1". ',. ; I t~ " O~mAC£ ".FF = 107 ," , % ,.. ... ~' '" ............. · ..... e~", · ". ... . :"~ wr ~ '..... ,o¢"... !\ '.., ,,.' ... '"'% 20,597 S.F. i MUNICIPALITY OF ANCHORAGE I Development Services Department fir.% Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 05029323 1. GENERAL INFORMATION Expiration Date Complete legal description EAGLE CREST #2 BLK J LT 4 Location (site address) 18736 CITATION RD Current property owner(s) Mailing address Real estate agent THORNS Kathy Geraci 2. TYPE OF DWELLING: Fx_1 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 g-s-zo2z Day phone 242-5276 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well 0 Private Septic ❑ Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer R Waiver request for: Distance: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 2 s5i� Date of Payment 5 LZ_ Receipt Number COSA # 0SG2 2117( Date: Waiver Fee $ Date of Payment Receipt Number Waiver # 5. 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 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 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm NorthRim Eng. Phone 694-7028 Address PO Box 770724, Eagle River Engineer's Printed Name Steve Eng Date 4/30/22 6. DSD SIGNATURE System #1 Approved for bedrooms System #2 Approved for Disapproved bedrooms Conditional approval for bedrooms, with the following stipulations: C QL V\. r vv,�( L'o S -w2 V- ttil %,e&( . C? SSy .,��\V g -\T Y OF441_11� Original Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COGt Gsec hst blue Sheet o ATER AND m" r-• F OCA R o R E Original Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COGt Gsec hst blue Sheet Legal Description: EAGLE CREST #2 BLK J LT 4 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA Al Well log is filed with Onsite (or attached) Date drilled 9/93 Total depth 182 ft Cased to 181 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 18 in. Date of flow test for COSA 4/25/22 Static water level at beginning of test 139 ft. Comments B. TANK DATA Age of tank(s) years Tank type/material Measured operating fluid level in septic tank ❑ Standpipes/foundation cleanout per record drawing Date of pumping D. ABSORPTION FIELD DATA Which system tested (date installed) ❑ ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet Parcel ID: 05029323 Structure served by this system Well production at time of test 5+ gpm Water storage tank volume0 gallons Well disinfected for coliform test? ❑ Yes ❑ No OR Coliform bacteria is Negative Nitrate 1.23 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by NRim Eng. Date of Sample 4/25/22 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date Results ❑ Pass For bedrooms Fluid depth prior to test in Water added gal New depth in Elapsed time min Final fluid depth in Absorption rate gpd Any rejuvenation treatment (past 12 months) If yes, enter date E. SEPARATION DISTANCES From Private Well onLot to: (Please enter distances if less than required orifcommunity well) SeoiicTonk/Lift Station onLot >1O0 EJ Yes ifNoM Community Sewer Manhole/Cleanout �>100' |fabsorption fie|d/sunderdhvovveyoOmrnmrdbolow nYeo ifNoM ifNu0 r�lYaa JNoft Neighboring Tank >1O0' P,1 Yes ifNOft Private Sewer/Septic Line >25'Yes hNoft Absorption Field onLot >1O0' El Yes ifNoft Community Wells >2U0' El Yes ifNoh Holding Tank >1OO' Yeo ifNuft Neighboring Absorption Fields 100' Animal Containment >50' Yes ifNoft 21 Yes ifNnM K4anure��ninno��xunetaS@oneQ� 1UU' ��on}munih/Sewer &4ain > 75' �__ � Yes if � ~- �� Yea if ft_ From Septic/Holding Tank onLot to: (Please enter distances if less than required) Building Foundations >10' CJ Yes ifNoft Surface VVoter>1OQ' Yeo ifNoM Property Line >5' [] Yoe ifNnft Wells onAdjacent Lots: Absorption Field >5' El Yes ifNoft Private Wells >1O0' E]Yes ifNoft Water Main >1O' El Yes iyN0ft Community Wells >2OO' FlYeS ifNmft Water Service Line > 10' [3 Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation >1O` EJ Yes ifNoM |fabsorption fie|d/sunderdhvovveyoOmrnmrdbolow Property Line >18' El Yes ifNu0 Wells mnAdjacent Lots: Water Main >1O' El Yes ifNo# Private Wells >107 [lYes JNoft Water Service Line >1O' El Yes ifNoD Community Wells >2U0' El Yes ifNoh Surface Water > 100' D Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION / certify that / have determined through field inspections and review u/Municipal records that the above systems are /nconformance with MOA COSA guidelines in effect on this date. COSAChecklist yellow sheet MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage. Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 1. GENERALINFORMATION Complete legal description [z)t 4, Block J, .--.a,.,!e Crest SuSd~visf. on Location (site address or directions) 18735 Citation, .~a?,].e River, Alaska ~9~77 Property owner James D. and Paul-"- L. ?~l.~.d Day phone Mailing address 18735 Citation~ ~ae,!e River, Alaska 99577 Lending agency Nor'Nest Day phone §D4-5998 69~,-1144 Mailing address 15555 Center£Jeld Drive, Z~gle P, ivev, Alaska 99577 Agent P~lf Hilton, Jack White Company Day phone 6~,4-~500 Address 11825 Old Glen :Iiqh:,..~v. Eaele River. ^la~k,3 ~9577 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 -~ 3. TYPE OF WATER SUPPLY: Individual well X Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OFWASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: 4 If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 5. 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 of this Health Authority Approval application shows 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 Municipal and State codes. ordin'~nces, and regulations in effect on the date of this inspection. Nameof Firm Douglas T. Kenle), Phone 746-1073 Address HC01 Box 5034, Pal~..er, ?~aska 99545 DHHS SIGNATURE Approved for -~ Disapproved. Conditional approval for bedrooms. bedrooms, With the following stipulations: Additional Comments Date The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Municipality of Anchorage ~ DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Sewices Division _ 825"L' Street. Room 502 · Anchorage. Alaska gg,01o (go~.~'~ V E D MAR 19 1996 Health Authority Approval Checklist_ Municlpall~ of AnchOrage uept. Health &Human Le~l ~p~ion: Xo~,~f~.~e~ J ~'~,~.ao',~'- Pa.,cell.D.: ~.4-z~ A. WELL DATA Well t)12e If A, B, or C. al~ach ADEC letter. ADEC water system number Log pre~gnt (Y/N) ~' Date completed Total depth /~,g- Cased m '/~,g-- Samt~,, seal (Y/N) ~/ FROM WELL LOG S~tic wat~ level WcU production WATER SAMPLE RESULTS: Coliform ,~ Nitrate Casing height (above gn~nd! wires properly protected (Y/N) AT INSPF_,C'~ON Date of smople: "~"~ ~/r~i~ B. SEPTiC/HOLDING TANK DATA F~on ci~ {Y~ D~ of ~ping C. A~O~ION e-se:Ln DATA D~ ~ w~d~ ~ ~don ~ ~. / Other bacteria Collected by: Depression (Y/N) Pumper Nnmhe~ of Compaltments __ Cleanouts (Y/N) High water alarm (Y/N) Soll rating (gp.d./fl" or ~/'~lnn) __ System .t.t.t.t.t.t.t.t.typc Fluid depth in absorptionS): Immediately after gal. water adrt~ (in.): Fluid depth (.---'~ms.) Minutes later: Absorption rate = g.p.d. ~ent (.east 12 months) (Y/N) If yes, give date D. LIFT STATION Size in gallons lvlanhole/Ac~ss (Y?lC} "Pump on" level at* E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WI~I.L ON LOT TO: Septic/holding tank on lot ~,~','~ : On adja~m lots Absorption field on lot ,4Jj,~ : On adjac~m lots Public sewer main Sewer/septic sen, ice line PubUc sewer pmnholc/clcanom Lift station SEPARATION DISTANC~.S FROM StiFTIC/HOLD1NO TANK ON LOT TO: Building foundation PropcsW Uric Absorption field Wat~' ~ain/zwim linc Suffa~ w~'ldr~inn~ Wells on adjac~lt ~/~/ S PAI T ON tasrm c ,SSORPT ON 97 Or Building foundation ~-~'Witcr mnin/senqcc line Surfa~ warn' ~ Driveway, patkingt~eblelo storage area ~ Wells on adjaccm lots Property Im~ F. ENGINEI~R'S CERTDICATION Rev. 8/95 OSS: haa. wk.doc CT&E Environmental Services Inc. Laboratory Division Laboratory Analysis Report CT&E Rt f.,0' 9607~7.5271 Client Sample [D 4/$ EAGLE CRESTJ0737-01 Dr~k~g Water Collected D~te 03/04195 T~:hnlcal Director PWS[D 0 Released Byf,,~_ - .: Sample Rcm-~rks: ~: At iDa,bis Prep Parameter Results eua[ PQL Units Heth~ Limits 0ate 0ate Inlt NIJ~iJI-I 0,76~ 0,1 ~/L IPA ~,~ ... 200 W. Potter Drive. Anchorage. AK 99518.1606 -- Tel: 1907) 5§2.2343 Fax: (907) 561-5301 3190 Pager Read, Fairbanks, AK 99709-6471 -- Tel: (9.07) 474.8R§~ Fax: (907i 474.9685 [NVIR{~)NMSNTAL FAClLn'IES IN ALASKA. CAMFORNIA, FLORIDA. ILLINOIS. MARYLAND, MICHIGAN. MISSOURI. NF.W JERSEY, OHIO. WEST V~RGINL MUNICIPALI'P/OF ANCHORAGE ; DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P,O. Box196650 Anchorage, Alaska 99519-6650 343,4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING GENERAL INFORMATION Complete legal description ~' Location (site address or ~i~ections) Property owner "/~,-,~o,~' ~.~. Mailing address ~,~'~ Lending agency ~L~/ ' Mailing address Day phone. Day phone e Agent Address Day phon~ Unlessotherwise~queste~ HAA willbeheld~rpickup. NUMBER OFBEDROOMS: ~ TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- . lng to the legality and status of system. 4. TYPE OFWASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesti/~g to the legality and status of system. 5. 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 of this Health Authority Approval application shows 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 Municipal and State codes. ordinances, and regulations in effect on the date of this inspection. Name of Firm ~,¢,~,/_.x,c-x'~, y_ ~_~,~ Phone Address Engineer's signature 6. DHHS SIGNATURE · . ' Approved for "7'-,',,bc~:-.-(.-~//~) bedrooms. Disapproved. Conditior~al approval for f bedrooms, with the folJowing stipulations: Additional Comments Date The Municipality of Anchorage Department of Health and Human Sen~ices (DHHS) Issues Health Authority Approval Certificates based only upon the representations given in paragrap~ 5 above by an.independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not ' - conduct inspections or analyze data before a certificate ts issued. The Municipality of Anchorage is not respo.n.sib[e for errors or.omissions in the professional engineer's work. Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: ~/~,,- /~/. Z~,~- ,-J A. Well Data Well type Log present (Y/N) Total depth Sanitary seal (Y/N) Date of test '~,/~ Static water level /~ ~, Well flow ~ Pump level1 ,/,~ ~ Parcel I.D. If A, B, or C, attach ADEC letter. ADEC water system number Date completed ~i, /9 ~, Driller'~;~,~ 0 Cased to ! ,~ / Casing height Wires properly protected (Y/N) '~ FROM WELL LOG AT INSPECTION g.p.m. ; On adjacent lots /~V'/..~-- ; On adjacent lots /-~/~- SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer service line &.? ~ Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform &:~ Nitrate C~. L! '7 Other bacteria /'J Date of sample: ///'Z. 'Z,/'~ ~ Collected by: B. SEPTIC/HOLDING TANK DATA Da~ Tank size Compartments Cleanouts (Y/N)~'""'""'~.-,. Foundation cleanout (y/N) ~ (y/N) High water alarm (Y/N) ~ Ala~) Date of pumping '~-,~-----------~umper SEPARATION DISTANCES FR~OLDING TANK TO:~ Well(s)~on lot ~ On adjacent lots ~FounSat~.~ To prope~ li~3~ Ab~tr main/service line S uj:faC~ water/drainage 72-026 {3~33)° Fm~t CONTINUED ON BACK PAGE Date .Manufacturer Size in .Manhole/Access (Y/N) Vent (Y/N)__ on' level at 'pump off' Level .Cycles tested SEPARATION Well on lot D. ABSORPTION FIELD DATA Date installed Length .Width Total absorption area Date of adequac~ Water level in absorption field before test Peroxide treatment, _IFT STATION TO: .Soil avel thickness __Surface water. System type .Total depth Depression over field (Y/N) .for After test date SEPARATION FIELD TO: Well on lot ' line To building To existing on lot On adjacent lots Cutbank. line .Driveway, parking/vehicle storage area Curtain drain E. ENGINEER'S CERTIFICATION I certify that I have checked, vedfied, or co~formed to al~ MOA and HAA guidelines in e~7 ~da$~f~tF~s inspec§on. HAA Fee $ Date of Payment Receipt Number 72-026 (3/93)' Back Waiver Fee $ Date of Payment Receipt Number. COMMERCIAL TESTING & ENGINEERING CO. ENVIRONMENTAL LABORATORY BERVICEa "'¢''z~ REPORT Of ANALYSIS Chemlab Ref.~ ~93.6294-1 Client Sample ID :L4A B J EAGLE CREST Matrix :WATER $;33 B STREET TEL'(907) 562*2343 Client Name :ACUMETRIX CORPORATIOU Ordered By Pro~ect Name Pro~ect~ PWSID :UA WORK Order :73489 Report Completed :11/29/93 Collected :11/22/93 @ 06:30 hrs. Received :11/22/93 @ 12:00 hrs. Technical Dlrector~$T~E~_C.~£DE . Sample Remarks: ROUTINE SAMPLE COLLEC']'YJ3 BY: R. RADVANSKY. OC Allowable Ext. Anal Parameter Results Oual Units Method Limits Date Date Init Nltrate-N 0.47 mg/L EPA 353.2/300.0 10 11/22 LLI~ * See Special Instructions Above UA - Unavailable ** See Sample Remarks Above NA - Nat Analyzed U - Undetected, Reported value is the practical quantification limit. LT = Less Than D - Secondary dilution. GT - Greater Than EUvI~ONMENTAL 85RVIOE$ IN ALASKA. COLO~A~)O. UTAH, ~LL~NOI$ OHIO. ~ARYLAHO, W£$T V1ROINIA. NSW ~E~SEY. SOUTH CA~OLINA