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HomeMy WebLinkAboutSTONY BROOK BLK 1 LT 1AStony Brook Block Lot IA #015- 511 -07 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 Permit Number: ~LO al G' cO (°~5 PID Number: . Roc~,K,.,~.'~ Wastewater System: D New ~ Upgrade Address: ABSORPTION FIELD Phone: ~ G~ Ne. of Bedrooms: ~ Deep Trench ~ Shallow Trench ~ Bed ~ Mound ~ther LEGAL DESCRIPTION so,,.~..,: o, ~ ~../s,.,~. ~o~a~ ~.p~, ~rom~o,i,i..,~. ~,~d~: Lot: Block: Subdiv~ion: Depth to pipe bottom from original grade: Gravel depth beneath pipe Township: ' -II Range:II Section: ~ Fill added above o°dginal-- I grade:l Ft. Gravell ~length:'7~ '1 I ~ ~' Ft. Number of lines: I D~s[ance between lines: WELL: ~m~ New ~ Upgra~ Gravelwidth: ~ ' F~. ~I il Ft. Classification (Private, A,B,C): T~ Cased TO: Total absorption area: Pipe material: ~'o Driller: ~ Date Drilled: Static Water Level:Ft. Installer:~oC~ ~K~o~ Date installed: ~ ~pMIPump Set at: Fi, I Casing Height Ab°ye Gr°u;~: TANK SEPARATION DISTANCES ~ Se~tio ~ .o,~ino ~S.~.~... TO Septic Absorption Lift Holding ~ublic/Private Manufacturer: Cap~city iR gallons: Prom T~nk Field Statio~ Tank Sewer Lines ~CHO~ Well i l~ ~ to~ ~ 11~ I ~ ~' + Material: ~L Number°f C°mpa~ments: Sudace W~r I0o'* ~oO~ ~o'~ ~ ~ LIFT STATION Size in gallons: Lot Line ~'~ ~I ~' -- I~O~ ~ "Pump on" level at: ~ "Pump off" level at: I High water alarm at: Foundation ~G ~ ~ I ~ G ~ -- ~ ~5//I ~ //I I Electrical Inspections pedormed by: ~umpMa~e&Model -~ ~, ~, ~ Cu~ain ~ ~O~ ~ K~O~ ~ o~1 Drain ~ Remarks: ~T~ ~s~ ~o~t~O. BENCH MARK Location and Description: H.oo3 I Assumed Eiewti0m ENGINEEE'S SEAL ~.~ ,,,' ~ ',.. ~.~ S & S ENGINEERING "~ Inspections performe~Og~.le River LoopRoad, No. 2~ Dates: 1st ~'~-~ ~ ~'Z/~:M ~'~ Eagle River, Alaska 995~ 2nd ~ - I - ~ ~....: .......................... Department of Health and Human Se~ices approval ~:;~3.. ...'.,~ Reviewed and approved by: Date: ~-2B -?~ '~ ' '~"'~'~' 72-O13 {Rev. 9/91) MOA 25 SW950065 2 2 Permit No. Page of Municipality of Anchorage 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 LOT lA, BLOCK 1, STONEY BROOK SUBD. 01551107 Legal Description: PID No.: i C01 CO 95.8~ 1500 A B FCO 25' 21' ST1 59' 40' ST2 46' 48' MH 48' 50' -MT.t~..5t.~-42' MT2 77' 81' MT3 98' 102' MT4 65' 52' NEW 1500 S.T.E.P. FINA~ ,& 79,6' 97.2' t~0 WATER FOUND -NEW TRENGHES WELL 72-013 A (1/93) * SEPTIC SYSTEM ROBERT C, CQWAi~ CE - 880! , ,, "~" ·" ~"' "v l;~.. ~UNI(~Ii;'ALITY OF ANCHOI':AGE. bd].~]NG oA~I~ Dlk ?~500 '" ~" ]ZNSP~]CT!ONS: (907) 563...3464 INFORMATION'.' (907 NAHI:',: ilIPAi~I?.OW ELEC PER~]ZT :~: 9'.5-7834 ADBI~B?;S: 11100 ~TONY BROflK DATI;: 06106/95 ~ PHONE I,OT~ i BLOCi(: IA aUBI.~IVISION: COMHR~YfS: SEPTIC LI[~T ~;TAirION '.I;YPI; [iT' INc*}~:,. llOU:; ~ . '/:;].eot, r"[c':~l ic-e .~ [ ] NJ.) ~ONCOi~):~L].~.~[.I_ OE:Sf~PVEB ~..r' ] . J~.~hC.t l( .lo .oSo~: !~ IAI ...... ~o ~ ~.. ~. "'. -, ...... . t t.~iLL l~}~../.~hlNll AT NB)iT IU.t"iiCIiT[N [ 'J 1'~ NOT CONCEAL ................. ~ 1~~,~2 ~:i l. ....................... Z Z ............................................ ~,~. ... .~ ......... c. . ~ WHEN CORRBCTIONS A~B/~ArlE, PLEA(;g. CALL EO}". ]]NSPI~C].ION MUNICIPALITY OF ANCHOP~AGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 0N-SITE WASTEWATER DISPOSAL SYSTEM (UPGP~ADE) PERMIT NUMBER:SW950065 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:RAE ROBERT W & OWNER ADDRESS:ill00 STONEY BROOK DRIVE ANCHOP~AGE, ALASKA 99516 PAGE 1 OF 1 PERMIT DATE ISSUED: 4/27/95 EXPIP~ATION DATE: 4/27/96 PARCEL ID:01551107 LEGAL DESCRIPTION: STONY BROOK BLK 1 LT iA LOT SIZE: 78000 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHOP~AGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 ~ 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 INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 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 PROVI S I/DNS~.' >/ , BY: ROBERTC. COWAN, RE. ROBERTA. SHAFER. RE. SEWER & WATER INSPECT[ON ENGINEERING STUDIES AND REPOR'rS WELL INSPECTION & FLOWTEST SITE pLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS April 21, 1995 CIVIL ENGINEERS (907) 694-2979 FAX [907) 694-1211 MUNICIPALITY OF ANCHORAGE Depar~ent of Heath and Human Services P.O. Box 196650 Anchorage, AK 99519 REFERENCE: Lot IA; Block I; Stony Brook Subdivision RequeSt you issue a p~rmitto upgrade the septic system to serve the existing four bedroom house on the referenced property. A test hole w~ excavated and p~r¢olation test performed. The approximate location of the test hole d~ located on the attached design. At the tlme of the excavation no water was encountered and after seven day monitoring, the monitoring tube was found to be dry. We do not anticipate any adverse effect~ on n~ighboring properties by the i~t~ation of the proposed septic syst~. There are no points of contamination within the proposed wU radius which can be seen on the attached site plan. If you require additional information Please contact us. Robert C. Co~n, P.E. ROC/gk Enclosure RECEIVED MAY 2 995 Mu~iCipa!i~,y of Anchorage Dep/, Health & Human Se~'vJces 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOWTEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ROBERTC. COWAN, RE. ROBERTA. SHAFER, RE. April 21, 1995 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519 REFERENCE: Lot IA Block i Stony Brook Subdivision Request you issue a permit to upgrade the septic system to serve the existing four bedroom house on the referenced property. A test hole was excavated and percolation test performed. The approximate location of the test hole is located on the attached design. At the time of the excavation no water was encountered and after seven day monitoring, the monitoring tube was found to be dry. If you require additional information, please contact us. Sincerely, Robert C. Cowan, 17034 NORTH EAGLE RIVER LOOP SUITE 204" EAGLE RIVER, ALASKA 99577 o oF- oom~ ~o i1~1I },..q ~ I[m. 3oVLISdN[ ' °~ -IIVI3G/NOIID3S'--~ A S'I'N Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST SLOPE 1 2 SITE PLAN 8- 9- 11- 13 14 15 17 ~8 20- WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? ]/ DeoIh to Water Alter ~,D,Z Da e' //~'-~"/~/~- MonitorinD? ~' / . Gross Net Depth to Net Reading Date Time Time Water Drop : ~o ~o" ~/~ %" ;~y IO ~ ~'~ ~" i;o~ /~ ~r~, 2.~" y~,, PERCOLATION RATE ~, 0 (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN J"'J ,5 FTAND 5,~--'~ FT PERFORMED BY; ~ ~ ~ ~MOlM~I~ I ~~ ~ERTIFY THAT THIS TES/T WAS PERFORMED IN ACCORDANCE W Tfl t~x~eA~*~g~ iN EFFECT ON THIS DATE. DATE: ~/~g /` ~ Eagle River, Alaska 99577 72~8 (Rev. 4/~) ROBERT C. COWAN, RE. ROBERTA. SHAFER, RE. ON-S[TE ~IASTE~ATEE PISFOSAL SFSTEU CIVIL ENGINEERS COI~$TEUCTIOH FJ~crICF_~ f,C. TERIAL SPECIFICATIOI~ (907) 694-2979 FAX (907) 694-1211 SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE pLANS ROAO DESIGN SO]LTEST PERCOLATION TEST REFEI~ENC. E= Lot IAi Block I; Stony Brook SubdZvision GENEF, AL '. Thz scope, of this project includes the, instal~on of a 1500 gallon septic tank e,ffl~e,nt pumping (S.T.E.P.) system and three, pr~ssurize,d absorption trenche~ to s~rve, the, fou~ be,droom r~side,nce, located on the re,fe~ence,d property. The, e,xisting 1250 gallon se,pile tank is to be, e,xeavated, pumped, crushed, and r~move,d from the, property and properly dispose,d of. Construction shall be, in accordance with the, approved site, plan and d~sign drawings, Municipal p~rmit with any spe,cial provisions or conditions, and att appliea§le, State, and Municipal Wastewater Disposal Regulations. The, contractor shall be responsible for obtaining any ne,c~ssary underground utility local~s. U,~ss spe,eifi~ally ogre,ed otherwise,, the, property owner shall be. r~sponsible, for final grading ar~as su§seque,ntly de,pr~sed from soil se~ng. Contractors installing watt,water disposal systems must be, certifie,d by the, Municipal He~h Oe,part~e,~t for system insta~d~tions. Owners installing their own syst~s must also re,c~ive p~or approval from the Municipal Health De,par~e,nt. $EFTIC TANK INSTALLATION= I. A septic tank is to be, constructe,d by a c~rtifie,d se,ptic tank manufacturer. Construction shall include, two 4" cleanouts for pumping ace, s. 2. The se,ptic tank shall be, sufficie,~tly be,dde,d to pre,vent s~ttling or shifting of the, tank. 3. All standpipes on the se,ptic tank shall e,xte,nd a minimum of 12 inch~s above, final grade. 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 Page Two Lot IA; Block I; Stony Brook Subdivision Janu~ry 24, 1995 Seplic ~znks i~t~J~e~ wilh £~ss than 4' of eov~ sh~ll be insu2~ed. foundation ~leanout shall be installed on~ to four fe~t from bu~ding foundo~tion. In the l~ne b~tw¢~n th~ tank a~ th~ l~hfi~d ~ sh~ b~ ~o adja~ ~no~ (u~s an ~ff~ p~p~ng ~st~ ~x~ w~n th~ s~p~c ~nk). Th~ ~ano~ s~ b~ lo~ on un~b~d so~ ~t mor~ than 10' from th~ ~nk, Th~ f~st ~no~, ~n~, sh~ b~ ~ ~ toward th~ l~hfi~d. Th~ s~cond ~no~ sh~ b6 to ~n towed th~ s~p~c ~nk. Final grading over th~ septic tank shall be such that a positive slope exist~ away from th~ septic tank. Excavate the proposed trench to the dimensions shown on the d~sign. The bottom of thc ~x~avation shall be w~t~n 2 inch~s of level. If the sidewalls of the ~x~avat~on becom~ smeared, they m~st be raked or s~ratched (roughed-up) before gravel (sewer rock) plac~mcat. 0nc~ the gravel is installed, th~ distribution pip~ is to be installed level with the p~rforation~ faced downward. Gravel is then to b~ placed over the distribution pipe to provide a minimu~ of 2 inch~s of cover over the pipe. A si~t barri~ mu~t bc installed b~tw~en the final gravel layer and thc native soil backfill. Ensure the silt §ar~r covers thc ~ntir¢ gray61 surfa¢6 b~fore placing backfill. Monitor tu§~s shall be of four (4) inch diameter and insta~%d approximately ~n the £o~ations shown on the d~sign. Thc portion of the monitoring tab~ cxtanding through th~ grav~ shall ~e p~rfarat~d from th~ bottom of the trench to the inv~t of the distribution pip~. Th~ is equivalent to the eff6e~tive depth of the gravel ~s noted on th6 d~sign. Backfill over th~ final graval layer must not be l~s than twenty-four (24) inch~s. Insulation must b~ installed when the backfill depth l~s than t~irty-six (36) inch~s. Thc fi~b5h grade over thc ~¢nch mu~t b~ mounded to prevent the formation of a depression after s~tt~ng. UIHIUUUUATE~IAL SPECIFICATIONS= I. Any septic tank proposed for installation must be constr~eted b~ a Munl~pally approved septic tank manufacturer. Page Thrge Lot IA; Block I; Stony Brook Subdivdsion January 24, 1995 2. Th& following pip& materials ar& approved for us~. in septic system installations in thc M~ni~ipality of Anchorage: Type of Pip& P~r~orat&d So~id Cast Iron Y~s Y~s ASTM D3034 (PVC) Y~s Y~ ASTM F810 (HDPE) Ye No ASTM D2662 (ABSI Yes Ye Usc of a type of pip~ other than l~ted above must be approved by th~ inspecting ~nginecr. Insulation sh~ll be afl,asr 2" thick extruded dir~t burial po£ystyren~ (Dow Chemical Company Styrofoam HI or equal). Septic tank i~ts and outl~s shall b~ fitted with watertight coup~ngs (Cauldcr, F~rnco, or ~qual). A permeable nontoxic silt barrier (Ty?ar 3401, Mirafi 140/N, or ~qualJ must b~ installed b~tw~en the final l~achfi~ld graval layer and th~ no~tive soil backf~. All lcachfi~d graval (s~w~r ro~k) shall b~ 0.5"~2.5" screened gravel with less than 3% passing the #200 sieve. When sand is ~ing used as a filter material, its gradation spzcifica~o~ must conform to curr~ntM.0.A, or D.E.C. requ~m~nt~. ~ypically there wi~ b~ a minimum of thr~e (3) inspections r~qulr~d during th~ instalt~tion of the wast~watcr d~posal system. Thase inspeo~ions will oc~ as follows ~ I. The first inspection must b~ conducted aft~ the excavation of pits, trenche, or beds and ~efore the i~tallation of any ~rav~l. A septic tank may be s~t in place, but may not be backfilled before th~s inspection. 2. The second i~pection must be conducted after the placement of the silt barri~, grav~l, distribution line, standpipes, eleanouts, and ins~ation, but b~for¢ th~ placement of any other backf~. Page Four Lot IA~ Block I~ Stony Brook Subdivision January 24, 1995 3. The final iv~pe¢~ion is to occur upon fir~ 9radin9 of the property. Often there will be more than these 3 i~spe~o~ required, ~spe~b~lly with the i~tallat~on of m~pl~ ~neh~, sand f~s, pr~s~z~d syst~s, ~c. T~, th~ i~p~ng ~ngin~ ~ ~ b~ ~o~d ~ l~t 24 ho~ p~or to th~ s~t of co~u~on. If n~sary, a pr~-cons~u~on m~ng w~ ~k~ p~c~ on-s~. Th~ i~p~ ~ngin~ w~ not coor~, ~ or cobol in any ~y th~ co~a~or's a~v~. The owner shall contract wi~h the contractor to p~fo~ th~ work o~n~ ~ th~ sp~fi~o~ and p~ and in accor~nc~ w~h th~ ~ch~d M.O.A. p~. Th~ w~ b~ no co~a~ ~ran9~ ~x~ng b~n th~ ~o~a~or ~d S & S Engin~ng. S & S Engin~ing sh~ b~ th~ own~'s r~pr~v~ and w~ i~p~ the work ~ s~d ab~v~ to d~ th~ ~o~a~or's a~v~. FZ~ a~c~p~nc~ of th~ ~o~a~or's work r~ w~h th~ own~ and th~ M.O.A. S ~ S Engine~rin9 shall have no liability to the owner or to others for a~t~ or omissions of the ~ontractor or any other p~rsons p~fo~in9 work on t~ proj~ or th~ f~ of th~ ~o~a~or to ~ry o~ th~ work in a~or~nc~ w~h th~ co~u~on do~. S ~ S Engin~ng's i~p~ng ~ngin~ w~ not b~ r~ponsibl~ for th~ co~u~on m~a~, m~hods, t~h~qu~ s~qu~ne~, proc~ or th~ saf~y pr~o~ in~d~ to t~ proj~. CONTRACTOR/INSTALLER ~'919~(,,C¢ Municipality of Anchorage Page ~of I 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 Permit Number: '~10([~' PIDNumber: ~l~5 Name~ ~ ~ Wastewater System: D New ~Upgrade Address: ltloo ~y ~ p~ ABSORPTION FIELD l No. of Bedrooms: ~Deep Trench ~ Shallow Trench ~ Bed ~ Mound ~ Other Ph°ne~. ~9 LEGAL DESCRIPTION so, Rating:[,O~ GPD/Sq. Ft. Total Depthll ~Om original grade: Block: Subdivision: Depth to pipe bottom from odginal grade: Gravel depth beneath pipe WELL: N/~ D New D Upgrade Gravel depth: ~ Ft. Jt ~/~ Ft. Classification (Private, A.B,C): Total Depth: Cased To: Total absorption area: Pipe material: Driller: Date Drilled: StaticWaterLevel: Installer: Date installed: SEPARATION DISTANCES ~Septic ~ Holding ~ S.T.E.P. TO Septic Absorption Lift Holding >ublic/Priva~e Manufacturer: ~ ~O~) Oapacityin gallons; From Tank Field Station Tank Sewer Lines ~[~ ~C' I I Number of Compartments: Surface W~e~ lO'+ [4~'+ ~/A ~/~ ~/~ LIFT STATION ~/A Lot Line Cu~ain BENCH MARK Remarks: I~P~TED [[~1~ Location and Description: Assumed Elevation: Inspections performed by: ~ ~~ Dates:lst ~-~-~1 2nd Department of Health~d Huma~rvices approval Reviewed and approved b Date: 72-013 (1/91) MOA 25 ~,o, ~ [ s~(~ of Municipality of Anchorage 'i '", DEPARTMENT OF HEALTH AND HUMAN SERVICES · :' ' ENVIRONMENTAL SERVICES DIVISION p,o, Box 196650. Anchorage, Alaska 99519-6650 ~. Telephone: 343-47,14 On-Site Wastewater Disposal System and/or Well Inspection Report Legal DeScription': ti' IA 8L. ot_.l-' I ~T~NY 6¢.~oK. 9,.,,8Dl'q PIDNo,: O1~'~'~ Mol-CS ~-XI 51'. Permit No, of, ~ Municipality of Anchorage DEPARTIVIENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 o Anchorage, Alaska 99519-6650 w Telephone: 343-4744. On-Site Wastewater Disposal System and/or Well Inspection Report Legal Description': ' LoT IA. ~5~-0¢---Ic- I ~"F~CY I¢~¢-co~c- gu~O~/ Flub q." crc ~ VEgT: ii1.= i0~ PAGE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT NUMBER:SW910112 DESIGN ENGINEER:HIGH, PHUKAN ~ SORENSEN CONS. OWNER NAME:WEEKS RALPH H OWNER ADDRESS:P. O. BOX 112129 ANCHORAGE, ALASKA 99511-2129 PERMIT DATE ISSUED: 5/21/91 ENGRS EXPIRATION DATE: PARCEL ID:01551107 LEGAL DESCRIPTION: STONY BROOK BLK 1 LT iA 1 OF 5/21/92 LOT SIZE: 78000 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD 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 (18AAC80). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: 1. VERIFY INTEGRITY OF EXISTING SEPTIC TANK. MAY BE NECESSARY. 2. INSTALL TWO POST-TANK CLEANOUT. ISSUED BY: ~-~-----~ ~ REPLACEMENT DATE' DATE' H91366 ON-SITE SEPTIC SYSTEM NARRATIVE Project: Lot lA Block 1 Stony Brook Subdivision Date: 5-9-91 The following narrative is submitted as part of the leach field upgrade for the on-site septic system for Lot lA, Block 1 Stony Brook Subdivision, and is submitted in accordance with the Municipality of Anchorage Ordinance - Chapter 15.65 (wastewater disposal regulation), Section 030.D,4, Item A: Wells Lot lA is bordered on three sides by developed and undeveloped lots, The entire south boundary is bordered by an undeveloped tract. Due north is Lot4, to the northwest is Lot 3 and due west is Lot 2, all of which have systems well away from subject property, None of the lots surrounding Lot lA have wells within 200 feet of either the existing or proposed systems. The existing system does not affect any of the existing wells or prevent placement of new wells on adjacent properties. Item B: Wastewater Systems Due to the size of the undeveloped lots and the location O.~.¢xisd~3g.uti!ities on the developed lots, the proposed leach field system has minimal to no impact on lots to the east, north and west. The existing and proposed systems on Lot 1A do impact the lot to the south. However, There is adequate room for placement of wells, septic system, and reserve area. See attached sketch. Item C: Reserved Space There is space remaining on all adjacent lots for placemeh-tbf neW'g-¢~'te~s or upgrade of eXisting systems. See attached sketch. Item D: Drainaqe Drai~age for the entire area is generally to the west. There is a creek that cuts through the subject property. See attached sketch. The proposed leach field is outside the 100-foot setback requirement and the creek should not be affected by these !mprovements. ***End of Report*** No, Page I ol ~ · Municipality of Anchorage · " DEPARTMENT OF HEALTH AND HUMAN SERVICES -. ENVIRONMENTAL SERVICES DIVISION P,O. Box 196650 v Anchorage, Alaska 99519-6650 .. Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal Do~m:iption':"LoT IA '81...0¢~~- I'~'P~NY 6¢.~y.. S~SOIW PIDN0.: ] . ' ~ToNy ~oo~ P~iV6 .............. I ...... ; ........... ,' 1 ~ / ..... '"'- I' ' · ........ 'lc:, ls:Kl%T T,'~ , l N G"rA.k.I.. .E. XI%IF. $1~i2TiC. PiT \, TI~ST ~IT5 IO~ ¢~ ~¢'E:R.T'r' ._ Permit No, , Page Z gl '~ Municipality of Ancnorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O, Box 196650 e Anchorage, Alaska 99519~6650 ,. Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report LegatDescription: L-o"r IA. I~l-oc.y-- I %'1-O~' g~-zolc-- gu~,o/,,/ PIDNo.: °ECSIVED uept, Health & Human Services /~2Pcrmll No, Munioipslity of Anchorage - DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P,O, Box 196650 · Anchorage, Alaska 99519-6650 ~ TeJephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal De~cription'~ ' LOT NOTES 1. Puml~ existing septic pi[. Backfill pit with sand and abandon in' place. Contgar per topographic survey 'by HPCE on 5/8/91. 3. All c~nstruction to be in accor~lance w/MOA (DHHS) regulations as currently amertded. Puml~ wiring to b~ placed in'cd,'nduit from top of well casing to 24" below grouted. Fill in dePression around well. 5. Existiln9 1,250-gailon concrete septic tank to be inspected and tested. Contr~actor to exp~)se sides and top. 6. Contiactor to verify invert elevation ~f tank outlet prior to commencing with cons!ruc[ion. 7. Septi~ system sized for 4-bedroom home. Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 995~,02-0650 SOILS LOG -- PERCOLATION TEST Township, Range, Section; PERFORMED Eon: LOT IA F~ L/.)~_ ~.. I LEGAL DESCRIPTION: 'Fo ~ANpy eolbT' SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? s L IF YES, A'r WNAT 0 DEPTH? p E ngplh Io Walcr Aller .. Moltitorir~9? ~ ~]ate: '~"~Z- a} J ACCORDANCE wI'rH ALL STATE ANDIMuNI~IPAL GUIDELINES IN EFFECT ON ]HIS DATE. DATE: ~ ~,/ 1 2 3 5- 6- 7 8 9 10 11 12 13 14 15 ~6 17 18 19 2O PERCOLATION RATE "7, J (minutes/inch) PERC HOLE DIAMETER ~.~ II TESI RUNBETWEEN . "~'~ FTAND ~'.O F1 Reading Date Gross Net Depth t Time Time ('~1 I/'~ Water~l N'~ Net Municipality el Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, .69chorage` Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: I I [0~;~ (~ ~:'~'C~ j~ ~' ~)~.- J'~/~/'~/~-- DATE PERFORMED: LoT I~- I~1-0~.~~-- t LEGAL DESCRIPTION: c~T(.~N Y ~AC~'Ot~.. 'SUI~P. Township, Range, Section: 'T 1 2 3 4 5 6- 7 8 9- 10- 11 12 13- 14- 15 16 17 18 19 20 COMMENTS SLOPE WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? SITE PLAN Reading Depd~ [o 2~ V~. PERCOLATION RATE ~. ~-- (m~r,ule$/mchJ PERC HOLE DIAMETER TEST RUN BETWEEN ~ ' FT/,ND ~' ~ FT PERFORMED BY: I ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. 72-008 (Rev. 4/85) CERTIFY THAT TI IlS TEST WAS PERFORMED IN DATE: PROJECT SUBJECT ~ f:-FTic I:~S ~&,N II F'\ \ ;0 N 89°55'10"E 300.00 RCJ /A 30000 ,10° U il Esm 3O OAA8 HD-I GPr~TER ANCHORAGE AREA BOROV~iH HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM LOCATION r--~/, ~ ~/~[* SEPTIC TANK:~ DISTANCE FROM WELL LIQUID CAPACITY /'~ '~ ~'~/~ GALLONS. SEEPAGE SYSTEM: SEEPAGE PIT: ~.~.~. ~.~ ~ NUMBER OF / MATERIAL COMPARTMENTS '~-~/~ / ~ ~'~'~ LIQUID INSIDE LENGTH INSIDE WIDTH DEPTH__ NUMBER OF PITS LINING MATERIAl NEAREST LOT LINE TILE DRAIN FIELD: OUTSIDE DIAMETER OR WIDTH DISTANCE FROM WELl LENGTH '~/ / , . DEPTH BUILDING FOUNDATION ~' TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) DISTANCE F~OM WELL FOUNDATION , NEAREST LOT LINE /~ NUMBER O ES ~\ ABSORPTION A~,,~_.~.,~,~,~/ SQ. FL _ENGTH OF EACI~.~....,~' DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE .SQ. FT. TOTAL LENGTH · OF LINES IN. T~.~.D EFFECTIVE IN. ABOVE TILE ~,~, '//~ DISTANCE FROM WELL: TYPE ! DEPTH , BUILDING FOUNDATION. NEARES] SEPTIC SEEPAGE LOT LINE .. SEWER LINE .TANK , SYSTEM WATER SAMPLE NEARESE OTHER CESSPOOL , SOURCES DISTANCES: A DIAGRAM OF SYSTEM DATE GREATE1 ANCHORAGE AREA . ~)ROUGH HEALTH DEPARTMENT 327 Eagle St. Anchorage, Alaska 99501 279-2511 Case N o. /~'~ SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT -~ . NAME OF APPLICANT ."~/~LPhz ,fi, RESIDENCE ADDRESS '3~FWN ,~ LEGAL DESCRIPTION ~:l~."' ~..y f/v'e 2.-/t PIT_ APPLICATION TO INSTALL: SEPTIC TANKc_~u~EEPAGE , DRAIN FIELD TOSERVETHEFOLLOWINGFACILITY ff ~EI~OO/VI FINANCED THROUGH TO BE INSTALLED BY PERCOLATION TEST RESULTS ANTICIPATED DATE OF COMPLETION BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT MAILING ADDRESS~'~'~/7 ~"1~/¢'t~/'q/6 PHONE { (, · LOCATmN OF ~NSTALLAnON -Y-~,~,,V~ ~,e~O,~ ,OTHER THIS IS TO SERVE AS DISTANCES: A'ro B [?, -r'o c. :Z. ~C PERMIT TO INSTALL A 5'~_~.u~.¥1(; .AS DESCRIBED BELOW. 81ZE OF UNIT TO BE SERVED TYPE · SEPTIC TANK SIZE ~TYPE ~StltJ6'~ SEEPAGE AREA DIAGRAM OF SYSTEM Health Authority certify that i am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the ~ove described system is in accordance with said code. ATE ,'¢._~ z/- 1~ APPLICANTS SIGNATURE ~, --. _ Municipality of Anchorage Development Services Department Building Sa!ety Division ' On-Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 995t9-6650 www.ci.anchorage.ak.us (907) 343-7g04 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-513_-07 1. GENER~,L INFORMATION Comprete legal description Lot lA; Block 1_; Expiration Date: / Z/~'/¢ 7.... Stony Brook Loc~ii~n (site address or directions) 11100 Stony Brook Anchora~.e C~r. rent Propedy owneris) Bill. & Rosemary Cody Day phone 3/~6-3803 Mailingad~l~ess illO0 Stony Brook Anchorage, AK 99516 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless othem4se requested, HAA will be held by DSD for pickup. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class ~ Public Water System Well [] [] [] TYPE OF WASTEWATER DISPOSAL: Individual On-site ~ Individual Holding lank [] Community On-site [] Public Sewer [] The Municipality of Anchorage Development Sen/ices Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given In paragraph 5 by an Independent protesslonal civil engineer registered in the Slate 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 1o homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for propedies sen/ed 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 sen/ed 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 al'fixed hereto and as ot Ihe validation da{e shown below, I verify Ihat my Invesllga[ion, based on procedures outlined In Ihe Health Authorlly Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal syslem Is(are) safe, functional and adequate for Ihe number of bedrooms and lype of struclare indicated herein. I J'udher verify tha~ based on file Information oblained from the Municipality of Anchorage files and from my Investigation and Inspection. the on-site water supply and/or wastewaler disposal system Is(are) In compliance with all applicable Municipal and Stale codes, ordinances, and regulations in effect at the time at Installation. NameofFirm S & S En~ineerinF, Address 17034 N. Ea~le River Loop' Ea~le Engineer's Printed Name Robert C. Cowan 5. DSD SIGNATURE Approved for .4/ Disapproved. Conditional approval for bedrooms. River, Phone 694-2979 AK 99577 Date bedrooms, with the following slipulations: Additional Comments Allachments: HAA Checklist Septic Sys{em Advisory Well Flow Advisory Maintenance Agreements SUpplemental Engineer's Report OIher By: Original Cedi~icale Dale: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw Bt. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak, us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST LegalDesc~tptlon: Lo~' ~t/f j~-oc~ I S'7o/,/¥ J~,e=oK ParcellD: O/3---5"1/-O7 A. WELL DATA. Waft typo P~,,,~,r-~L Date completed Total depth ~ ~ Date of test Static water level Wall production WATER SAMPLE RESULTS: · Coliform O .colonies/100 mi. Ameni~' n~.~. B. SEPTIC/HOLDING TANK DATA ifA, B, or C provide PWSID # -- Sanitary seal (~YN) Cased to ~ 0/'ft. FROM WELL LOG ~o waft Log (~) y L.C W~res properly protected (~N) Y~ ~ Casing height (above ground) ] ~'~' in. AT INSPECTION ft. I ! ~,. ft. g.p.m. ~'- ] g.p.m. Nitrate O. =~* mg./I. Date of sample: Other bacteria O colonlas/100 mi. 1/034 F.,~Io Rt~r Leap Read Ne. 204 Date installed //c~ ~- Cleanouts ~) Y ~ ~ High ~r ala~) ~ J Date of pumping ~/'~../o ~-. Pumper CH ~' (:> Systemtype 7'~/~c--/V¢-s' ff. Gravel below pipe '~ ff. Eff. ebsorpflonamaJO~J,'~-ft2 Monltodngtube ~Yg$ Depmssion over field ~0 AB~oRPTIoN FIELD DATA Date installed ,(D/ /eS" , 'Soil rating ~or ~/edrm) Length'"/e d~ ~'~-- ff. ~'~ldth ~ Total depth .~o ft. Date of adequacy test ~/')/0;Z- eesults~Fail) ,~$-f Fluid depth in absorption field before test t '~. Water added (~q~(gal. Elapsed Time: ~ ~ min. Final fluid depth I $ in. Absorption rate >= Any rejuvenation ~reatment (pest 12 mo.) (Y/N & type) /ve/v~. J<'~0 w/~/ If yes, give date For z/ bedrooms New depth/ )1 ~. ~ ~ ~ g.p.d. D. LIFT STATION 'Pump on' level at ~=/ in. Datum TeP O~- ~,t~J~..f.. Size in gallons / ~'d o 'Pump off' level at -/G in. Cyctes tested ~' Manhole/Access~) ~ -.f' High water alarm level at ~o ~- in. Meets alarm & circuit requirements? 'YF_. J* E. SEPARATION DISTANCES SEPARATION DISTANCES FROM Vi/ELL ON LOT TO: Septic tanMift station on lot !¢~0 ~'~* Absorption field on lot Public sewer main Id Sewer/septic service line On adjacent lots / 0 4 /'/' On adjacent lots ] O O '-F Public sewer manhole/cleanout ,/V/,~ Holding tank ~'///'~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation ~ (0 ~ Property line ~ ? Water main l~ lA Water service line / Wells on adjacent lots / Oo /~- SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line '~ 3 / Building foundation Absorption field Surface water :7( ' Water main /0 /'~' Sun<acewater ldo ~'/'" DHveway, parking/~mhiciestomge ~.0/"~' /< ~vO~-, ~/Wells on adjacent lots ~4) Water Service line Curtain drain F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I heve determined through field inspec~ons and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name Data HAA Fee $ Date of Payment Receipt Number {Rev. ~2/~) o ;A ¥ Waiver Fee $ Date of Payment Receipt Number AUG-14~OZ 05:5?PM FRO~CT&E ENVIRON~NTAL SRV ,d~TE CTI£ Environmental Services Inc. 9075615~01 T-T?2 P.02/O? F-188 CF&F. aef.# 1024946001 L-~ient Name S & S l~nginecfing Project Ntm~ Vinous ~ltnt Sample ID ~t IA Block I Stony Drive MatH~ D~g Wat~ O~r~ By PW$~ 0 All Dat~a/Tlme, are Alaaka Standard Time ]h'lnted Datetl'lme 08/09/2002 15:48 {~olleetrd Daletl'lme 08/07/2002 11:30 Received Date/Time 08/07/2002 13:15 Technical Director £dc Released By ~~ Param~n~ P.~ts PQL Allow~blc ihx'p Analysis IAmlu De~c Dam Init Nitr~tc-N 0.200 U 0.200 n~/L F-PA 300.0 (<10) 0B~8/02 ?LW Total Coliform 0 col/100eL SMI8 9222B (<11 0~07/02 SBH I ~1 -DJ. 'ON IV'Id O~ (bi) .00'00£ $1SVI~ (ti) ,t~t~'66~ 3.01,~Cfio6g N "4 0 81 0 ,6°66 (~) ,00'00~ 3.01 ,~<;o6g N 1. GENERAL INFORMATION Complete legal description L_OT- 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 HAA #. I,~, 6LOC~. I Location Mailing address '~OX [IZIZC~ ,Z~d,J~A~J.F~; Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: Dayphone 5~- ~l~l Day phone 577-0700 : Dayphone ~-/7-~,01~ AF- ~l TYPE OF WATER SUPPLY: Individual well X Community well Publie water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-O25(Rev. I/91) Front MOA#21 s~uewwoo leUO!l!pp¥ :suop, elndBs I~U!MOIIOJ eq~ q),!M 'suJooJpeq 'SLuooJp@q Joj 'eAo,~dde leuO!l.!p,.u~oo.- 'peAoJddema ~n±¥Ng~S SHHO '9 EI:~NION=I A8 NOI.I.O~IdSNI =lO J.N=fl/~IJ.V.LS '~ Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L(~T I,Zg. ~ /2~1..0C~._ I Parcel I.D. WELL DATA Well type ~JWAT'~--~ If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) ~ ~(~") Date completed ~-~C)-7C~ ~'~ Driller ~C)5~ r~l~l~.L. If,.(~('~') Totaldepth ~.t.~¢ I ~_~ Casedto ~-(~'! (~ Casing height 127' (~ Sanitary seal (Y/N) ~ ~ Wires properly protected (Y/N) ~' © NIYNICIPALITY OF ANCHOP. AGE FROM WELL LOG Dat~ of test 3' :~-'7 C:~ ('~ ' Static water ievel J ~C> I (~ Well flow ~ ?-- (~) /,,/~,~ F_ c-.w/~' -------------------~ (.~g.p.m. Pump level AT ~.~A~ ~(o~~ AT INSPEC"I'~ONMENTAL SERVICES DIVISION 6 1991 E'ECEIVED g.p.m. SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot i2.~ ~ "r C~ ; On adjacent lots Absorption field on lot Public sewer main Public sewer service line WATER SAMPLE RESULTS: Coliform /Oh~ Date of sample: ~/~/9/ ; On adjacent lots Public sewer manhole/cleanout PetroleUm tank Nitrate J~P Other bacteria Collected by: B. SEPTIC/HOLDING TANK DATA Date installed (.o-~.~ '-'~ ~'~ Tank size J ~'~ ~.1 (~ Compartments I (~ Cleanouts (Y/N) ~ (~) Foundation c[eanout (Y/N) /,,1 ~) Depression (Y/N) ~' © High water alarm (Y/N) ~ /,ZN Alarm tested (Y/N) /~4 /,~ Date of pumping ~;:~--c) ~ ~) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot J2..~ ~ ''f t~) On adjacent lots To property line '~J~ ~'~ (~ Abso/~iOn field Surface water/drainage I I ~ 't- ~ Foundation -- Water main/service line f~J/,2k CONTINUED ON BACK PAGE Nor f~--~'~ C. LIFT STATION Date installed N/,& Manufacturer Size in gallons Manhole/Access (Y/N) Vent(Y/N) "Pump on" level at "Pump off" level at High water alarm level Cycles tested Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacentlots Surface water D. ABSORPTION FIELD DATA Date installed {O-~-c~-~ I Length ~"7 ~ (~ Width Total ab~sorption area -7 ~ Depression over field (Y/N) Soil rating Gravel thickness Cleanouts present (Y/N) Date of adequacy test System type ~ Total depth Results (pass/fail) for Peroxide treatment (past 12 months) (Y/N) C;~N~,,I¢~ I~ PlCP, I"E.O If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Wellonlot lOS ~ ~ .On adjacent lots IC2O(+C'~ Propertyline To building foundation ~ ~ (~} To existing or abandoned system on lot On adjacent lots I CO ~ + (~ Cutbank N /A Water main/service line Surface water Curtain drain bedrooms i?_: (Z) Driveway, parking/vehicle storage area E. ENGINEER'S CER'rlFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in' effect p,.r]., the date of this inspection. Date of Payment Receipt Number Waiver Fee: $ Date of Payment Receipt Number CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 B STREET ANCHORAGE, ALASKA99518 TELEPHONE (907) 562-2343 FAX:(§07} 561-5301 ANALYSIS REPORT BY SAMPLE for WORKordezf 37881 Date Report Printed: StP 6 91 @ 12:03 Client 3ample ID:STOHTBROON 1ilO0 HOSE BIB BACH OF HOUSE P~SID :UA Collected SEP 6 91 ~ 16:65 hrs. Received SEP 6 91 ~ 15:30 ~s. Preserved with :AS REQUIRED Client Name :HIGH PNUNAN CONS ENGR Client Acct :NIGNPHU BPO S PO $ NONE RECEIVED Req S O~dered By : Analysis Completed :SEP 6 91 Send Reports to: Laboratory Supe~vi~o~ :STE~_J~r7. EDL .~ 1)HIGH P,U~N CONS ENGR Che~ab Ref {: 916582 Lab Smpl ID: 1 Natri×: ~A~ER Allowable Pa~a~ete~ Tested Result Units ~ethod Limits NITRATE-H HD(O.IO) ~/d EPA 353.2 10 Sanple ROUTIHE SAMPLE COLLECTED BY: CARL ABRAMS, WITNESSED BY O?~EN/CLAHN. Remarks: 1 Test~ Performed See Specidl Instructions Above UA-Unavailable ND= None Detected "See Sample Remarks Above NA= Not Analyzed LT=Less Than, Gl=Greater Than Member of the SGS Group (Soci~t¢ G~n~rale de Surveillance)