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HomeMy WebLinkAboutCHUGACH PARK VIEW LT 11 Municipality of Anchorage On-Site Water and Wastewater Program • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP181009 PID Number: 090-042-11 Dwelling: 11 Single Family (SF) ❑ Duplex(D) ❑ Multiple(SF and/or D) Project: El New ❑ Upgrade Name: ABSORPTION FIELD Christopher Fell Address ❑ Deep Trench ❑■ Shallow Trench ❑ Bed ❑ Mound 320 Rand Drive ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 907.229.1617 l 4 1.2 GPD/SFI 4.47/4.29 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot 3.97/3.75 Ft.0.50/0.54 Ft. Chugach Park View - 11 Fill added above original grade Gravel length Township Range 5 e Section 0.52/0.71 Ft. 2@60', 120' total Ft. 10NGravel width Beds:Number of Lines Distance between lines SEPARATION DISTANCES 5/5 Ft. - - Ft. To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist.between trenches From Tank Field Lift Station Tank Line 600 Ft2 2 10 Ft. CA ` TANK Septic 0 S.T.E.P. 0 Holding 0 Other Well 1 QQ'+ 100'+ Wj eg 25'+ Manufacturer Capacity GfS� Greer Tank 1250 Gal. Surface Water 100'+ 100'+ - - Material Number of compartments Lot Line 5'+ 10'+ - NA Steel 2 Foundation 1 Q'+ LIFT STATION 10'+ - - Manufacturer Capacity Gal. Curtain Drain N/A N/A - - Pump on level at Pump off lev- - High water alarm at Remarks No curtain drain present or proposed in. in. Pump make -•. model Electrical Inspections performed by Tan PIPE MATERIAL House to tank 3034 drain6elk tod 3034 Installer Drainfield 3034 CO/MT Pioneer Earthworks & Restoration 3034 Inspector Christopher Fell, CPG for Bob Pintner, PE BENCH MARK (Assumed elevation)97.46 ft Inspection 1" 4/202nd 4/20 Location and description dates: 3'" 4/21 4'" 4/21 Top of Septic Tank @ inlet COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL AC mp Conditional Approval: Date O'�,CV sr 4 f '°''"t . 49th «.».«..»�.....� �,,ti.M...•.N rzefit rlis...•.../ • dire.1.....•.•f PO fir,% ROBERT M. PINTNER f`j�, 90 G, CE-8525 ._ici•d ki. II...v �` r, `,; hApprovedGU / Date ((( �'? �i_��`'` .a . Inspection Report_9-1-12.doc 1 /- INDIAN VALLEY s17 7 LOT1 �� / BLOCK 1 M M M AA� �,_ • / / / 7.5 FOOT /------ PUBLIC TRAIL EASEMENT CHUGACH LOT 10 VIEW(C7V)/ 1- 3 ----_1 SEPTIC IS LOCATED/ \ \ TO THE NORTH LOT 11 WELL // ' / 41 nn / Q 15 FOOT / ` � �'P / Q INDIAN VALLEY a T&E EASEMENT 3ft LOT 2 - - 2 G o BLOCK 1 1.7 - - 0�F �y./ F w CPV `,y� B # tY W LOT 26 O L, ELL AND SEPTIC ARE Q`"= �' 1rv` LOCATED TO THE WEST . ST1 ~ 1 FCO � ' --- w 5%GRADE ST2 1250ga1 SEPTIC TANK TO THE SSW .<:1DCO1 DCO2 %/ � 6%GRADE FLOW SPLITTER y TO THE SSW CO1 --- MP1 ' v .=� _ CO2 / TH-11 ', �i. MP2� CO3 �' MP3 -�� CPV ,� - PRIMARY DRAIN FIELD coa LOT 25 III ,.MP4 UNDEVELOPED �= t INDIAN VALLEY (NO WELL OR SEPTIC) 30'Radius TH-11b ��-- 3 LOT 3 BLOCK 1 l TH-11c RESERVE DRAIN FIELD ; 4%GRADE LOCATION DISTANCE TO THE SSW (FEET) I/ A B FCO 21 17 'LI ST2 28 491/1— `M M M• M ST2 37 59 DCO1 39 62WUNDEVELOPED _ DCO2 41 63 4%GRADE (NO WELL OR SEPTIC CO1 101 132 TO THE SW W ( CO2 89 105v, CO3 114 144 0...W W` C04 103 120/ / CPV PV ,-� LOT 12 a�t / • N *,(c. •»... -,k Date: 15 NOV 2018 Notes: Chugach Park View Subdivision �sQ', '••:`c;��'T Scale: ASBUILT, REV1 Lot 11 gyp' f f � ...1.1 'ti� �� 1" = 60' 090-042-11-000 a r 49th .41 Prepared By: A,, •"' Parcel No.: tti RO6ERT M. PINTNER i A 090-042-11-000 Fell Residence �4 `Q • ::: P181OO9 PLAN VIEW Indian, Aska 99540 a4 r41Pp0,r,Q\0*'. . No.: �k3�, " -.�,7 - 2of3 SOUTH TRENCH NORTH TRENCH (10 FEET FROM NORTH TRENCH) (10 FEET FROM SOUTH TRENCH) MP1 CO1 -I-, MP3 CO3 MP2 ---46.....- ---'44.- CO2 _? MP4 -\__ _r C04 n a f_.,, BACKFILL SURFACE \-7-- SURFACE BACKFILL \ 100.96199 46 FT EN.' 100.46199 17 FT ENV m om„': �. Y'C? ... •� •. 2 1 ORIGINAL GS 4 V-. .a 4.,�.. •< 4.� • �•q•,',0:. 4•t}- 10002198.98 FT ENV 4'V' d •4..1.1-. 4 ORIGINAL GS ,p'-• O. Q /.Os: .0.a O.: 'C d. O.: •O.a4 .0 : .0 9992/9867FTENV '•4. 0.: • 4• ' •0 ;4•: ' • 4;4.• 0.: • d . o '. :•• o •. ; • Q '.0 •..• -.zi 0-. d ..{ • d 0.. d.. . d ••0 • 4'.1••••°:• - '1'..-0 .4'.�• .0..a:. 4•Q• '.o: • •• 4'1':•'4 •.4 1 .• - •4'4';••cr- • • 6-q • • • ?. 0' •• P Q . 0 ' .P d-.O': . `4..0' •' 'P :'4 o •• 0 • •4. 0•? 0;4.• 0.o '.4;4. e GENERAL FILL � .. ' . ',d •. ' • ••• • .� .. ' . 0 c 0 • 0 '4: -0. _�O�. d • . O.d_.a• O. d GENERAL FILL •(y'. ..' C f• .•'0 . .� ' ... � •. T . •6 .d . ... •p .'Q• •'. -6 "'• '� FILTER .4..1:.•0.'6 •41•'•.a 4','4'• .0..a • p•.1' • 0. FILTER • - •Q •1:•.0 -.4 .1 ).Q.•4 1: ,a• • •.4'-q• FABRIC ,. c� t :' 0 : C d.•C : P -4• •c : a FABRIC 4. 00 4' 4 a ; •.' < +rr•rr�+•r .+rrrr+•r•rr 1 FOOT 4,...41...4.4...M.41.42.1&..41.41. ••+•rrrrrrr+• rrrr+rir++ rrrrrrr+•rrrr •rrr+r•+rrrrr ••rrrr♦ rrrr ♦i•♦rrrrrrr♦ ...-.-414.-#1644111"+-4.1.44. rr+rrrrrr+rrrr •+ rrr•+rrr+rrrr rrr+r• rrr+�r•rr•rr•+rrrrr -DRAIN ROCK 41.449.-4.-4...4.-4%.-W.11%.4.41.411100•ir+rr+rrrrr+ 1 FOOT r+rrrrr�••rrr••ir+rr+rrr+rr+• r+rrrr r+r ••ir•+rrrr♦+•• •rrrr+ rrrr•rrrr•••+rrr+r• (6"BELOW PIPE) rrr+rrra!�rr+ ••i+rr•+rrrrr• rrrr+rr�i•+rra••+rr+r•+rrr+• •rrr+• ♦+rr••irrr+•ir•rr+rr - DRAIN ROCK •rrrr• +•7.407 .rrrrrr+rrrrr rrrr••• rrrir•rri+r•rrrr+rr+ � l�r+ r•_ ��+_�f+4�S•�+! I BTM DEPTH +rrrrr •rrr+♦rrrr••••+rrrr (6"BELOW PIPE) 95.15 FEET 4.414.4.4.4•41.4.41..e.41.4.41.4.1.4.4.44.4.4.4•..4•r+rrr+ y, •• _L_BTM DEPTH 4"SCH 40 94.83 FT PERFORATED PIPE(INVERT 95 69 FT) 4"SCH 40 5 FT WIDE PERFORATED PIPE(INVERT 9533 FEET) 60 5 T LONG 5 FT WIDE I 60 FT LONG TH-11b(DRY 1/15/17 8 4119/18).RELATIVE BTM(AT TRENCH)88.30 FT(S)88.50 FT(N) '�_ TH-11c(DRY 1/15/17 8 4119/181.RELATIVE BTM(AT TRENCH)89 30 FT(S)89.50 FT(N) FINAL GRADE 103 79 FT .... ........... STI $T2 MINIMUM 48 INCHES OF FILL (NO INSULATION) TOP OF TANK ORIGINAL GRADE 97.46 FT 103.25 FT INLET INVERT _� ' NEW 1250 GALLON OUTLET INVERT 97.08 FT 96 83 FT SEPTIC TANK (STEEL) i I -ti',.0 uF Ai ,, Date: Notes: �'�.•,,..••.•........ , c; ); 15 NOV 2018 Chugach Park View Subdivision a��� ,. .' f- �� scale ASBUILT, REV1 Lot 11 f -9f. �' ...-7 Scale. NTS 090-042-11-000 �� r 49th •.=`+ (� Prepared By: rf, CDF ...........•..•..% Parcel No. ROBERT M. PINTNER •i L;f. 090-042-11-000 Fell Residence �''6,• CE-8525 .;;<', Permit No 573 Rand Drive I� %;.•..,( f 1 -/i- d OSP181009 SECTION VIEW Indian, Alaska 99540 •t'''tk`�F OFE3SA;;N --"' Sheet No.: .-,-•;�,R 3 of 3 M-W Drilling, Inc. •P.O. Box 110389•Anchorage, AK 99511• •907-345-4000 • Job No. 18-114 Permit No: Municipality of Anchorage 05P181009 GROUNDWATER WELL LOG Well Owner: Chris Fell Use of Well: Domestic Legal Description: Chugach Park View,Lot 11 _ CONSTRUCTION Drill Method: Air Rotary Hole Size: 6" Hole Depth: 286' Casing Size: 6" Cased to: 126' Material: AS3B Wall: .250" Well Completion: Open end X Screen Perforated Method: Screen/Perforation description: Grout Notes: 3 Sacks of Bentonite Well Development: Air Surge Well Disinfected: Yes Method: Bleach Yield test at 8 GPM for 1 hour(s)with i00% of drawdown(DD)from static level(SWL). Method: Air Lift Static Water Level(SWL): 83.6' Start Date: 8/8/i8 Completion Date: 10/12/18 Test Pump Date: n/a Final Pump Install Date: 10/12/18 WELL LOG Depth in feet from top Details of formations penetrated, size of material,color and miscellaneous details. of casin•. o TO 3 Casing Stick Up 3 TO 122 Gravel very cobbley, intermittent boulders, some sand & silt 122 TO 126 Bedrock: weathered, fractured 126 TO 286 Bedrock:water-bearing fractures from 265 to 286, well blowing 8-logpm _ - NOTE: - -- 6" Casing was advanced through overburden to bedrock using a georock rotating casing shoe. - WAYNE E. WESTBERG President,M'N Drilling,Inc. WATER QUALITY TESTING NGWA Certified Master Groundwater Contractor Coitorm NJ-( Cott100mL Ak Gen Conic Lic No 1000 Nitrates N 1) L Arsenic N 0 ug/1- MUNICIPALITY OF ANCHORAGE Development Services Department )- - Phone: 907-343-7904 On-Site Water & Wastewater Section � Fax: 907-343-7997 Pump Installation Log Well Drilling Permit Number: 05P181009 Date of Issue: 1 -23 -18 090 042 >>--00a Parcel Identification Number: - - Legal Description Block Lot Property Owner Name& Address: Chugach Park View Subdivision 11 Chris Fell 573 Rand Drive Indian, AK 99540 Pump Installation Date: 10 -12 -18 Pump Intake Depth Below Top of Well Casing: 283 feet Pump Manufacturer's Name: Grundfos Pump Model: A9010021 Pump Size: 1 .5 hp Pitless Adapter Burial Depth: 1 0 feet Pitless Adapter Manufacturer's Name: Mass Pitless Adapter Installer: M-W Drilling, Inc. Well Disinfected Upon Completion? x Yes No Method of Disinfection: Bleach Comments: Pump Installer Name: Bernie Sommerville Company: M-W Drilling, Inc. Mailing Address: PO Box 110389 City: Anchorage State: AK zip: 99511 Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation. i I . /i , I N / ' I ...._...� Q \ / / / / 7.5' PUBLIC TRAIL EASEMENTS / / / Lot 10 / / ^) / / oP/ /Is .4/ / eA / _ _ ./ /� I N / \ HOUSE DETAILS \ \\ // / \ SCALE: 1"=30' \ \ v / \ WELL \ / I �1 r'0\ •o. \ / X 88°� °° ,o\ \ A�OT \ / \ F. Q •o. CD N 1• X11 cT`� 10/ / Irt `•a �cA k•C Jim 'o. 15'x15' T&E AND S PUBLIC TRAIL �,1 • • 0t5,11 rn W ,3 c/‘oc/ti EASEMENTS .' 'i(�G� tO G 'O. C\ 73 � ao `�± . F 57.6' ) H- `'o o $ _ . I e � P / 73 ob 0CO c `' 0 o SFR 1. o� 1 oreo Z. am- OS• rn.,2•p v Nrip to �37`>' 'XI c9 \ 0 • SEPTIC V PIPES o I 0 ori N. N II ir / CV/ Lot 11 li 111,477 s.f. S.', / / / / N 76.42,56 / ' 250.68• / 0.0' 7/// Lot 12 I PLOT PLAN AS BUILT X SCALE 1" = 60' GRID SW 4456 Project No. 17-495/55 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & Associates , inc . (907) 522-6476 Phone 4000Op�� (907) 522-4625 Fax `, 0 F ^ C�\\\4 Professional Land Surveyors kenOlangsurvey.com jonathanOlangsurvey.com ��P s QO I hereby certify that I have surveyed the following described property: OAC j:' 49TH %\ COQ LOT 11, CHUGACH PARK VIEW SUBDIVISION (PLAT 2005-202) Q* : — . * Q Anchorage Recording District, Alaska, and that the improvements situated thereon are vA within the property lines and do not encroach onto the property adjacent thereto, that -� VA no improvements on the property lying adjacent thereto encroach on the surveyed KENN G. N,(,: itl premises and that there are no roadways, transmission lines or other visible 0 •�, ` • o easements on said property except as indicated hereon. g 14L, O�I�w��'�vft.- i��\': oO � •..�S-520 .••'•�J�p� Dated this the Day of , at Anchorage, Alaska Q ,o • O c� Wq,'ro SSIONA-��c It is the responsibility of the owner to determine the existence of any easements, 0040Ooo`". covenants, or restrictions which do not appear on the recorded subdivision plat. AECC963 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Water & Wastewater System Permit Permit Number: OSP181009 Work Type: WellSeptic Renewal Tax Code Number: 09004211000 Site Legal Address: CHUGACH PARK VIEW LT 11 G:4456 Site Mailing Address: 573 RAND DR, Indian Owner: FELL CHRISTOPHER DAVID & Design Engineer: Pintner Bob This permit is for the construction of: Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy Effective Date: Expiration Date �,,,cnc `off �.. C � Department 1/23/2018 1/23/2019 Lot Size in Sq Ft: 111477 Total Bedrooms: /Z y�le'lii Q Private Well ❑ Water Storage All construction shall 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 wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing 0.h`0 S 6 l (Z) 6o L 7 rer1 C k eS e1C 7kn c11',1� w leo.- t� V fir— nved vlerr,�� Received By: Issued By: yQc"e, lvo.Jj Date: Date: 2-S 2018 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On-Site Systems Approval Parcel I.D. C)90 -- ©WL \ Expiration Date: _ /i 1. GENERAL INFORMATION 1 19 Complete legal description l_ G kL? G1 Vr�lC V l ew' l— 1 1 + 1 ! Location (site address) S 7 3 d2, d cpri l/2� Current property owner(s) F�.�t , C1nr1S--a Aer' Day phone . 2.0314(7... Mailing Zc1.x(7-- Mailing address 3 • L. I rt t1e- _ i • S Real estate agent Day phone 2. TYPE OF DWELLING: Single Family (w/wo ADU) ❑ Duplex n Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well Private Septic X Water Storage n Holding Tank Community Well ❑ Community Public Water System (l Public Sewer Waiver request for: Distance: Received by: " La. ( ,ay1� ' (PI) Date: I A 5 S COSA to be rete. e o the engineer, unless otherwise requested by the engineer. COSA Fee $ 69 . C30 Waiver Fee $ Date of Payment II J 31113 Date of Payment Receipt Number 61250, D Receipt Number COSA# 0SC--I91SaS 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. Name of Firm it) p• Phone 2 3 0 _6 V 3 Address 7'63( Tv�gro,�,,. 5�_ ��c�olo.r . A z c)1T-OL Engineer's Printed Name @oer# ? v -t- vie r Date ti// 3/i ,44 ac-)f' • ,..9 %) 6. DSD SIGNATURE : h °` �gd X System #1 Approved for l bedrooms .,..•• V.* •• ' iK f..••p System #2 Approved for bedroomsft, Disapproved . ,c chi3i85tT ���� F f, � a Conditional approval for bedrooms, with the following stiptwAt . .`,s'. y,�, / h is COr.)p 15 7104- -to br r r:r 5)c a ±i is I rGLns�e{; CThe own cr 'LA(Ied ihP Gw ter c-or Sa,-,,,l,In ) /`'lGty By: ► / / Original Certificate Date: MC/ The Municipality of An 'orage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations giv• 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 engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet COSA Checklist Legal Description: Chugach Park View Parcel ID: 090-042-11 If more than 1 septic system on lot: COSA Checklist# of Structure served by this system A. WELL DATA ❑� Well log is filed with Onsite(or attached) Well production at time of test 8 gpm Date drilled 10/12/18 Water storage tank volume NA gallons Total depth 286 ft Well disinfected for coliform test? Yes ❑ No Cased to 126 ft • Coliform bacteria is Negative ❑■ Sanitary seal is functioning correctly Nitrate mg/L ❑■ Nitrate less than MRL (ND) ❑■ Wires are properly protected Arsenic ug/L ❑■ Arsenic less than MRL(ND) Casing height(above ground) 36 in. Collected by Christopher D Fell Date of flow test for COSA 10"2118 Date of Sample 10/26/18 Static water level at beginning of test 83.6 ft. Comments B. TANK DATA C. LIFT STATION Age of tank(s) 0 years ❑ Required maintenance c• • eted Tank type/material gra115 P7f C- Age of lift station years D Standpipes/foundation cleanout per record drawing Lift station ma : al Date of pumping NEW Comm-• : D. ABSORPTION FIELD DATA Which system tested (date installed) 4/21/18 Adequacy test date NEW ❑■ ALL standpipes present per record drawing Results ❑Pass For bedrooms Total measured depth from grade 5.a6 ft(max) Fluid depth prior to test in Measured depth to pipe invert from grade u01 ft(min) Water added gal ❑ N/A-pressurized field New depth in ❑■ Monitor tubes go to bottom of drainfield. If not, state Elapsed time min depth into effective 1] Code-required soil cover over field Final fluid depth in CI presoaked Absorption rate gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment(past 12 months) date of test) Gallons introduced gallons If yes, enter date Comments/Deficiencies:NEW COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' Community Sewer Manhole/Clean•ut > 100' 0=- 2 Yes if No ft Cic0 Yes if No Neighboring Tank > 100' ✓EYes if No ft Private Sewer/Septic Line 25' ✓❑Yes if No ft Absorption Field on Lot> 100' 2 Yes if No ft Holding Tank> 100' ['Yes if No ft Neighboring Absorption Fields > 100' Animal Containment> 50' 1✓ Yes if No ft ❑✓ Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' Yes if No A ft QYes if No ft Gam' 410 From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑✓ Yes if No ft Surface Water> 100' p Yes if No ft Property Line > 5' ✓❑Yes if No ft Driveway/Parking >0' p✓ Yes if No, comment Absorption Field > 5' ✓O Yes if No ft Wells on Adjacent Lots: Water Main > 10' if No ft Private Wells > 100' ✓❑Yes if No ft Water Service Line > 10' p✓ Yes if No ft Community Wells >200' E Yes if No ft From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' Q✓ Yes if No ft Driveway/Parking >0' Z Yes if No, comment Property Line > 10' Q✓ Yes if No ft Wells on Adjacent Lots: Water Main > 10' Af_ if No. .,0 Private Wells > 100' ✓❑Yes if No ft Water Service Line > 10' ❑✓ Yes if No ft Community Wells > 200' LI if No ft Surface Water> 100' ❑✓ Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION OF C I certify that I have determined through field inspections and review „r'S of Municipal records that the above systems are in conformance with �1 cl '1.--••\1 vIS MOA COSA guidelines in effect on this date. 1 qqt�, ✓� •*�p P to 3-t, ROBERT M. RIMER f d� C. CE-8525 r,4`'I li`�F;••• 1111 CPI. ':..c.`>c':I' COSA Checklist yellow sheet atZ`• �,�'A0;i:;;S`:I`''-, ,•