HomeMy WebLinkAboutWTR2700761 Kay Spinal Rehab Clinic 1
BEGINNING
OF FILE
FILE TIME UJ �1
Tr. Kayspinat
9 p
*Rehab Clonte
cLt I It
E n9inee �io�9
wTra-�r o�ee�s
CSY Qi RENTON
JUN 12 1984
BILL OF SALE FOR WATERLINE J
For snd in consideration of Jae Dollar. 01 .00) and oth^r
good and valuable consideration PUBLIC 110SPITAL DISTRICT NO. 1
OF KING COUNTY, a municipal corporation ("Seller") , does hereby
convey and q!iitclaim to :HE CITY OF RENTON , a municipal corpor-
ation ("Purchaser") , that certain personal property described on
Exhibit A hereto and by this reference incorporated herein.
Purchaser agrees to promptly pay any sales , use or like tax
imposed by any giverrmental authority because of the sale of the
property referred to above by Seller Co Purchaser.
SUCH PERSONAL PROPERTY IS SOLD AS IS , NTERE IS. SELLER MAKES
NO WARRANTIES OF AN`. KIND WHATEVER,� EXFFXSSED OR IMPLIED, AND ALL
IMPLIED WARRANTIES , INCLUDING THE 11IPLILD WARRANTIES OF MERCHANTA-
BILITY AND —ITNESS FOR A PARTICULAR PURPOSE, ARE HERcBY DISCLAIMED
A14D EXCLUDED.
Seller hereby assigns to Purchaser all guaranties , warranties
and the like, if any, by any manufacturer of the personal property
described on Exhibit A. This assignment is made without warranty
by or recourse to Seller.
DATED this ,Z day of 1982 ,
Purchaser: Seller :
THE CITY OF RENTON, PUBLIC HOSPITAL DISTRICT NO. 1
a municipal corporation OF KING COUNTY, a municipal
corporation
By
ort ar wic rest ent , oar
of Hospital Commissioners
.ts er
Jo n ieTds, ecreta:y,
Boa of Ho pital Commissionerc
1 l i
B
urray, Admin6tstrator
tt1Y O�P.EMTOM
STATE OF WASHINGTON ) 1UN ytogP
ss .
COUNTY OF KING )
On this day of C)C4rl2-i r 1982 , before me ,
the radersigne , a Notary Public in and tor the State of Washington,
duly commissioned and sworn, personally appeared MORT HARDWICK,
JOHN SHIELDS, MD and WM. E. t1URRAY, to me knoim to be the persons
who signed as President and Secretary of the Board of Co=issioners
and Administrator of Public Hospital District ho. l of King County ,
the municipal corporation that executed the within and foregoing
instrument; and acknowledged said instrument to be the free and
voluntary act and deed of said municipal corporation for the uses
and purposes therein mentioned, and on oath stated that they were
duly elected, qualified and acting as said officers of the municipal
corporation, that they were authorized to execute said instrument
and that the seal affixed, if any, is the municipal )porate seal of - .
said municipal corporation.
WITNESS"my hand and official seal hereto affixed the day and
year in this certificate above written.
/ R U span or e
Udashington, residing in `
STATE OF WM HINGTON )
ss .
COUNTY OF KING )
On this 28th day of October 1982 , before me,
the undersigne3-a Notary u is in an or the' State of Washington,
duly commissiorLed and sworn, personally appeared Earl Cl er and _
Actin City Clerk , to me known to b, the ppersonsw o signe as
o fer
ic"I of TKE CITY OF RENTON,' the municipal corpor-
atiTn tFiat executed the within and foregoing instrument , and acknow-
ledged said instrument to be the free and voluntary act and deed of
said municipal corporation for the uses and purposes therein men-
tioned, and on oath stated that r t were duly
elected as said officer to the municipalorporation, that
-they
were authorized to execute said instrument and that the sea]. a ixe ,
if any, is the municipal corporate seal of said municipal corporation.
WITNESS my hand and official seal hereto affixed the day and
year in this certificate above written.
A.Y $L C n an or the tate o
Washington, residing at Rento, -n
-2-
EXHIBIT A
To Bill of Sale for Waterline
Approximately 1 ,042 linear feet of ductile iron pipe
Four fire hydrant assemblies
Seven gate valves
oa
�}� r
JtJN I2 IQ
. $4
LICENSE ACP.EEMENT
COMBS NOW pUMJ.IC HOSPITAL DISTRWf NO. 1 OF K1 NO CUIIN'1'Y,
4
s municipal corporation (Valley General Iospital) , and hereby
0
• m grants unto the CITY UP RL•'NTON, it municipal corporation, a license
0
ON to go upon, over, across and under the property described on
Exhibit "A" attached hereto and incorporated herein as if fully
set forth, in order to install, replace, maintain or repair
N
wafer linen installed and Co be installed at locations shown
on Exhibit "B" ("installed" shown in red, and "to be installed"
7
v
,•, shown in Preen) attached hereto and incorporated herein as i ,
fully set forth.
This license shall likewise extend to any such water lines
that are installed or relocated by the Hospital District or the City
or its agents with prior agreement with the Hospital District from
time to time when such water lines form a part of the City's
water system and are conveyed to the City. The City shall limit
its activities on the subject property as much as is practical
to the immediate area of the water lines.
Further, the City agrees to repair or return the premises,
after any work on the premises, to the condition in which the
premises were prior to the City's work.
This Agreement shall be in full force and effect until
resc'.nded by the parties in writing.
DATED this 13th day of my 9vst. 1971,
CITY OF'RENTON - PUBLIC IIOSPITAL DISTRICT NO. 1
_ I� `--r, OF KIF COUNTY (VALIL•'Y GENERAL
B �Y LtLL 1."" ��-. HOSP A )
ar es aurent ayor t
^ J Ig •4.k
BY„e or A. lVA 7J yViLTrCemF. urra mi-n� tratur
e ores l`d y eY
�C � UQ ' •J�G�'zuLiLJC /KC*Ct�ct-('n I
EXHIBIT A.
"PRESENT HOSPITAL PROPERTY"
VALLEY GENERAL HOSPITAL
PUBLIC HOSPITAL DISTRICT NO. 1 OF KING COUNTY
LEGAL DESCRIPTION
That portion of the North 112 of the Northeast 1/4 of Section 31,
Township 23 North, Range 5 East, W.M, lying west of Springbrook
.pO Road, east of SR-167, and lying northerly of the northerly margin
O of S.W. 43rd Street (South 180th Street) , except the worth 85
(V
feet thereof,
r
Information From: Renton Engineering Department;
King Comity Tax Roles
Tax Lot No. : Tax Lot 2 in Section 31-23-5
Contact Person. Arlene Haight, Legal Description
Renton Engineering Department'
Date: August 8, 1978
- 1 -
"BRAIN PROPER".'Y"
(being purchased by Dr. Lwai and wife and being
sold to Public liospital District No. 1 of King County)
Parcel A. That portion of the SI: 1/4 of Sec. 30 Twn. 23 N. Range 5 E.W.
in King County, Mashington, described as follows:
Beginning at the S 1/4 corner of Sec. 30 thence N along the North and
south centerline of said Sec. 30 a distance of 250' ; thence N 89.06'03" `
1055 feet thence S 74039'53" east 365 feet more or less to a line that
•• is perpendicular to the So. line of said SE 1/4 at a point distance west-..
thereon 300 feet from the west line of County Road No. 80, being 60 feet
wide. Thence southerly along said perpendicular line to the south line
of sail, z•E 1/4 , thence westerly along said south line 1406 feet more or
less, to the point of beginning.
^ EXCEPT that portion lying westerly of the easterly margin or Primary Sta:
. highway NO. 5.
0 Parcel B. The north 85 feet of the NE 1/4 of Sec. 31 Township 23 North,
Range 5 E.W.M. , in King County, Washington.
QQ+` EXCEPT that portion lying westerly of the easterly margin of Primary Sta t.
Highway No. 5
ALSO EXCEPT that portion lying easterly or a line that is perpendicular
to the north line of said NE 1/4 at a point distant westerly thereon,
300 feet from the west line of County Road No. 80 being 60.feet wide.
Parcel C. That portion of the S 30 feet of the N 85 feet of the
_ NE 1/4 of Sec. 31 Township 23 NorLL, Range 5 E. W.M. in Kiny County,
Washington, lying westerly of County Road No. 80 being 60 feat. wide.
EXCEPT that portion lying westerly of a line that is perpendicular to the
north line of said NE 1/4 at a point distant westerly thereon 300 feet
from the west line of County Road No. 80 being 60 feet wide.
2 -
EXHIBIT "B"
INI
• t fs�t, e e.,ai i t ,e
�,+e l f Isl:'•;elttlf9l.,tr..r�.flfti•!!
/ l - � •� j:itetl:+r%S:'t�lrli R I-jt;:1=t
F"ta�(S i i 57��`gi- �Frlisl SF
I 1 i i t!+ Klt+� tal iv rl
➢➢m }
ml
m� t
,
y< t
_ --- ...........
co
,• 11/ i ruC,'
i , t .� -, � II 'lll,•I ,III � tI •t(! ����1 '
�o o
U • JJ
,�j. �. Fi ti •U 0 +
147.OD +
Da4
325- Ou
323.00
24 .00 =
.7 , Aoo - Ga '
�.�. 7 •00 +
rs j -00 +
n i 1
COST UAIA ANO INVLNTURY
SUBJECT: CITY PROJECT NUMBERS: W-_^7��
NAME OF PROJECT
TO: CITY OF RENTON FROM: _
UTILITIES DIVISION
200 MILL AVE. SO.
RENTON WA 98055
DATE:
Per your request, the following information is furnished concerning costs for improve-
ments installed for the above referenced project.
L
WATER SYSTEM:
Length Size Type U
1 "
L.F. OF _�_ WATERMAIN
L.F. OF WATERMAIN
L.F. OF WATERMAIN
L.F. OF WATERMAIN
EACH OF GATE VALVES
_ EACH OF GATE VALVES
V
EACH OF GATE VALVES
S .
Size Type SUBTOTAL --
EACH OF FIRE HYDRANT ASSEMBLIES S_
(COST OF FIRE HYDRANTS MUST BE LISTED SEPARATELY').
TOTAL COST FOR WATER SYSTEM S �
SANITARY SEWER SYSTEM:
Length Size Type
L.F. OF SEWER MAIN
L.F. OF SEWER MAIN
L.F. OF _ SEWER MAIN
EACH OF DIAMETER MANHOLES
TOTAL COST FOR SANITARY SEWER SYSTEM S
STORM DRAINAGE SYSTEM:
Length Size Type
L.F. OF STORM LINE
L.F. OF STORM LINF
L.F. OF STORM LINE
L.F. OF STORM LINE
TOTAL COST FOR STORM DRAINAGE SYSTEM $
STREET IMPROVEMENTS: (Including Curb, Gutter, Sidewalk)
TOTAL COST FOR STREET IMPROVEMENTS $ _
(SIGNATURE)
(SIGNATORY MUST BE AUTHORIZED AGENT OR
OWNER OF SUBJECT DEVELOPMENT)
STATE OF WASNMTON STATE OF WASKINGTON
DEPARTMENT OF SOCIAL AND MIA '^'�Ea\ncES OEI MENT OF SOCIAL AND HEALTH SERVICES
WATER BACTERIOLOGICAL ANALYSIS WATER BACTERIOLOGICAL ANALYSIS
SAMPLE COLLECTION READ INSTRUCTIONS ON BACK OF GOLDENROD COPY SAMPLE COLLECTION READ INSTRUCTIONS ON BACK OF GO!.DENROD COPY
It instructions are not followed,sample will be(ejected, If instructions are not followed,sample will be rejected.
DATE COLLECTED TIME COLLECTED COUNTY NAME DATE COLLECTED TIME COLLECTED COUNTY NAME
MONTH RAY YEAR : .QQ �IIa� MONTH DAY YEAR A4 L�
�� AM ❑ PM 1 �4 AM •0 PM T�1�6
TYPE OF SYSTEM IF PUBLI SYSTEM,COMPLETE, TYPE OF SYSTEM IF PUBLIC SYSTEM,COMPLETE.
Pueuc I.D. No. D [ 1 I ELASS sp PUBLIC c CIAEL{CLASS
[] INDIVIDUAL ' 8 5 L I ? 3 / ❑ INDIVIGUAL I.D. No. T S Q a 3 /
Iaewa onN r•aa.NncR 9 I Dear T naJ L
NAME OF SYSTEM NAME OF SYSTEM
z11Y aFE Tttt11uN. II (nY EIP lAtvAI
SPECIFIC LOCATION WHERE SAI Couccri SYSTEM DINNER!MCA rM1Af TEIERAIhk NO I; SPFCItIC LOCATION WHERE SAMPLE COLLECTEC SYSTEMD/IIfA/MGA ANDTELERONE NO•.r1t'yn NO a KNIp Irn KKNr•.IKMWN e ra.irarYn Tap KnNM rx.a1✓pn rOynlµq
${rNEe# f FYAI�4BE lny u I.SMIaJ �Av 4Ee l\r14616 et Q U i•14• {�tt ��Y
�LB\L. SE Il Td�+Y RI ykM 7c1 IIlly/4 RhM1W {
3 L4 6 5P164 EORw • 1fQ�a1�.t M.S• ( ) 6
BA/�MaPwLE COLLECTED BY'.Hermit, SAMPLE COLLECTED BY:drama
1]�PUML GnEDU G. 1t179F Ra..vGN . U11a11•L `N-A'{r'{y Ems' lit ;� �A�a f /CLTY �1 Q[klW \,\1.1'f 1tL�1•l71
SOURCE TYPE 1 SOURCE TYPE i
COMBINATION �I COMBINATION❑ SURFACE ❑ WELL ❑ SPRING ❑ PURCHASED X or OTHER SURFACE ❑ WELL ❑ SPRING PURCHASED Or OTHER
SEND' REPORT TO,IMm FUN NarN.AAPreaa Ane ZIP CPM) SEND REPORT TO.(Pnnt FUN N. arq ZIP DOnrl
_Z11-1LH QIN\Cal• lisMtS. IIT_R(HIDN . )AAIH
3555• NE 9� {W�r' �; 3555 . NE . 20e
"•e� D WASHINGION.IOe55 _PRII�
__.WASHINGION 4 Y Dim
TYVF OF SAMPLE TYPE OF SAMPLE I
•r'+a rnn•+•Y n mn.ur�nnr � KMr.+1.Iwa merx rMa.�w•M
'1. DRINKINGWATER ry❑ry CnlonnPledlRnlduaL__Tolal_F,%.) 1. U DRINKINGWATER ❑ CMonneletl lRealtlwL__1a1a1_Fnej
C"Ck tlealrrment Filtered I check treatment•-1 ❑�-t Filtered
❑ Unlreat.d Or Olner ' u Untreated or Duke,
2. O RAW SOURCE WATER 2. O RAW SOURCE WATER
3.1] NEW CONSTRUCTION olr RS I 3.* NEW CONSTRUCTION OWVQMBS
4. OTHER(Spe,...r) 4. OTHER(Spec,ly)
COMPEL(E IF THIS SAMPLE IS A CHECK SAMPLE COMPLETE IF THIS SAMPLE IS A CHECK SAMPLE
IVIDnSIASNO 6164 i MIT VIOUSI Ali NO LL920CI
PREVIOUS SAMPLE COLLECTION DATE EE/L/J4 PREVIOUS SAMPLE COLLECTION DATE
REMARK$ (C nc� /TKO fE,lpprG SA(I REMARKS: "
QlhYfeel �F,Hflk (p){a {yry1 J// I
1 T tlYaa APT SAHIN oa rl[ PR)1 I
{ LABORATORY RESULTS(FOR LAB USE ONLY) K LABORATORY RESULTS(FOR LAB USE ONLYT
MPN-COLIFURM SITU PLATE COUNT SAMPLE NOT TE$TEC I' MPN COLIFORM STD PLATE COUNT
SAMPLE NOT TESTED
/^� - BECAUSE. T�.a BECAUSE
' 1�5�.u,T.,..1... �mi yC/5 r„pa.I.�.,.... �nn
1 MPN DILUTION TEST UNSUITABLE Sample Too Old Igpr MPN UILUtION TEST UNSUITABLE Q SanlPte Too Old I
W InI T, Q Oonlluent Gm tK L, Not m Proper Container {j �NII^0 L 0 Conllugnl Growth
❑ Not in Proper Container
MF COLIFORM ^^ e CC ME COIIFORM
2. E) TNTC (� Insunlcunt InfOnfr on 2. ❑ TNTC I isuttic.ent Inlo.Mallon 1
/IOO m ed
NoYld --Please Reed I illy)nrI Provided-Ple/N Read
E.cess Debns J
3. ❑ Instructions on Form -- instructions on FIRM I
FECAL COLIFOR FECA]CO UFOR 3. ❑ E.cess Oewls❑ MPN Q MF 4. ' [] M ❑ MF 4.
100 m) II mI L]
FOR NO WATER SAMPLES ONLY.THESE RESULTS ARE. FOR EKO WATER SAMPLES ONLY,THESE RESULTS ARE
SATISFACTORY ❑ UNSATISFACTORY SATISKACTORV ❑ UNSATISFACTORY
SEE REVERSE SIDE OF GREEN COPY FOR EXPLANATION OF RESULTS SEE REVERSE SIDE OF GREEN COPY FOR EXPLANATION OF RESULTS a
LAB NO DATE,TIME RECEIVED- RECEIVED BY LAB NO DATE.TIME RECEIVED- RECENEO BY
1Gq 8,• is y �� '� G'' (�6�2165 K, V-cl P
DATE REPORTED I LABORATnnY D�ETEE FW1 pt LABORA(ORY i
REMAR 5 AM TEST INC, REMARKS -•(jJ, AM TEST It
4900 sin Ave, N .4, 4900 9th A - N .V
WATER SUPPLIER COPY SEATTLE. WA g8107-3g97 WATER SUPPLIER COPY SEATTLE, WA 7,0.3 47
STATE OF WASHBMFTON STATE OF WASHINGTON
I E/ARTMENT OF SOCIAL AND HEAL HIVICES MPAKTMH:T OF SOCIAL AND HEALTH 'MICES
WATER BACTERIOLOGICAL ANALYSIS WATER BACTERIOLOGICAL ANALYSIS
SAMPLE COLLECTION READ INSIHUCTIONS ON BACK OF GOLDENROD COPY SAMPLE COLLErIC" READ INSTRUCTIONS ON BACK OF GOLDENROD COPY
It instructions are not followed,sample will be(elected. If instructions are not followed.Sample will be rejected.
DATE COLLECTED TIME COLLECTED COUNTY NAME DATE COLLECTED TIME COLLECTED COUNTY NAME
MONTH DAY YEAR � ; L /1 MONTH DAY YEAR �� l�
C ❑ AM M PPMM I KI~4 g 6 �a ❑ 4M YM ^iNa
If PUBLIC SYSTEM,COMPLETE. IF PUBLIC SYSTEM.COMPLETE'. 1
� TYPE OF SYSTEM 1 TYPE OF SYSTEM
BLIC
IIRGIf QA55 LIPCIk El A55
O IND1v1ouAL I.D. No. -� 18 5 0 �, z l e �Q PUBLIC I.D. No. 7 1 d rj L 2 3 A
UBLOC ❑ INDIVIDUAL
IMiw.aP.,�-nax.tH
NAME OF SYSTEM — NAME OF SYSTEM
cn11' 40 1REtA14•J City or R6800*1 .
SPECIFIC LOCATION WHERE SAMPtf COLLECTED SYSTEM OWNER:lar NAME AND TELLOKM No SPECIFIC LOCATION WHEM SAMPLE COLLECTED SY•SIEM DAMN,MGR NAME AND TELERONE NO
1. ,t.ly a\.Mq,,4„41wn
. n .0 - fNNm
S.p"I QAatt.- Sd7'1A111 R' city ai WN't wl jlaau(.� etill C6IASEs C III ofRtrE.Md
hta N 4.Ar )ZSS- 2946 Sr#4A9 (lt.lx. "119Akk 116S• I iz ) 23f I[46
SAMPLE COLLECTED BY INamq SAMPLE COLLECTED BY.Me")
60e _4AAfeMI. (111 of, WN"low. AQpotn, CA64111t , Cl"' Ell 94011- 11'r—C41" _
SOURCE TYPE
SOURCE TYPE
❑ SURFACE ❑ WELL`(] SPRING ❑ PURCHASED COMBINATION or OTHER
a OTHER ❑SURFACE ❑WELL ❑ SPRING ❑ PURCHASED or OTHER
SEND REPORT TO 1Pn I FWI N{{mf.A,wow ea hp Coal I SEE�'REPORT TO'. Pnnl fyll NM[H.AnOrot ane 2P GWfI
CLSY of QEN1<A✓ - Wpt%fd SNse I C1�'/ Of T EN\1d - t,I,LsRfA SYIaP
P. St,••A'
WASNINGlON 9io sb_ M��A�M WASNINGTON
TYPE OF SAMPLE TYPE OF SAMPLE
KMu uny or.m is cMumni ,p,-,,,,,.,,qy,n mn cwumip
1. DRINKING WATER ❑ Cnlonnaled ReSldual._Total_Free!
1. LJ DRINKING WATER ❑ CNlonnautl(Reeldual Total Free))
checR treatment—► ❑ F llerad 1 cr Ck tf"IM*nt—10 ❑ Fdtarod
❑ Untrealso or Other 1)J C Untreated or Other
2. ❑ RAW SOURCE WATER 2,aaa❑III W 9A SOURCE WAT'R
3. NEW CONSTRUCTION O.&MMMS 3.>DI NEW CONSTRUCTION INREBMR► —
4. OTHER(Sp1nW) 4. ❑ OTHER ISp.cllYl
COMPLETE IF THIS SAMPLE IS A CHECK SAMPLE l. \ COMPLETE IF THIS SAMPLE IS A CHECK SAMPLE
PREVIOUS IAB NO Atos6 �� I', w.M/ PREv10U5 I All NO 820513
PREWOUS SAMPLE COLLECTION DATE 17IiI ; PREVIOUS SAMPLE COLLECTION DATE 4
REMARKS REMARKS
NetrMa. CFM,ett Wt. -111MEN11' A fl(ifilli ff L.xA1[s I pDll]low•
1 LABORATORY RESULTS(FOR LAB USE ONLY) LABORATORY RESULTS(FOR LAB USE ONLY)
N COLIFORM STD PLATE COUNT SAMPLE NOT TESTED MPN COI IFORM STD PLATE COUNT SAMPLE Not TESTED
'yS BECAUSE �^Y BECAUSE
MPN DILUTION LEST UNSUITABLE ❑ Sample Too Old MPN PII UUON • TEST UNSUITABLE ❑ Sample TV O
a
/'00 mI 1. ❑ COnDucnl Glowln _ of, ;ontamer /Ito n" 1. ❑ CDp1luarl Growth ❑ n tow
MF COLIFORM MF COLIFORM
2. [1iNTC hcpnl Iormatlpn 2, ❑ TNTC In
INI II, enlP Il
�00mI pa"',Read
3. ❑ Excess De f atruclwnS on Fc.m -- TslacHuns un Funn
FECAL COLIFORM 3. ❑ Excess Debris
� FECAL COUFOR e
❑ MPN ❑ MF 4. ❑ ❑ _ ❑ MPN ❑ MF 4, ❑ ❑
/100 mI 4IDO InI
FOR ORENKINQ WATER SAMPLES ONLY. TT SE RESULTS ARE: FOR DRINKING WATER SAMPLES ONLY,TH-SE RESULTS ARE
G SATISFACTORY L7 UNSATISFACTORY VSATISFACTORY ❑ UNSATISFACTORY
SEE REVERSE SIDE OF GREEN COPY FOR EXPLANATION OF RESULTS SEE REVERSE S10E OF GREEN COPY FOR EXPLANATION OF RESULTS
LAB NO DAq TIME HECEIVED- RLCU VLN BY LAB NO DATE,TIME RECEIVED.. RECEIVED BV
1
D REPORTS(' LABORATORY DATE REPORTED LABORATORY
46- AM TEST INC. 8=o-g4 �" AM TEST INC.
ArMARAS 'ICr+An.S g900 91h Ave. N. W.
4900 91h Avd. N W. I
WATER SUPPLIER COPY SEATTLE, WA 98107-3697 WATER SUPPLIER COPY SFAITLF, WA 98107-3697
CITY OF RENTON WATER DEPARTMENT
Pressure Test 6 Purification Test Form
PROJECT NO. UI-'LI
NAME OF PROJECT: Sv1AAl (Alibi . U11 TeLkWr " Scu% _ QanAyn .
PRESSURE TEST TAKEN BY ALA WA 6 ON 7173/91
AT A PRESSURE OF scio PSI , FOR IS W-iA MINUTES
TEST ACCEPTED ON -/I"11
PURIFICATION TEST TAKEN BY NINAX 6044 / ON 107'4
PURIFICATION TEST RESULTS, SAMPLE Ni Qttbuq at 0A' enA 01 USA-
SAMPLE k2
SAMPLE k3
PRESSURE COMPLETE AND PURITY COMPLETE a
No connections to mains or Peter permits issued until above box is
checked by Inspector.
REMARKS: _ 1)!404e Olt CJuII+t Sa"4 s �caw.e preAkw), aa,wye Ca fire 460r '
.r It/QgSAa�'&dl ua tee _ S4 f+Mlaj.p' RtF«tr—Y= �I �Cgzo61
CITY OF RENTON WATER DEPARTMENT
Pressure Test 6 Purification Test Form
PROJECT NO,
NAME OF PROJECT: iC � PIN At R+EhA6luTi� ip�c - 3F1� 'talbtt' Qd South
PRESSURE TEST TAKEN BY At6d A DN 7113)f*
AT A PRESSURE OF_ 250 PSI , FOR IS W--" - MINUTES
TEST ACCEPTEb ON 1It3ib 4 /�
PURIFICATION TEST TAKEN BY A80001L 6ftu2 ON
PURIFICATION TEST RESULTS, SAMPLE kl Al %"WCK Al "g OFtAuE
SAMPLE #2 M 0 HYo"oT
SAMPLE N3 !f
PRESSURE COMPLETE AND PURITY COMPLETE ED
No connections to mains or meter permits issued until above box Is
checked by Inspector.
REMARKS: _yPNj*S U 2 t" CK"A- Sa "-O 90AU14 _PftliUUA SAK/Le
EA�►,�p PURtt-1 TfsT' YMcE•s 0,+ 4 t' Z� � 1
CITY OF QEN`WN WATER DEPARTMENT
Pr eure Test 6 Purification Test F 1 V1 0• A 3 XA
PROJECT N0. VI- 76
NAME OF PROJECT
PRESSURE TEST TAKEN BY ON
AT A PRESSURE OF PSI, FOR MIN.
TEST ACCEPTED ON
PURIFICATION TEST TAKEN BY AQ4-lk
PURIFICATION TEST RESULTS, SAMPLE #1
SAMPLE #2
SAMPLE #3
REMARKS: 00 a fttrht FmrR4 - �• yn""►� ��"r °* 1/ 113ig4
CITY OF RENTON WATER DEPARTMENT
Pressure Test 6 Purification Test Form
PROJECT NO. W ' 7( 1 _
NAME OF PROJECT: SpInCA ChUtkA1-
PRESSURE TEST TAKEN BY P6DoAj GAfou2 ON
AT A PRESSURE OF Z ]y PSI , FOR �C- MINUTES
TEST ACCEPTED ON /Z�,/ Ate_
V'%
PURIFICATION TEST TAKEN BY hBj%u 6"aj-.
PURIFICATION TEST RESULTS, SAMPLE #1 4-4
SAMPLE #2
SAMPLE #3
PRESSURE COMPLETE AND PUKITY COMPLETE
No connections to mains or meter permits issued until above box is
checked by Inspector.
REMARKS: SG Vrk V`
STATE OF WASHINGTON
DE PARTI.IENT OF SOCIAL AND HEALTH SEE
WATER BACTERIOLOGICAL ANALYSIS
SAMPLE COLLECTION READ INSTRUCTIONS ON BACK OF GOLDENROD COPY
It instructions art not followed, Semple will be rejected.
DATE COLLECTED TIME COLLECTED COUNTY NAME --
MOONT DAY/ 0yvEAR 3— ; Do KtNa (et•+-�y
/ / 23 4 ❑ AM J_C_pm
TYPE OF SYSTEM IF PUBLIC SYSTEM,COMPLETE: 1
LifiCli CLASS
INDIVIDUAL I.D. No.
w.e.m�•eFwwa
NAME OF SYSTEM %K*P Df .Pf.
1111 of RENie►i
SEECIFIC LOCATION WHERE SAMPLE COLLECTED SYSTEM OK4ER/"allJ1Io TFLUNGE NO
1.W~I..a Knom .1.1r�,eIO n Y 1 Gv kwvL, f atei 7
8te.0 a alr ¢aid _1 4ne K MI'
splay MA• 3dn aMIE�Rd•S• (246) 23y L647
SAMPLE COLLECTED BY:Mamel Wit IQ E1
A640uti 6APO4- 6iy oe Rww- INSO�t-TDti
SOURCE TYPE
❑ SURFACE ❑ WELL ❑ SPRING ❑ PURCHASED [)COMBINATION
or OTHER
SEND REPORT TO IPam Fun Hems,AdWns aiM 21P Cowl
Cm BrREaibel - U ital;F ,
3555 - N. 6. Z"" Y6W*W-
P*4(q J WASNIN TON 9 80 _
TYPE OF SAMPLE
ICMO mq oie.n m..cowmnl
1. DRINKING WATER ❑ Chlormated(RBSIdual.—Total_Free)
check interment--to ❑ F01wed
❑ Untreated or Other
2. RAW SOURCE WATER
3. NEW CONSTRUCTION dBM"MNG
4. OTHER ISW.fy)—
COMPLETE IF THIS SAMPLE IS A CHECK SAMPLE
PREVIVUS!AB NO
PREVIOUS SAMPLE COLLECTION DATE
REMARKS:
LABORATORY RESULTS(FOR LAB USE ONLYI
MEN-COLIFORM STD PLATE COUNT SAMPLE NOT TESTED
22 BECAUSE.
MPN DILUTION TEST UNSUITABLE ❑ Sample Too Old
/'O5 ml 1. ❑ ConllVenl Growth ❑ Not In Proper Container
ME COLIFORM
2. ❑ TNTC ❑ Intalheri mlormRoad
400. Ptovldetl—Pleaee Rtutl
Instructions on Farm
FECAL COLIFOPM 3. ❑ Eacnss 1'Mons
❑ Al ❑ ME 4 ❑ ❑
/I0Urn, ��—
FOR DRINKING WATER SAMPLES ONLY.T ESE RESULTS ARE
❑ SATISFACTORY UNSATISFACTORY
SEE REVERSE SIDE OF GREEN COPY FOR EXPLANATION OF RESULTS
LAB N0. DATE,TIME PFCEIVED— REC IVEU BY
�� R2u - 23�gy 3
DATE REPORTED LABORATORY'-
U AM TEST INC.
REMARAS
4' 00 9th Ave. N W.
OP CENTER COPY SFATTLE, WA 98107-3697
PUBLIC WORKS DEPARTMENT
BUILDING DIVISION
CITY OF RENTON, WASHINGTON
APPLICATION ONLY - UNTIL VALIDATED PERMIT
NUMBER
Owner Z)& location of Worklf z� r^l�
Address. /L A�� 6 / r - O'L Sn7- /a
n
oS iTA 1_ 40,e
INSPECTIONS FEES
CONSTRUCTION : Side Sewer
Storm Sewer
Right-of-Way Construction
PERMIT
Water System Dev. Fees
(Public Right-of-Way) Water Latecdfner Fees
Water Insp./Approval Fees
Sewer System Dev. Fees
p , r? Sewer Latecomer Fees
`' Sewer Ins p./Approval Fees
Date Issued Right-of-Way Insp. Fees
Special Deposit
Expiration Date TOTAL FEE J�4 OD
Description of Work ,�. t Q •71; /� A and Number of Feet j (_
(T
Contractor Business
S d 7ft. License n`uJt-2P'"
Address (/_� /D� �• .1 1/7 I �' Bond J!
/\'P j_ /77A TelephonE L o/
r d.
IT IS UNDERSTOOD THAT THE CITY OF RENTON SHALL BE HELD HARMLESS OF ANY AND ALL
LIABILITY, DAMAGE OR INJURY ARISING FROM THE PERFORMANCE OF SAID WORK.
ANY WORK PERFORMED WITHIN THE RIGHT-OF-WAY OR ON SEWER MAIN MUST BE DONE BY A
LICENSED, BONDED CONTRACTOR. LOCATE UTILITIES BEFORE EXj7AVATING.
ALL 235-2631 FOR INSPECTION.
all between 8 AM and 9 AM for APPLICANT
nspection in afternoon; call ..
afore 12 Noon the day before N _
or inspection in morning. PUBLIC WORKS DIRECTOR , .
PECIFY TIME FOR INSPECTION. '� �9 r
ALL 235-2620 for street signs BY
nd lighting.
PRECONSTRUCTION CONFERENCE
A 7e
PROJECT: s G?DATE:
ADDRESS/LOCATION. d �I
PROJECT # CD __ PERMIT t _ WORK ORDER M d
r r + t r r r r + r w r r r r r r r r r r r ,• + r r r r r r r + r t + r r r r r
THOSE IN ATTENDANCE
NAME COMPANY PHONE
Ay?o,gL 61kfovrL (,41y or R6n-cou , 'a6eefa,. Z35-z631
lZN 0isoi co 23s_2es�
Le 1 1L AI 4 11- 927
�.���'/.tlIll '`tt// �cx,c' ,1 ++A.r,ar nC • �7.a/.Ic.�F'�� P.i. Cori - / 36
Rona ocsl�tv er7Y
DATE
CITY OF RENTON
UTILITY ENGINEERING
200 MILL AVENUE SOUTH
RENTON WA 98055
ATTENTION: ARLENE HAIGHT
SUBJECT: � .'� ����� c.lyt� tiGs
PROJECT NUMBER: W-_ WORK ORDER NO. :
Dear Ms. Haight:
You are hereby authorized to have the Finance Department bill: w
Name: S r.L__ 71.c
Address: -]
City: e.-i-)—a,
Attention: 1LL_ cr! 1"% Phone:
for time and material for the related water work on the above referenced
project. The work is described as follows:
AL
:,. Ve truly., _. � Y yours,
NAME
WO `�
WATER AND SEWER PROJECTS
PRESENTLY UNDER CONSTRUCTION
IN
THE CITY OF RENTON
�J/
WATER PROJECT # /if SEWER AAPROJECT 4 DATE �T
WATER PROJECT TITLE
PROJECT LOCATION
DEVELOPER _ aM
ADDRESS
PHONE / 1-� I b-v
EMERGENCY
PHONE may/ e
CONTRACTOR h0 C /T 1IA
ADDRESS _ /� 0 O NE /1 '!
PHONE
EMERGENCY
PHONE 9.2 7 G 2 z 7
FOREMAN /Rn/o /l�& jrn
PHONE O 2 ,?
EMERGENCY
PHONE Z 7 - G 2 2
City of Renton Inspector—A EIPA t, ��f0U11
Other Insnector ------
c.ty of Renton Engineering Department
235-2631
PRECONSTRUCTION CONFERENCE
DATE: June 22, 1984
TIME: 10:30 A.M.
PLACE: 3rd Floor Conference
DEVELOPER / CONTRACTOR OR SUBCONTRACTOR / NAME OF PROJECT
Name: James Bakke
Phone:
Project: Spinal Rehabilitatic Clinic
Proj. N: 8" Waterline West of Talbot Road So. at 3817 Talbot Road So.
NAME OF APPOINTED INSPECTOR
Abdoul Gafour
Please check departments to be notified and specify person to attend.
X Engineering Dept.
X Fire Dept.
X Police Dept.
X Street Dept.
X Traffic Dept.
X Utilities Dept.
X Water Shop
Other
Additional outside departments you may wish to notify.
Department of Transportation
X Pacific N.W. Bell Company
X ➢uget Sound Power 8 Light Company
X Teleprompter Cable TV Company
Washington Natural Gas Company
Other __
y of Renton Engineering Depart it
235-2631
PRECONSTRUCTION CONFERENCE
DATE: June 22, 1984
TIME: 10:30 A.M.
PLACE: 3rd Floor Coiference
DEVELOPER / CONTRACTOR OR SUBCONTRACTOR / NAME OF PROJECT
Name: James Bakke
Phone:
Project: Spinal Rehabilitation Clinic
Proj. N: 8" Waterline West of Talbot Road So. at 3817 Talbot Road So.
W-761
NAME OF APPOINTED INSPECTOR
-' Abdoul Gafour
Please check departments to be notified and specify person to attend.
X Engineering Dept.
X Fire Dept.
X Police Dept.
A Street Dept.
x Traffic Dept.
X Utilities Dept. _
X _ Water Shop
Other
1 Additional outside departments you may wish to notify.
,_ Department of Transportation
X Pacific N.W. Bell Company
- X Puget Sound Power 6 Light Company
X Teleprompter Cable TV Company
_x Washington Natural Gas Company
Other
6
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Dti/ 7JU)ei�c�G f''GAdJ�U�A
OR OOAI/$1-?Qt)Oi /oA-J.
N0T & D
.iUN w 1 J984
IN, A. HARR;S
Valley General hospital
4(K)5(X11H4IR05EREE7 RENION W4YIYG;. N142?16-3,4SO
i 114JJ1
June 11, 1984 JUN 121984.
SU'LOING ZONING DEPT.
Mr. Ron Nelson, Building and Zoning Official
200 Mill Ave. S.
Renton, Washington 98055
Subject: Water Main Plan for Spina] Rehabilitation Clinic
Dear Ron:
Attached are two prints prepared by Barghausen Consulting Engineers, Inc.
showing the extension of the hospital water main loop to the Spinal Rehabilitation
Clinic located north of the hospital.
We concur with this water system extension and enclosed is a copy of the City
if Renton and Valley Medical Center's water agreement.
Please give me a call if you have any questions.
Sincerely,
omulo M. Alm da
iDirector of Engineering
cc: D.A. Popp, Valley Medical Center
Dennis A. Donovan, Barghausen Consulting Engineers, Inc.
FIT
'=
JUN 121984
N!III k H(XI'DAE DIVRR-1 .11)E KIN .((L %I N
ENDING
OF FILE
FILE TITLE U) _ V�� /
Kay Spina (
*Rehab Clin ic
l�lti l icy
Engineer ( n9
pfo� I