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HomeMy WebLinkAboutWTR2702258 W-2258 Springside Office/Warehouse Bldg. ax :M BEGINNING OF FILE FILE TITLE �� I Y, Return Address: City Clerk's Office 6 City of Renton 3 200 Mill Avenue South p' Renton,WA 98055-2199 A BILL OF SALE Property Tas Parcel Number 125381-0060 Project File a C-960130 Sued lmers"tion. 901 S.W. 39 th St. Reference Number(s)of Documents assigned or mleasel:Additional reference numbers are on page Grantor(s): Grantee(s): 1 OGIMA LLC I. City of Renton,a Municipal Corporation The Grantor,as named above,for,and to consideration of mutual benefits,hereby groom bargain,sells and delivers to [� the Grant".as named above,the following described personal property now located at rl LEGAL DESCRIPTION: Springside Office/Warehouse Building WallWater system, consisting lire main loop and fire hydrants. C�0 k YV i i)y this conveyance,Grantor will waremt and defend the sale hcrebr made unto the Grant" every person y against all and eve on or persons,whams lawfully claiming orto claim C same This convey:•nc<shall bind the heirs,executor.admiNstmmrs ausig and assig¢s toner. IN WITNE 1EREGF,I a hemonlo set my hand and I the d and y"r as wrinen below. MEL I IVIDDAL FO��KNO LED6'MEAT shin be. TA�GTON )SS ' COUNTY OF KING ) -- I certify //that[know or he satisfactory evidence that /CJ'L� ; &We� , sikned this instrument and acknowledged it to be los/herltheir free and voluntary 9cl for the uses and purposes r*A I Ze mentioned in the'pstrument •' ' \�� Notary Public in and fm the Star of Was o 1\\\v\"`\ ` Notary(Prin)A/ J 1D n 11 Myappoimm tucxrires Dated. -s -97 'S7-oo�y R tiLRMSVCCRECORDV)O".r.DOClhh Page 1 d C W A Return Address: CIFY CLERK'S OFFICE ' CITY OF RENTON 200 MILL AVENUE SOUTH RENTON,WA 99055-2189 Please print or tvpe information rWA UMENTTITLE: EXDIBITA JECTNAME: SPRINGSIDEOFFICE(W'AREHOUSE TERSYSTEM: Lfulh 1 58 L.F.of 8 1. Ill Water Main ll41_ L.F.of 12 Water Main L.F.of Water Main L.F.of Water Main i each of 10 ' Gate Valves �._ each of g Ge1<Valves 3 _ Fire Hydrant Assemblies SANITARY SEWER SYSTEM: Ls0gW 'Sly. y:Rt L.F.of Sewer Main L.F.of Sewer Main L.F.of Sewer Main each of Diameter Manholes 0 each of Diameter Manholes each of Diameter Manholes STORM DRAINAGE SYSTEM: Lcoah Size L.F.of Storm Line L.F.of Sturm Line L.F.of Storm Line each of Storm InIeL'Outlet each of Storm Catch Basin 1 each of _ Manhole { STREET IMPROVEMENTS: (Including Curb,Gunter,Sidewalk,Asphalt Pavement Curb,Goner,Sidewalk__L.F. Asphalt Pavement SY or L.F.of Width SIGNALIZATION: STREET LIGHTING: k of Poles PROJECT CLOSING e1 Final Cost Da,a FINAL COST DATA AND INVENTORY and Inventory SUUIECT Springside CITY M CJtCr NUMBERS. WTR WWP Building SWP � N,inc of prolcci "nto IEI) rep City of Renton FI(OM Anderson Richardson Co. Plan Review Scclion 0 Bel-Red Road Plznning/BuI1dini;fNblk Works Suite #2 03 200 Mill Avcnuc South Bellevue, WA. 9R00 Itcnlon,WA 99055 DATE January 24, 1997 i Per the request of the City of Renton,the following information is furnished concerning final costs for improvements installed for(he above referenced project WA'ITR�SYSTEM ONST'R CEON CQM Lcng,h Size .1.yP 58 LP.of B • D.I. WATERMAIN I 1 .193 L.F.of • n.I WATERMAIN Lk of WATERMAIN 'h. L.F.of WATERMAIN EACli of 10_ FLxMJ GATE VALVES _ 2 EACH of _ 8 • INxFL GATT:VALVES ,.., _2 EACH of _6- • MJxFL GATE VAI.VUS :I 3 EACR of 6 ' Corey FIE".IYORANT AS.NiMIIIJ S S 6.600 ((rt t of fire I IydrantA must be limed scparmcly) $35,001 Ool ludo Engineering and Sales Tax i(Apphcabk S5,862 _ TOTAL COST FORWARRS"ILM $ 7� SFWER SYSTEMS ' Laryph Size Trrr Icngul Size Type 1,1' _ ' SF.WI:R MAIN I..F.o STORM LINE 41 1.1- ul ALN'1'R MAIN I..F,of ATORM I INI: LF of VSt`L'M MAIN LA°.of al'OHdI'.NE — LA of IMIF MANIIOLm EA of _ ' SruRM INLIIAIUILIa' 17A of Ill A MANIIOtfS EA of _ ' STORM CA I'C UJASIN tincludnyt rnpnrTnng and Aka Tax EA of N CAl'CIIIUMN A appgaa4lq 1 Onchllkng rnginccnnt,anJ Stk,f,x IUrALCUSI IURSANI1ARy SEWCKNy (I.M 1 J9'IJAabk) I Vol'At COxTrORSTORM IMAINAGE SVrITW S SO(CCr IMPROVEMLN'IS' 011c1udiog Cur4,Guucr,AJewaa.Mpb.Jl lhvcnk-m mnlAmcl l�t,hlntg) Not applicable. SIGNAt.1EA rioot (Including Eng.Design(int%,GM'lino lies,WA A Saks'1'aq Not applicable. SI RU I'LIGIII'ING (Including Ent, I)'-slgn Coos,City Penn)F^n.WAS,Saks 1'ax) I Not applicable. Douglas Richardson (206) 644-9505 Pon,a,g.loty nano ---- --- — --- ,hone-1 f `I (AI(NAIUIII) r 41-1.n ehlnAlf UU,/44 (N,om ) ....11 ' II.......J.b 1 iii u 1 11 1 11 l r# qrY 1 tI [ �pi 4 T ( er r: y r � (� Y x f, y 5 + il� a 1 eF FOR DISTRIBUTION TO: water Utility ® Building Division e, i.J wastewuer Utility ® Public Works Consir lnspeetur f�ee7ll Surface Water Utility ® Fire Prevention 'J Maintenance Services 'Transportation Systems !'rUj eCl — e2ry�a esat.= Locaiion 357d . —S. q'60i3D �1i Auacned please find copies or: t PERMIT BILLS OF SALE {{{{ RECEIPT � COST DATA INVENTORY i LETTER OFSPECIAL BILLING ® EASEMENT(S) I STUB SERVICE AGREEMENT ® COPY OF AS-BUILT PRECON NOTES L�J *, PRECON ATTENDEES t i4N DRAINAGE REPORT ® 3 f ± , 0 MEMO•WATER BREAKDOWN i MAP WITH NEW MAINS AND VALVES t s. OTHER w From: V f gat,. 7- as -p� j - -0,UCer;V11rI411 iy t Ma�AMYiY9HiWWwhrr+n...m.� r r�4 t e �] rq" r � Return Addres, City Clerk's OL.ce City of Renton 200 Mill Avenue South Renton,WA 99055.2189 BILL OF-SALE Pro ptm Tas Parcel Number• Project Fil<a. C-960130 '125381-0060 Sucet lm<rseaion 901 S.W. 9t:1 SC.Reference Numbers)of Documents auigned or rcleasW:Addnimnal rcffereercnce numbers are on pa ge__Gr intor(s): Gran ni : 1. OGIMA LLC TheGnnlor.unamW above,!oq and in consideration of mumel b<M tOfhercby ran Municipal Corporation the Granter as named above.the following described g bargains.sells and deliver to personal progeny n noow located a LEGAL DESCRIPTION: SDrinnside Office/Warehouse Building Water system, consisting of fire main loop and fire hydrants. By this conveyance.Grantor it III wenant and defend me sale hoeby made unto the Grantee against all and evm person or persons,whomsoever•lawfully claiming m or to clam the sae I-nis convevann shall bind the heirs,executors. Win in.strators and assign fo"., IN WITNE EREOF.I e hereunto set my hand and 1 me d and year as wrinen below fy fVIDGAL�Fr�I RNONLEDG,HE" N Sc dun bo+ TATE OF'd'ASHINGTON ,SS COUNTY OF KING 1 I certify that I know or have satisfactory eetdence that eclnowlWgW it be Mvherrtheir hee and volun signed this instrument and tary act for the uses and purposes 3 mentioned,.tqt,unmro,iir, ••"�t`+ONNNO` Not Pbntgt�nor the state of Wuhi on hly appointment rx�ira. N�iOR.NSU:fRECORDV30g.OGC�ba Page I Retra-n Ad*ess: CITY CLERK'S OFFICE CITY OF PENTON 200 MILL AVENUE SOUTH RENTON.WA 98055-2189 Please print or N information DOCUMENT TITLE: EXHIBIT A PROJECTNAME: SPRINGSIDE OFFICE WAREHOUSE WATERSYSTEM: Leugth Si2C 58 L.F.of 8 DI Water Main IL2,3 L.F.of 12 DI Water Main L.F.of _ Water Main L.F.of Water Main each of 10 Gate V.Ives each of 8 G:!e Valves 3 Fire Hydrant Assemblies SANITARY SEWER SYSTEM: Lauglh sat 1= L.F.of Sewer Main L.F.of Sewer Main L.F.of Sewer Alain each of __ Diameter Manholes each of Diameter Manholes each of Diameter Manholes STORM DRAINAGE SYSTEM: I=gth a � L.F.of Storm Line L.F.of Storm Line L.F.of Storm Line each of Storm Inlet Outlet each of Storm Catch Basin each of Manhole STREET IMPROVEMENTS: (Including Curb.Goner.Sidewalk.Asphalt Pavement) Curb,Goner,Sidewalk_L F. Asphalt Pavement: Sy or ,L.F of__WSdN SIGNALIZATION: STREET LIGHTING: a of Poles PROJECCCLOSING �4 final cost Data FINAL COST DATA AND INVENTORY and Invent TY ;un)ecr SpringaIde _ cyry PROlrcr NUMBERS: %mt Building WnVP SWP- Name of proiea 11D — IbU TO City of Renon II10M Anderson Richardson Co. Ph.Review Section 1440 Bel-Red Road Phmm.g/Ouilding/Pubhc darks Su to #2 3 200 MITI Avenue South Bellevue, WA. 98007 I�I Renton,WA 98055 DATIt. January Z4, 1997 Per the request of the City of Renton,the following information is furnished coneeming final costs for improvements installed for the above referenced project WATER 515nM CONMOCTION CQM, Length Slie 58 L.F.of B D.I. WAT@IIMAIN 1 .193 LF of 70 ❑•I" NWATEItMAIN LF a( WATERMAIN L F.of WATERMAIN 2c EACII of - 10 FLXMJ GATE VALVES �j• UCH or _8 MdxFL GATE vntvEs _ 2 EACH of _ 6 . MJXFL CATF VALVES _3, EACH of _ 6 . Corey PIItE HYDRANT ASCEMnt.1l.S $ 6,600 (Cast of fire I Iydnalt must be listed aq,anrelY) $35,001 (Include Engineering and Sales Tax if applicahtc S — TOTAL COSI'FORWAIF:RSYS'I'EM S4 ,4 f. Lcngdl Siee Tfpe Lcngdl Sire 1'ypc L I' SEW I'R MAIN L.P.o Sroµ}I LINL _ I.I ul p'u'CA MAIN L.I',of \TOµM LINIi - d) .; - 1.P 0( SIwLN MAIN L.P.of Sl'OXM nNE rrl UOf IAa10l!R aIANIIOLLS EA of WOW INLM'/OVI LI'I 1 S CA of DI TR MANIIOI PS EA of STORM CAMIIIIASIN �y OnclW,ng rngmeern,g and Stitt Tax EA or M CA 1`0IIIASIN (T(rs'W J tf aPPkaai) a Onchaxryl EryIna' Nn and Saks l'a ) .�. (+`( I I'U1ALCOa11URaAH11ANY SLWUI.MS1j Id 1 .1 y,pMNdv) y IOTAI MST FOR RrONM DRAINAGE SYrrEM $ S'I'l(EL r tmmuvEABiNTS: (Inctudlnµ Curb.Cultar,Snkwslk.AsphAt Ihvclmnl and Shell I.iµblmµ) Not applicable. I #a SIGNALI2d'rION (Including ling.Deugn Cous,GIT Ikmuu poet,WA M Sxla't'1'xx) Not applicable. 31 REM LiClil ING. (Ineludmg Edit, DcMgn Casts,Cn)•I'cnna FeeA,WA M Saks lax) Not applicable. } `a Douglas Richardson (206) 644-9505 sr Pmu uµnnOry mmu -- IYnY11CIII l UA la IXR lid, (SIGNAII M IF) (S."mw{urusl Im xulh,vlatd agad w oww r of salaµn shvdnlrn,c00 711 a A ,$ r SF Vw t s�,�✓LV�Fr �r:, o- , , ? I. �t ,�, ,. 1p'h ,L rev` 'p .T � ,.Ffi s• r�n . F.: - :rvsyiu\1rh yen 2•»-91 -test' a-18'y7 BACKFLOW PREVENTION ASSEMBLY o�zHla TEST REPORT c/o -r RIM�sTE ) - 22St.5 qel sW 39TH St' RETURN BY: Rc •n 1 rNA aDSS 2 NAME: '�x1 y �' ,Q�r FILE NO r SERVICE ADDRESS: l ' 1AJ4 LOCATION: CROSS CONNECTION CONTROL FOR: F�'c' Sy�"r�-L� �:rsr>••M TYPE ASSEMBLY lL _ MANUFACTURER. . 4,M P< MODEL: 9000 Se SIZE:_ � SERIAL NO 1 L 0 3�T• e e-R }';'INITIAL TEST RESULTS ' "'t+"'^��aY% TEST AFTER REPAIR OR CLEANING" i Line Pressure_ _ _ I Pressure Drop Across Pressure Drop Across ` No,1 Check Valve Paid No.1 Check Valve_. ps�o +' Relief Valve Opened paid Relief Valve Opened -_ psid RPSA No,1 Check: Closed tight.... .......❑ No.1 CMck: Closed tight.......... ❑ Leaked .............__0 Leaked .,................❑ No.2 Check: Closed tight...............❑ No.2 Check. Closed light...............❑ k Leaked ..................❑ Leaked ..................❑ Line Pressure 75 No.1 Check Closed aght...............Glv� No 1 Check: Closed tight...............❑ JA Leaked ..................❑ Leaked ..................❑No.2 Check: Closed tight............... No 2 Check: Closed tight...............❑ Leaked ............. ....❑ Leaked ..................❑ Line Pressure Air Inlet Opened Paid ne A,r Intel: Oped- Faied to open paid P .... .. . ❑ Failed to open ............❑ . . ... Check Valve: paid Psb '. Leaked ..................❑ Leaked ..................❑ a ' Minimum Separation: Yea__ No— IS THIS A PROPER INSTALLATION? Yes No_ REMARKS :-- I CERTIFY THE ABOVE REPORT TO BE TRUE'. 0. —� B. �wea way 0 dG� 95Y8_ n 2 Typed or printed Nine — Ptgne NumWr Y 7v� CM Na�s'•�`�Z Data �'Z Z'9 7 loma Tpter-,�e� V - RaWrM I Cen No. Lk Repek Ter 9/ �wrtNo RETURN TO WATER DIVISION life— J ,r sr 2 . BACKFLOW PREVENTION ASSEMBLY TEST REPORT RETUR.BY: 2 7 4 NAME: Cior,v c s•oe /�� rs a- 4) .s-.¢� w..sC FILE NO.: 7 SERVICE ADDRESS. LOCATION: CROSS CONNECTION CONTROL FOR: TYPE ASSEMBLY: Dc ✓49 MANUFACTURER N t�HN) MODEL 9Jn Z� 3 �SIZE: •r SERIAL NO.:_qO,a Li_ '9tl�ra %INITIAL TEST RESULTS^4*Nle'-Y w TEST AF�R REPAIR OR CLEANING Lie Pressure _ Pressure Drop Acroes Pressure Drop Across r No.1 Check Valve__ paid No.1 Check Valve— ps�d Relief Valve Opened p,id Relief Valve Opened pee RPBA No.1 Check: Closed tight...............O No.1 Check: Closed eight...............❑ Leaked ..................O Leaked ..................❑ No.2 Check Closed light...............❑ No.2 Check: Closed tight...............O Leaked ..................❑ Leaked ................_0 Una Prawlive 7,S i No.1 Check Closed light.... ... .. ..ur_� No.1 Check: Closed tight. .. .......❑ Leaked .......... O Leaked .... ..........Cl No.2 Check Closed tight... ...W__� No.2 Check: Closed tight............... Leaked ...........❑ Leaked .............. ...❑ sel Lire Pressure_ Air Inlet Opened— pail Art Inlet Opened paid _. PYB; Failed to open ...........O Failed 10 open ............❑ Check Valve'. Paid Check Valve: paid Leaked ...... ... .❑ Leaked ...............❑ AG Minimum Separation Yes_ No_ IS THIS A PROPER INSTALLATION'+ Yes No REMARKS:___ I CERTIFY THE ABOVE REPORT TO BE TRUE' —; o«N O �.wn an.anH ow (7,-6)8G3-95Y6 Typed er Pnmed Name Phone Number nalm Test By -- -- C.nNa.��Y�— Data i-1-1- 97 RepWep BY Cert No. Dee Repair Test BY _ _ �,ert No Was RETURN TO WATER DIVISION I J i I L' :S 96 4(1\ •5 07 FAX '67 Sn67 L{CCKS TESTING "0-s H: . 2 2 5 8 WATER 13ACTERIOLOGICAL ANALYSIS WMU OXBM(DM:NERD IN XCn M Ck L#ZK OF DDIDeMCOPY S MRSTMIIMO M wl MMUS4 EEwIRIR M!M,EISEEEE. MTE G]lE >•E OLEECTEb COtMTT NwnE �]TRE�Sy SnTEM MRUkt SVM,OOMPLM: ... IWtJ❑(RbMouEE I.D.W 1 1 O O d is a w�.,Ea1mrtu , l0 blMtlr SwM1F COU! fb TELIRrgNE ND. 676 L( E�lRwb, SAMIE COItIE'1EDwn 1M STSI&owREµv6R #E ) SOU"M,ryK ORONO RATER UMOEw ZWACE&FUA-h F ❑SAFAM wg FE(o ❑VMG ❑NR SEOM ❑t wgnw hp 1 TIRE OR Sw fpE Rgwew�EEMJ ❑Dpw WTER QRWJTNE r"Ew QEYyy tltlEYE1W�+ 111MR1 UntRw1 a D•r ❑1�1wr/rYw�'rMM W R ow T ( ..;. i �RRM SfltWGEwEnR EAxOEQm ❑AIw OeYenn ` y.. NEW 001SfRUCTroMw RERWS RwiTM�RR 1 OMER�SaMn i AEWRRS 1 � E FN 11f!OMEN 011rn011b"W R MwLn ❑UMMn WACTM eEwwMMAV 0 V ZTo- rMn �* ❑E.orV.w QcCmESEMR REouwtn ❑RRIIMRM, ❑Ro1Mww OMER EwSOMMW REWn IOTA oauow nmw S.ew*—M a f REGLL p1lIRdM�_(room "en omw__RR EMOTkRs1 IRE D r SRw"F MOTTESTEOEKAVk nSTVMUn�BIEkGVSF 9wwww ❑Cawl+pwn SEE REVERSE fqE W ORFFM EORv TOR vo-- S OF RSSUETS Wwnoam InTR TRw mmt o RECEMDE• OK W4,IE� ID u,71. 2.712 CONSTRUCTION REPORT FOR PUBLIC WATER SYSTEM PROJECTS Effective September 9, 1983 the following Regulation applies: WAC 246-290-1a40(3)-A construction report shall be submitted to and accepted by the department within sixty days of completion and prior to use of any project for which plans and specifiruions have been approved by the department for projects designed by a professional engineer. The construction report must be signed by a professional engineer. The report shall state in the opinion of the signet whether the project has been constructed in accordance with approved plans and specifications and the installation,testing and disinfection of the system were carried out in accordance with department regulations. a) If a project is being completed in staged construction,attach a map and description of portion of project being certified as completed as approved on date given below. b) As future portions of staged construction projects arc completed,each must be certified as required by WAC 246-290-040(3). c) Additional certificai:�n forms arc availabie upon request from DOH offices listed below City of Renton DOH Weser System No. 71950L 200 Mill Avenue South "F Renton,WA 98055 Referendum No.(if any) 4 -. PROJECT NAME AND DESCRIPTIVE TITLE: Date Specifications Approved City of Renton Water System by Department of Health King County August 18, 1993 Renton Project Number WT4 272Z5$ (1990 Comprehensive Water System Plan) Project 7 itic: 5gem %dr uAti,e liyaig - S K) 31 r"SY Q Kaff rtum l Ave S fl/ The undersigned engineer or his authorized agent has inspected the above-described project which as to layout,size and type of pipe,valves and materials,reservoir and other designed physical facilities has been constructed in accordance with specifications approved by the Secretary,Department of Health,and in the opinion of the engineer,the installation testing and disinfection of the system was carried out in accordance " with the specifications approved by the Saretary. -r 1 It1 tvr lUAV Engineer EtsgNaarY9W r I 1, . , 'rSn7nete LZ4-=�'1 { Please return completed form to iSf3H offl&c"ow: t NW Drinking Water SW Drinking Water Eastern Drinking Water i ® Environmental Health ❑ Environmental Health ❑ Environmental Health IS I I Thud,Suite 719 Mail Stop 7923 I500 W Fourth,Suite 105 Seattle,WA 98101 Olympia.WA 98504 Spokane,WA 99204 11 DIv1SIONSAMl_MESSDOCs\%o67 DW J } r e y 'k xp M1t``'I 1 .Y. +IaM� CITY OF RENTON WATER DEPARTMENT Pressure Test & Purification Test Foes PROJECT NO. p3� QQ 11 NA+! OF PROJECT iN Slltk Ua1P�Ai 10 PRESSURE TESL TAKEN BY CF �oI�CON AT A PRESSURE OF _PSI. FOR 11 TEST ACCEPTED ON IE d Q6 t PURIFICATION TEST TAKEN BY Q F PURIFICATION TEST RESULTS. SAMPLE sl FH dI E SAMPLE s2 Fk tl L ow i SAMPLE ♦7 FN C I� REMARKS:�I�I�4 r j Ll A5 196 FRI 13:YY F.AS TST 5063 LAQCES TESTING ZOOP 11D 6.1Twnsy J►�AEA,Y/AwtOl .� I �( . 11101.EI�ntEE 6lIY.iNA M105 WATER BACTERIOLOGICAL ANALYSIS WATER BACTERIOLOGICAL ANALYSIS w.+�ml�lall�w.swlaoaawxaoolm.moovT wnaooua�aE.acwr�w�clv+sawxaoam�oolavE ■111E�IWMM41Atl.AAllI��MU�4 ENA�EvmnANMTArwAI.WIIPY��AA�I, aTemuec"o TTEECULtYGTlD !'OIERTTLAAE wTE EaEn 1.1E ! '[Qy Ci1lARY1NAlE ,bM p .1.11 I 3O ,l Vln Mt .... I SJ "� f� /13 % p lA p �, KIh rl / l3 /46 p,� �� K 3.TKaomal optoxtxare,l�,.uE�*c as.srEv tErlalcm.aimE.vAm Mnuc y,a,A TRELTC El " l.o,lb. q f "'' G Ma pD��Ey�y�su+�y! of Qiwfon to T TL! L.��•a,L � �'� uwlErc jsAErt ouuoED u o lhx.. DAx1Aan 23S•2Ssf F1•E I iqR, #9 ml�lb 235-ZStS YYALE- STS]EEI pN1 :lyllul jAWll W0. WTED"'.ftI- SouRLE TxvE owDllnD WATER ywpERs�l/J-t S�1/LOR�� .__ /ISOWIC[/+ TMCIR/D+F/JVGDIWIMD EwIIq UrOE41(AJSWMM ALE IK{/WE_47/PALE � . p eIAEEAtt WEUELLREEn C pwxlRnEPEOM p.mwnTOi psunEAL! wlu rEtn pwwD p�EDE pEn TO. nRa ANUNL - I� ash H _- 'c�t. E: ",eAi."eMc`AIA•yr'°o'I �o rnrl JP pc __ 20a fniIf - —mod TTI!Of SMML[TATRAEsyw•M VAwI TxVE a SAv'lE h1ANA aF w R SlAaYnAI ❑DUYItlDRG WATER Cw�fRrMnr—TrYl_ LlrmrwF y❑Qltr'NwE1WWUW_TAIY _5�1 s+.x....11w �8 TTYIw DRIw.G W.TEA CWf lYAIaW _ E1wIAA p Unwvev p1AWAyAIVOOnr p R�w�enm v EOvlv+s WE ❑'•IE4T Sun^.f Nwbin flan,lnrw IApA _ '. DiIY �I .Er RAW SOURCE WATER EW -Cslm p`IEyyn n�jMW EOLNCE WATEN SwE b• lyy �^'Coht"1 TIDW tr REPMAS LJ BfwIPIMI� ( ]E NEW CoRSTALCTUMwREP4RS ❑m PAW Q~ ❑DMIR 1SP.Po O111ER ISEeNIp l EOWRS.oJA i039 I wwaTao Entpl tltWAn WUEolU111MRNERC TEATa11TlSYln ❑uwAntwcrTs }Fw��{1r.ullllR+w.w C�lrw' � ❑vwnwcTORr.wbn..�W,l p mE.cTw RE01PM �J"AI�IMII ❑fd lGYn S�Mn1lEs p l.orrlYlll ❑E.u.r.. �— tNEglIREO p wE1lNltlwl p T►alAe�v OMPlAV}u1dMq[SDUt OTTEw LAMMTOIMTESOLTS I - ! TOTAL CgLMOME_nm nl LOOU nmll TOTAL Cow ORY nmin ECoL1rItmTN TacALcarow_nmlW ELATE CQM—Aw _ EEC4 o0L�F011v__nmlW Ty,T[WtMR��Ax "TKO SMpF REoDAEO ANOTHER SAMLEKama SAM1MTTESTTD9ECADSI TESTORAA,WFKCWS! r- Ly!❑ SAML STED E[CAUSf'. TS UNSVITA KCAUSE O °"M7A�w�m wc "SARPN Ew p carat Imo.GnMMT.W Jjy W.lta..Ewrl �1 Ww.... B WI.Iv Aw.., TMe ❑ �IEWMAIbw W>0110Yw bUT TIMIEI trR'n ❑ ❑Faw OWR Q IEVBB�(�17®ImIUdIFAENMTMY10f Rl911LTS SElIEVl0.TE LDEa dE(MLTJ.'Tfp10ft/AUf10naIEERIS WbnO10iR� RATE a D Un wwrNAA'fAl TYW. ti Rif o8/Alryo� eulIEIR1MO IAEVEATaNT - j i aTllEEama, usawntaW l� 1 tJA i ' i n 12, I 9T q {'W 4 IArA1 11 C In i 11.11 FRI 13:R! FAI TOT 5063 _ LA STING e003 _. .APrmt�����.�. - �mmM.Nm14�t4w.ti•��.. ••�.•.• -tYrB,WAOBTOB '� -. �FDR OE.rMAy Semb,NA itW WATER BACTERIOLOGICAL ANALYSIS WATER BACTERIOLOGICAL ANALYSIS 1AWECMLWID1k PM MR)CTONS ON BACK OF GOLMRODOPY ME6EEOUSI4N:RE:EDI61TRE1K16p1BREX0FBOEOFIIRODOPT 9Mm1rTMA NRDIMrwr. 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TEST VILLIITAKE KCAUU: F�RL11 ft- []CaUWLD'^�S' F'I EaARmO MP C. V n �yI'YIIPIS mNYw QTNTC ❑�❑y�TWN/S�tr TNT[ ` INYIPRIISW� �6rau erwN �� BWecW.FAA ]TE.eueWiN �U5M REVERSE SSE OF OWN MPV AM ErIRANTOr1 OE RESULTS �ISEE REVERSE.SIDE OF GREEN MPY KA UftWT OF RESULTS w ND.n DIwm TN1C L'Sm nFFILI LIAR AEQI `D RK DF T. wTEic10R'ED� uRDRN01+. a+TSIR1O1No L.RPINDR. -, r- �rkIIX � V. 99 [CAG#P_ hort lat (SHPL a REQUEST FOR PROTECT 0 relim. Plat (PPtl I To: Technical Services Date WOO 17 179 Greene From: Plan Review/Project Manager /!�jn LL M — Project Name _ ,5 OV ! vto 51CIe ©I.0 .tt+if��va Description of Project: ._ W yY E Ii O S C, ,eL< - / y Circle Size of Waterline: 8" l0" 12" Circle One: New or Extension , Circle Size of Sewerline: 8" 10" 12" Circle One: New or Extension 1SIdP Circle Size of Stormline: 12 15" 18" 24" Circle One e, or Extension Address or Street Name(s) Dvl p r/Contractor/Owner/Cntl[. Check each discipline involved in Project Ltr Drw q B of sheets per discipline ❑ Trans-Storm ' (Awdvay/Drainaae) F:(OQ wprav/ K / / K�iOiH — 3�s1'ro� {S ❑ Transportation ls�puic ; � udu.g) ❑ Wastewater 4 (s.Mury w. w�.�,y — — - K sr.lr eT x..✓t• is {•&I e Water ❑ (Ma V<I.q Myaanul _ _ !..- � •, e2.c //V 2,�S l�rciue«umwuut Hmzerw�Qri Sheeul TS use Only i lara- 22 5L td ads i L �; C,t, c` Approved by TSM romwm„wzaeaooc ictwn DateAlm go � 1tIYWlr/IIItYMIa,.', Nawr .. _.. �:,.+.�....«..-• .. 1 1 laueks Tss"UttortlwNa,Inc. NOS Mary Sealtle.WA%I DO WATER BACTERIOLOGICAL ANALYSIS SW E COLLECTUN NFAD IWTRUlT04S CN BArK C)F G AD[Nwx1 rORr DAMF ECTEO T CO WD coB NMIE 1. [3µ ❑M TvvEas srBTEM FII.cs"M AoDt.tm ❑RABc wNDEeo�Nour A e NauE OF BYSTBI 9RtlRt WMWMESMF CbtECn MEMME10 o. ) Eva" I EMEEE COLLECTEOBr.p1wW1 9vSTENN OYAEnNOR:PFBulM�+1 BDUI10E lvpE— -�]UL. 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