HomeMy WebLinkAboutWTR2702883 WTR-27-2883
BEGINNING
OF FILE
BUMM StAYM APARTLIM
1.
c � a.
Laucks Testing Laboratories,Inc.
940 S.Hamey Seattle,WA 98- )8
WATER BACTERIOLOGICAL ANALYSIS
SAMPLE COLLECTION:READ INSTRUCTIONS ON BACK OF GOLDFNROO COPY
If kmtnittions Bra not follow",sample will be releoteo.
GATE COLLECTEL TIyeE COLLE COUNTY NAME
MDNM Mr vEAR
ILA :`
I� i4 00 SAM ❑PM k L .,�
TYPE OF SYSTEM IF PUBLIO SYSTEM.COMPLETE:
jj LIC cpCF�
❑INONIDUAL �EEE/-]
8 S Q L ,' GROUP
NAME OF SYSTEM p n-
C I{, O� J�t��^1
SyP�EOFIC LOGTION IHE SNAPIF7�EVEMNG
TELEMIONE NO.
I fIU F 'It1l' Ittp.I. DAY wr 23r• Z6Sv
re L ' d (A r rwCl —Ga
ii
* _ EM OwNeR/AIOR:/Ze S/c»
SWiK;E TYPE GROUND WATER UNDER SURFACE INFLUENCE
El SURFACE []WELL or ❑SPRING ❑PURCHASED or IpCOM&NATION
WELL FIELD INTERTIE or OTHER
_ SEND FfPORT TO:(Print FI,a Noma,Aaargs and ip Code '
_ 10 S S l A f_S ll Se
-- _
w�s�.w,on Y
TYPE OF SAMPLE(chmk oNV one In thus columml
❑ROUTINE
DRINKING WATER ❑CD E�Fotal Free)
ct Ck VMbnent ❑Fllt \a
❑ant �D[L
❑REPEAT SAMPLE G U L1RH
Praviq»cdilwn peaenca LaD E _
Date_ (iITNur" S
❑'IAW SOURCE WATER Sowce s FS1 m ❑Total Cdno•m
a NEW CONSTRUCTION or RFPAIRS Fecii cehio�
rL`J�OTHER ISDecly).,__
REMARKS
— .. 1. \ �a� anal.--
(LAS USE ONLY)OPAWINO WATER RESULTS
❑UNSATISFACTORY.Conforms Itlaesnt —_ ❑SATISFACTORY.
REPEAT ❑E.Con D'ssent []E.Con ebsem California abunt
SAMPLES
REQUIRED ❑FeeN present ❑F. ebAent
OTHER LABORATORY RESULTS
TOTAL COLIFORM_py/t00 nil E.COL, /100 ML
FECAL COLIFORM_ /100 nil PLATE COUNT_ /nil
ANOTHER SAMPLE REQUIRED
SAMPLE NOT TESTED BECAUSE: i EST UNSUITABLE BECAUSE
❑Sample too a,a ❑Con&w (Vm'w'tn
❑w"r.. ta' r ❑TNTC
n
J]In Chan Mrrn ❑Ttppa culture y �,
SEE REVERSE SM OF GREEN COPY FOR EXPLANATION OF RESULTS
W NO.P DIG"% MW TIME R UIVE_p~ RECLNED BV
I
CJ �]34 r
MMM1.01 o .ASOKA.oaY
RfWVea �� �
DwlOfamdAn'�
WATER SUPPLIER COPY
ShottPlat'(SlitPL'P�__ )
REQUEST FOR PROJECT P Prelim.Plat (PPP
CAGP
To: Technical Services Date �— WO# 885Z(y Green#
From: Plan Review/Project Manager
Project Name �'2A)ETT �no�kr�t•I��TS _
Descriptior of Project: /YIUCT/FiA�// QRyy���
I.tI/T!/ /Y/ Ty c -S/OESF2u67L G'�.uNt-GT1ONS /2 �tKf L�/Q�(ETE� l's7,llrt/E47O�tJ
r
�t LLSK /GE tir
Circle Siu of Waterline: 8" IO" Circle One: or Extension
Circle Size of Sewerline: 8' 101, 12" Circle One: New or Extension
Circle Size of Stormline: 12" IS 18" 24" Circle One: New or Extension
Address or Street Name(s) r �rrr,!// C
S �`�� � � a39 euQ,ve; AvS
Dvlpr/Contractor/Owner/Cns)t:: 4L&Lg �
/ (70 ehuacicn mu)
Check each discipline involved in Project Ltr Drwg #of sheets per discipline
G Trans-Storm G G
(Roadworlpcynaj<) (O(l rir i.^.rpnvcmcnu =Jn d<barin namcj
(ncludc tFSC ihccu)
G Transportation (S;9,Wiud .e ChLWchueon,Iljhdnj) G G
G Wastewater G G
5 rnmry Scwu jtain(imlud<buin none) _
IZ Water Xr 10
(Mi:s,Valvu.Hrd�aiu) /
G Suface Water (Include wmpotire 6 HonwnW CO 5e<cu)
Improvements ( )in<mde bssin nam<) G ❑
TS Use Only to�2-22-
L "
Return Address:
City Clerk's Office
City of Renton
1055 South Grady Way
Renton,WA 98055
via 0�°a�Nt OF
KTNGac01MTv %*A
BILL OF SALE Property Tax 111 Number:
Project File M: Street Interseett�ion: A
,. •err 9s•' ti S l aG _-
Refermee Numbers)of Documents assngned or released:Additiunal reference numbers are on page
Grantor(s): Grantee(s):
lM &r64hv1SrAr4 0,7 ( L.L 1`Az c-tptGtA'S 1. City of Renton,a Municipal Corporation
2. rn
The Grantor,as named above,for,and in cenMeration of mutual benefits,hereby grants,bugams,sell:and delivers to
the Grantee,as named above,the following demlr:d personal
property:
o WATER SYMM. : Len Size
r L.F.of 12 Water Main
m LF.of Water Main
an
L.F.of " Water Main
each of Gate Valves
co each of Gate Valves
u
each of Fitt Hydrant Assemblies
eC.a SANITARY SEWER SYSTEM: Length_ Size 7 e
rL.F.of •' Sewer plain
L.F.of Sewer Main
L.F.of Sewer Main
each of Diameter Manholes
each of Diameter Manholes
each of _� Diameter Manholes
STORM DRAINAGE SYSTEM: Length Size line
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,Gutter,Sidewalk,Asphalt Pavement)
Curb,Gutter,Sidewalk L.F.
Asphalt Pavement: _SY or L.F.of Width
STREET LIGHTING:
#of Poles_
By this conveyance,Grantor will warrant and defend the sale hereby msde unto the Grantee against all and every person
or persons,whomsoever,lawfully claiming or to claim the same. This conveyance shall bind the heirs,executers,
administrators and assigns forever. J
H:IFILE.SYSIFRM191HN!>OUTnILLSALE.DOCWAB Pagc 1
1
h,
W Form 84 0001/bh
E OF,I have hereunto set my hand and seal the day and year as written below.
^— INDIVIDUAL FORM OFACRNOIYLfibGMENT F
Notary Seal must be within box STATE OF WASHINGTON )SS
COUNTY OF KING )
I certify that 1 know or have satisfactory evidence that
signed this instrument and
acknowledged it to be his/h ritheir free and voluntary act for the uses and purposes
mentioned in the instrument
Notary Public in and for the State of Washington
Notary(Print)
My appointment expires:
Dated:
RSPRSSSM;InvR FORM OFACINOWLEDGMENr "—
Notary Sal must be within box STATE OF WASHINGTON )SS
COUNTY OF KING )
elf I certify that I know or have satisfactory evidence that
o signed this instrum
ent,on oath
e= stated that heishdthey waslwere authorized to execute the instrument and
o r Jmowledged it as the and
of to be the Lee and voluntary act of such
.� party/parties for the uses and purposes mentioned in the instrument
m
0
Notary Public in and foi the State of Washington
o Notary(Print) _
ear My appointment expires:
Dated: _--'
CORPORA'S FORM OFACENOWLRDGMENT
Notary Seal must be,within box STATE OF WASHINGTON )SS
COUN Y QE KING )
• On this t day of J U�4CQl beforr tm personally appeared
,Z"AnIES A. SCnmt DT' to me known to
Q4LL y elate—L4 of the cot----�� portion that
executed the within instrument,and admowledgo the said instrument to be the free
and voluntary act and deed of said corporation,for the uses and purposes therein
mentioned,and each on oath anted that heys6e0las authorized tE`Kecute said
instrument and that a seal affixed is the corporate sal Ift r1*%
7 sl
Notary Publiem and for the late o W ingt ,0�
Notary(Print) �t ~iYe
S
My appointment expires: -e C
Dated: — , '• jr �f
'�t4%liINt0 Rage 2