HomeMy WebLinkAboutYALE BLK 2 LT 3Sep_21.2022 09:33 AM Anchorage Well & Pump Service Inc 9072430742 #0565 P 1/ 1 Municipality of Anchorage Community Development Department On -Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.Muni.org/onsite • (907) 843-7904 r Well Decommissioning Log CIO-? sqj Legal Address: Subdivision A L6 Block 2 Let T R Section Lot On-site Water lt, Wastewater Program certified contractor performing the well decommissioning: Name' __7= IMA. MVA i Signature;gr__ Well decommissioning date Method of decommissioning: AMC 1,55.Q6DL1, [� h. C, Locatlow Use the space below -to provld& a drawing -of the proper1"howlpqjh&following Items; • North arrow • Decommissioned well, • Other water wells on the property, • Two separate awing-tle distances for each well shown on the drawing, Note: The swing -tie distances shall be measured from either permanent structures or the property corners, 1. M 3 w Development117evelopment ServiceslBul[ding SafetylOn Site Water and EM 4231 Emerald Dr, Anchorage, AK 99502