HomeMy WebLinkAboutSCHROEDER LT 22ARCTIC PUMP & WELL INC.
E fun Sullivan, CPI
PO Box 770197
Awa g app Eagle River, AK 99577
(907) 688-2510
(907) 258-2510
apwa og i.neC
Decommissioning Log
Well Drilling Permit Number: SW
Parcel Identification Number:
Date of Issue:
Arctic Pump & Well, Inc.
Page I of I
Legal Description: Schroeder
Property Owner Name & Address:
Lot:22
Steve Arturo
Block:
PO BX 212041
A nrh ATI 00071
Pump Installation Date: 6/26/2013
Pump Intake Depth Below Top of Well Casing: Feet
Pump Manufacturer's Name: Pump Model:
Pump Size: hp
Pitless Adapter Burial Depth: feet
Pitless Adapter Manufacturer's Name:
Pitless Adapter Installer:
Well Disinfected Upon Completion? Yes
Method of Disinfection: Chlorine
Comments:
Well permanently decommissioned by procedure 15.55.060L.c.
Pump Installer Name:
Arctic Pump & Well, Inc.
Arctic Pump & Well, Inc.
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FNA Form 1573
R•. My IVSB
July 5, 1973
Farm Appro,ed
u. s- DFPARTFAENT OF HCuSING NrID CurSArI Nit LDVIdENI Budget Bureau No, 69-R 0296
FEDERAL HOUSING ACM Ha15?Rp T:CN
HEALTH AUTHORITY APPROVAL
INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM�
PART I._TO BE COMPLETED BY FHA
SERIAL NO.
- -- MORTGAGEE
SUR
ININO OFFICE
Anchorage _ First National BAnk of Anchorage____-_
-- �ROPERTY ADDRESS — --
MORTGAGOR OR SPONSOR
SELLER: Richard Cogdell %Smiley's Realty I Marcus St., Eagle Rivers -
Alas>
BUYER: Rodolfo Rodriguez —_ -- --- – roLO CK NO.
LOT NO.
SUBDIVISION NAME
Schroeder S/D —� — «c,
s � I.an mtTle oe oi3ary grata Iia mach Into
TOTAL NUMBER: _ BASEMENT New installation r ( nddldnnel Fta�droomo9
=,"T''IDROOMS
—Qf YaT, how manyF)11VIN0 BATHS rX Yes NoYes 0No Unknown 2 e ��•-�.�-^-e���.._.- �...r.._.F._z - OYSTErA DE5144NED POR
wi+TER SUPPLY ®Y: c—T--- —
�� Community system Individual No. or annr:+s. cnaenor DI3101A6
Public system —–.------ _– –�-- – _–
SEWAGE DISPOSAL BYt Individual 111 Yes
Public system Lj Community system
PART 11.--70 BE COMPLETED ELY HEALYH DEPARTMENT
HEALTH D__- .. . ocrrnoc t1rFTCN
REPORT OF INSPECTION—INDIVIDUAL, SEWAGE -DISPOSAL SYSTEM
PRIMARY TREATMENT Consists of E) Septic tank. ❑ Cesspool.
Septk Tank:
Distance from well. _-.feet- Matenal,___ __—_— —__ Number of companmems_._«.
Total liquid eapaciry, __ - gallons. Capacity inlet +nrnpanment_._ ____ gallons.
Inside length,— _. __-__feet Inside width, _feet Liquid depth,____—feet-
Ceupool:
Distance from: Well, _ feet, fou nCLm on _-fear, nearest lot line at ❑ front, D side, ❑ rear, _fee(.
Inside diameter, __.--feet. I)CPth,__.__ ___ feet Liquid capacity. ____ _-_--_-_,Callon.•. 1.Intng material — __--