HomeMy WebLinkAboutTHOMAS L BOYLE BLK 2 LT 8Thomas L 0
Boyle
Block
Lot
2
#015-282-16
Mayor
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 Elmore Road
P.O. Box 196650
Anchorage, AK 99507
www.muni org/onsite
(907) 343-7904
Pump Installation Log
Well Drilling Permit Number: SW Date of Issue:
Parcel Identscation Number:
Legal Description
Pro erty Owner Name &Address:
THOMAS L 130 LLo
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Pump Installation Date: 3
Pump Intake Depth Below Top of Well Casing: ,5'p feet
Pump Manufacturer's Name: trc-- 4 -
Pump Model: (i6� $ 1 -2—
2-Pump
PumpSize Zhp
Pitless Adapter Burial Depth: feet /vd,v 7`
Pitless Adapter Manufacturer's Name:
Pitless Adapter Installer:
Well Disinfected Upon Completion?XYes ❑ No
Method of Disinfection: CI -2- 71RU .e.ts
Comments:
Pump Installer Name:
Anchorage Well & Pump Service, hw
330 East 76th Avenue
Anchorage, AK 99518
Phone: 907.243.0740
Fax: 907-243.0742
Attention: The pump installer shall provide a pump installatiAn log to the DSD within 30 days of pump installation.
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