HomeMy WebLinkAboutT12N R4W SEC 10 LT 15 E2Onsite File
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!2/27/2012 05:26 9072430742 AWPS~ INC. PAGE 01/02
Pure
Well Drilling Pornlit Number: SW
Parcel Identification Number:___.
-~'¢ 0
Pinup Intake Depth Betow T~p of Well Casint
Pump Manufaemrer's Name:
?urap Model: 7(F311)-TV
Pump S~e
Pi, floss Adapter Burl~ Depth:,~ feet
p~fl~ss.Adap~et
Pltl~$ Adapter [l~$~ller: ~j~
Well D~Jafeeted Upon CompJetion~es
Method of Disinfection:
Ancl
Pump %o~ta~le~ ~ame:
pump i~staller shall
'er & Wcst'ewa*er' Pt,ogn~m
P O. 8ox,tg6650
;cogs AK 99~19-o630~
Installation Log
Owner Nam,e & Address:
feet
[0
~oragePump &WelISe~ic.e
330Ee~75thAvenue
nchorege, AMska 99518
Phone:907-243~740
Fax:907-243-0742
tog t¢ the DSD within 30 days of pump bs;allation.
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
Descrzptzon ,
SEPTIC TANK: Distance from well</L~Material ~-~ Number of compartments__~r~
Liquid oapaoity/~q~ gallons. Inside length nside width ~ Liquid depth
SEEPAGE SYSTEM: Seepage Pit: Number of pits~Outside diameter. ~! or
widths, length .~ depth ~/ lining ' ~ Distance from
well ~ , building foundation_j2.%"_, nearest lot line~~ Total effective
absorption area (wall area) sq, ft.
TILE DRAIN FIELD: Distance from well , foundation__, nearest lot line
Total length of lines~Number of Iines Distance between lines Trench
width__ in. Total effective absorption area .... sq. ft. Length of each line
Depth: Top of tile to finish grade Depth of filter material beneath
tile in. Above tile
~ E L L ~t[//~j~i~ depth
______, distance from building foundatlon~ nearest
lot line 'L~~ nearest sewer line~, septic tank ~! , seepage system ~ ~ ~
cesspool~ ~ other sources
DISTANCES:
DIAGRAM OF SYSTEM
APPROVED
Health Auth0~itY ........