HomeMy WebLinkAboutPALATERRA ADDN 2 LT 12Onsite File
Palaterra Addn 2
Lot 12
PID# 017-151-36
Formerly Palaterra Block 3A
Municipality of Anchorage
On-Site Water and Wastewater Program • (907) 343-7904 Page 1 of 3
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP191029 PID Number: 017-151-11
Dwelling: ❑■ Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New Upgrade
Name:
Torr Family Trust / Sam & Mary DePalatis ABSORPTION FIELD
Address ❑ Deep Trench ■❑ Shallow Trench ❑ Bed ❑ Mound
12930 Summer Cir. Anchorage, AK 99516 ❑ Other
Phone Number of Bedrooms Soil Rating Total depth from original grade
242-4100 4 1.2 GPD/SF 6.7 Ft.
LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe
Subdivision Block Lot 2.7 Ft. 4.0 Ft.
Palaterra 3 Fill added above original grade Gravel length
Township Range Section 1.3 Ft. 50.0 Ft.
Gravel width Beds: Number of Lines Distance between lines
SEPARATION DISTANCES 5.0 Ft. Ft.
To; Septic 'Absor tion i Holding I, Sewer Total absorption area Number of trenches Dist.between trenches
p Lift Station
From ' Tank Field Tank Line 500 Ft2 1 Ft.
Well >100' >100' ' N/A N/A >25' TANK El Septic ❑S.T.E.P. ❑ Holding ❑Other
•
Manufacturer Capacity
Surface Water ; >100'( >100' N/A N/A Anchorage Tank 1250 Gal.
1 Material Number of compartments
Lot Line >5' >10' N/A N/A Steel 2
NA LIFT STATION
Foundation >10' I >10' N/A N/A Manufacturer Capacity
1
Curtain Drain None Noted Gal.
Pump on level at Pump off level at High water alarm at
Remarks Tank is insulated. Existing tank decom-
missioned per MOA Code. Absorption pits _ in. in. in.
pumped, crushed and backfilled. Pump make and model Electrical Inspections performed by
PIPE MATERIAL House to tank D3034 Tank to D3034
Installer drainfield—
Denali Excavating Drainfield D3034 CO/MT D3034
Inspector J. Millette BENCH MARK (Assumed elevation) 100 ft
Inspection ectio15f 6/10/19 2"d 6/11/19 Location and description
3d 4'" Top of conc foundation at A
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp
„,6".�t\\\\
OF
A"�,gill
Conditional Approval: Date ��,�.. ..• ; 6:f (+#
•
( j_,,,....
Benja chiller . /
0# �Fm•.. CE 12592 . • `vim/1
/,/ , ' '•, 7/25/19....ft,'Approved lit/ Date $,/Lf /�� (kk DPROFESSIO
Inspection Report_9-1-12.doc
PALATERRA, BLOCK 3
PERMIT # OSP191029 PID # 017-151-11
N /
�
\ 7 ' ,.
k N
/ \ DE ARMOUN ROAD \/ \ \
} // E>IISTING WELL --L -1-1----7--- \
1 \
N1'
(..\ I I
f 40.. I
\ ADJA N7 LOT WELL / � ` : , \
-----\
\ a9 r
100' WELL RAQII / 2C01 / LOT 1
\ j// /\--\ I UNDEVELOPED
EXISTING ABS PTION IT
PUMPED.CRU IEd BA L • // 1,250 GALLON
1 AND COMPACT. N SEPTIC TANK
sv1
\ \ / W�
\ \ 2CO2
•
BLOCK 1
ALTERNAT SITE' 001
eTH1 �`- - EXISTING ABSORPTION PIT
�- ------ _� MT1 • PUMPED,CRUSHED.BACKFILLED
AND COMPACTED.
ADJACENT LOT SEPT '• •
��
\
SYSTEM IS >100' FROM MT •• ` -
PROPERTY LINE
50'LONG x 5'WIDE x 4'
EFFECTIVE.DEPTH - -___________ _
BSO TRENCH
\ � � �� ` � —BLOCK 3 - - - - - ---� A B
2001 28.8 19.6
SV1 62.9 75.8
SV2 70.6 83.6
BLOCK 2 ~ - - - - - - - ^ - - 2002 76.6 89.5
C01 100.6 110.9
MT1 103.9 113.0
CO2 , 123.4 122.1
lieGE I MT2 124.8 123.7
f
NOIN[l RING
����xx�\\ LEGEND
.-,i-•"7a P 4gslli co-CLEANOUT
4g)p ,1� IF , 200-DOUBLE CLEANOUT
*:49TH ,\ .*I,� PLAN AS-BUILT
FCO-FOUNDATION CLEANOUT
-14-. Q Ql..-J.-, / 0 50 100 DV-DIVERTER VALVE
'. Michael E.Anderson : / FEET MH-MANHOLE
IrOlf(''•. 4831-E .•����� 1"-50' MT-MONITORING TUBE
`l�iF9F�'pCFESSIONA�. 8114'19 �s SV SEPTIC VENT
\\t\"``' TH-TEST HOLE
PALATERRA BLOCK 3
PERMIT # OSP191029 PID # 017-151-11
r N 0
0 (n > N0
- I- ,- 96.2 - - -
- 92.2
91.5 -///,// 1250 GAL 91.3
I, SEPTIC TANK
V /
`''''-- 87.2
92.6 FINISH GRADE
0 g 91.3 ORIGINAL GRADE 2 0
Iil - - ir
88.6 88.6
DRAINFIELD ROCK
85.2 84.6 85.2
50'
79.3 GROUNDWATER 6/5/19
72.8
II-
NOTE: DEPTH OF TRENCH WAS VERIFIED BY INSPECTIONS. MONITORING 4,..\\\‘‘
TUBES WERE PULLED UP DURING CONSTRUCTION AND DO NOT REFLECT FULL ''''' .9-tq
!4(, �\,'
TRENCH DEPTH. g•it.• _�'•!f,,I+,
0*: 111 49 i' •.* �
PROFILE AS-BUILT • Benja n Schiller
0 ��o .. CE 12592
GE +1 •. 7_25-19... i
P (NO SCALE) ‘i cvpRO8 4
Municipality of Anchorage
P.O. Box 196650 • 4700 Elmore Road
Anchorage, Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997
http://www.muni.orq/Onsite
Development Services Division
On-Site Water and Wastewater Program
**** VARIANCE/WAIVER REVIEW ****
Waiver#: OSV191072 COSA#: Permit#: OSP191029
PID#: 017-151-11
Legal Description: Palaterra Blk 3
Engineer: Forge engineering
Your request for a waiver of the required horizontal separation from the absorption field to the
decommissioned crib has been approved. The approved separation distance is 5.0 feet.
This waiver approval applies to the existing absorption field only. Any future upgrade to the on-
site wastewater disposal system will require all separation distances be met or another approval
from this department.
Waiver is Granted: X Waiver is not Granted:
Date: Approved by:
Name of Reviewer
**** VARIANCE/WAIVER REVIEW ****
•
GE
' ENGINEERING
PO BOX 240773
ANCHORAGE,AK 99524
522-7773 677-7766(FAX)
August 14, 2019
MOA Development Services Department
On-Site Water& Wastewater Program
4700 Elmore Rd
Anchorage,AK 99507
Subject: Palaterra, Block 3—7200 DeArmoun Road
Absorption Trench to Demolished Absorption Crib
Dear On-Site Services Engineer:
The new absorption trench was placed approximately 5' from the edge of the old Absorption Crib
on the subject lot. Prior to placement of the new trench the old crib was pumped dry, crushed,
backfilled in lifts and compacted with sandy in situ material. The area of the old absorption pit
and underlying soils are now at or near original undisturbed condition. The pit consisted of 4'
diameter perforated concrete rings with a 5' collar of silty gravel material. This material is similar
to in situ material with slightly less silt and more gravel and was probably mined from another
location on the lot. No drain field rock was found at or near the pit.
Underlying soils on the lot are primarily sand with varying amounts of gravel and silt based on
test holes recently completed. Absorption rates are typically under 5 minutes per inch. Very little
horizontal migration of effluent is expected and absorption should be in a downward direction.
Excavation on the lot indicated little or no migration from the existing absorption pit had occurred.
We request a waiver be issued allowing the proposed and alternate absorption trenches to remain
at the location shown.
Sincerely,
Michael E. Anderson, P.E. o''"'waOF 1414 u
IS47
49th it* 1,
__ �/
S/y/�9 MICHAEL E. AND RSON�
zt at
000 c56 •S,' No.8/14/198I c '•_•
o�tJ1d1I o7?
SGS Ref.# 1193207001
Client Name Forge Engineering Inc. Printed Date/Time 06/21/2019 11:20
Project Name/# Palaterra B3 Collected Date/Time 06/19/2019 13:56
Client Sample ID Palaterra B3 Received Date/Time 06/19/2019 15:05
Matrix Drinking Water Technical Director Stephen C.Ede
Sample Remarks:
Allowable Prep Analysis
Parameter Results LOQ Units Method Container ID Limits Date Date Init
Waters Department
Nitrate-N 4.92 0.200 mg/L SM2I 4500NO3-F A (<10) 06/19/19 EWW
ti
< Key (1
2of5
PLAT NO. 67-124
PALATERRA SUBDIVISION
BLOCK 3
46.385 S.F.
DE ARMOUN ROAD
b
In
N 89°56'00"E 165.08'
1 ,
A.C. PAVING
Ql
O
N WELL .via,
. 4
EXISTING BUILDING 40.9'
51.6' ft
I
• �G�
h
31,3'
5 eo vi
51.5' )� o. `0 4.2' 1.8
•
cq-
�o
b 0 e- ti�
gq 1.8'
N J a o
0 28.8' ,i
3 • 3 ,o,•S • A.C. BELOW l A.C. PAVING
O s iNs
0in
�C b Y
o SEPTIC SYSTEM c w
O O O
O U O a
Z 2 • Z ao
•
0-.-I M
Y
Q. O w
Q0
O W 04 a
a w
Q —, a
D a
a
t D
4.8' - 8.8'
Upp£6 )�30 /
¢<owf CfOKs
BUILDING DETAIL
SCALE: 1"=20'
•
N 89°56'15"E 165.05'
0
REVISED 7/26/2019 ADDED NEW SEPTIC SYSTEM. 1 " -401 401
AS - B U I L T I HEREBY CERTIFY THAT I HAVE SURVEYED THE
PROPERTY DEPICTED ABOVE AND THAT NO
GASTALDI LAND ENCROACHMENTS EXIST EXCEPT AS INDICATED. *1111
SURVEYING. LLC IT IS THE RESPONSIBILITY OF THE OWNER TO ♦♦ OF q� 1.
JEFF A. GASTALDI. R.L.S. DETERMINE THE EXISTENCE OF ANY EASEMENTS, ♦ P .••� •••.QS .j
2000 E. DOWLING RD.. SUITE 8 COVENANTS OR RESTRICTIONS WHICH DO NOT i C O: :9••
ANCHORAGE. ALASKA 99507 APPEAR ON THE RECORDED SUBDIVISION PLAT. •,*: 49TH ... * .,
%
PHONE 248-5454 UNDER NO CIRCUMSTANCES SHOULD ANY DATA •21- 7.• ;9;"c"tG411:
GRID DATE HEREON BE USED FOR CONSTRUCTION OR FOR I , :
c''""r'. MUNICIPALITY OF ANCHORAGE
:1:„- �� On-Site Water 8�Wastewater Program �on ' t : ;:
I .
PO Box 196650 4700 Elmore Road
Anchorage,Alaska 99519 6650 Phone:(907)343 7904 Fax:(907)343 7997
r.
i;:::: '
http//www.muni.orglonsite '1 cprMient
,NC
On-Site Water & Wastewater System Permit
Permit Number: OSP191029 Effective Date: 4/24/2019
Work Type: WellSeptic Initial Expiration Date: 4/23/2020
Tax Code Number: 01715111000
Site Legal Address: PALATERRA BLK 3 G:2939
Site Mailing Address: 7200 DE ARMOUN RD, Anchorage
Owner: TORR SONS LLC Lot Size in Sq Ft: 46392
Design Engineer: FORGE ENGINEERING Total Bedrooms: 4
This permit is for the construction of:
El Disposal Field El Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 Water Storage
All construction shall be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72)and Drinking Water Regulations (18AAC80)
3. The wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
Special Provisions: **Well is undocumented. For the COSA, if nitrates are over 5 mg/L then camera the
casing to confirm no perforations..
Received By: (.21/gitie� Date: 4/2-[llq
Issued By: A.,/,‘"-1/arr Date: -1/z(/i C(
MUNICIPALITY OF ANCHO ' GE
56 � � 9 �0
• ,biiiiniii.7?
Community Development Department '- �� •
Development Services Division '?hone`17-343-7904
a1 4 ?Tip: s.
FEBFE ty -343-7997
On-Site Water & Wastewater Program .
ti
ON-SITE SEWER/WELL PERMIT AP', ° • ► h4'
�/ 6 � g5
Parcel I.D. 017-151-11
Property owner(s) Torr Family Trust/Sam & Mary DePalatis Day phone 242-4100
Mailing address 12930 Summer Circle, Anchorage, AK 99516
Site address 7200 De Armoun Road
Legal description (Sub'd., Block & Lot) Palaterra, Block 3
Legal description (Township, Range & Section)
Lot Size 46,392 Sq. Ft. Number of Bedrooms 4
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(® all that apply)
Absorption Field X Initial Single Family (SF) I XI
X� (w/wo ADU)
Septic Tank [XJ Upgrade I IDuplex (D)
Holding Tank ❑ Renewal ❑ Multiple Dwellings H
Privy ❑ (SF and/or D)
Private Well n
Water Storage
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable� Municipal Codes.
,...04_ k --t-1
(Signature of property owner or authorized agent)
Permit/Rush Fees: R Waiver Fees:
Date of Payment: 0211 6119 Date of Payment:
Receipt Number: 6fi$aq-b Receipt Number:
Permit No. OSP/C/169 OSP/C/169Waiver No.
Permit App_:-: ::....c:,
PO BOX 240773
ANCHORAGE, AK 99524
522.7773
~ • GE 677-7766 (FAX)
' ENGINEERING FORGECIVIL.COM
April 22, 2019
MOA Development Services, On-Site Water& Wastewater Program
4700 Elmore Rd
Anchorage, AK 99507
Subject: Palaterra,Block 3 — 7200 DeArmoun Road
Septic System Design (OSP191029)
Dear On-Site Services Engineer:
The owner of the subject lot has decided to abandon the existing septic system on the lot and
construct a new system to serve the four-bedroom home. The existing septic tank will be
decommissioned in accordance with Municipal Code. We are submitting this permit application
for the existing well and to construct the new septic system. The attached site plan identifies the
location of the home and the existing well and septic systems along with the proposed septic
location and alternate site. No conflicts exist between this proposed system and any other well or
septic system on this lot or adjacent lots.
The ground surface on the lot slopes gently to the south at grades approximating 10%. There are
no slopes greater than 25% within 50 feet downslope of either the primary or alternate site.
Topographic contours are shown on the site plan indicating the grade and direction of flow.
Stormwater drainage will not impact this septic system. The new trenches will be constructed
parallel to the slope as much as possible.
Wells on this and adjacent lots are shown. The new system will be a minimum of 100' from all
wells and surface water, and more than 5' away from the septic tank.
Please refer to the attached test hole logs, soils lab analysis, plan and profile pages for the septic
design. If this design is followed, there will be no adverse impacts to adjacent properties.
Sincerely. .40.n.
-14 4." - 04,-(-9----1 •
Michael E. Anderson, PE 49th� %�
MICHAEL E. ANDERSON
1 kJ at
�.c� NO. CE-4381
vr
sT�!. .'mss 1
•♦x.44 pR;ESwogs.*
��� •+
PALATERRA BLOCK 3 co �"I
41
k �
DE ARMOUN ROAD �
E�ISTING WELL
III
ADJA N4 LOT WELL I \
\ / _4-BDR M H E
\ DECO M SSION
EXISgI SEPTIC
100' WELL RAQII CO TANK R MOA CODE
�� REMOVE EXTING
j\ MANrLE & P
P�C USH AND 4O 1,250 GALLON
BACKF�IJ� XE (STING1 SEPTIC TANK
SE P E PIT V2
-2c0—
�_ CO LOT 1
CO N1T
BLOCK DEVELOPED
5 ONG x 5' IDE x 4' TH1
FECTIV DEPTH`
PUMP, CRUSH AND
\ ABSORP IREIVCH
BACKFILL EXISTING
ADJACENT LOT SEP9aa�SEEPAGE PIT
T
SYSTEM IS >100' FROM
PROPERTY LINE
AL ATE SITE
- - y - B -G&K 3
I -----------
BLOCK
I
I
ENGINEERING
NOTE:
�` OF \�l NO SLOPES >25% WITHIN 50' OR SURFACE WATER WITHIN 100' OF THE LEGEND
PROPOSED SEPTIC SYSTEM CO - CLEANOUT
j * . TM *+�/ 2CO - DOUBLE CLEANOUT
ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS FCO - FOUNDATION CLEANOUT,
. y✓L �r�:: 9 j PROPERTY ARE SHOWN. NO CONFLICTS WITH WELLS OR SEPTIC DV - DIVERTER VALVE
'. Michael E. Anderson : / SYSTEMS. MH - MANHOLE
��F��s•. 4831-E���� 0 50 100 MT - MONITORING TUBE
(�IlF�PROFES510NP���r FEET SV -SEPTIC VENT
l�\o �SoO' I"=50' TH - TEST HOLE
PALATERRA, BLOCK 3 Co -=/x1
DESIGN FACTORS: SYSTEM REQUIREMENTS:
600 GPD PEAK FLOW 5' WIDE ABSORPTION TRENCH SYSTEM
PERK RATE: 1-5 MIN/IN 1,250 -GAL SEPTIC TANK
APPLICATION RATE: 1.2 GPD/SF
600 GPD / 1.2 GPD/SF / 5' WIDE *.5 RED. FACTOR = 50 LF TRENCH REQUIRED (50 LF SPECIFIED)
BOTTOM OF TRENCH: 7' BELOW GRADE
FLOW LINE ELEVATION: 3' BELOW GRADE
TOP OF TRENCH: .5'ABOVE GRADE
5
TYPICAL TRENCH SECTION
(NO SCALE)
RATED PVC
)OWN)
FIELD ROCK
� sll
•aj.•9 RL
y��
......................
'. Michael E. Anderson
I,�'cG •. 4831-E .••c`�i
�1`F�PROFESSIONP��
SOILS LOG AND PERCOLATION TEST
LEGAL DESCRIPTION: 7200 DEARMOUN RD
PERFORMED FOR: TORR FAMILY TRUST
DATE: 9/07/18 PROJECT No.:
PARCEL ID#: 017-151-11 TECHNICIAN: J. MILLETTE
DEPTH DUG ON 9/7/18 TEST HOLE 1
(feet)
8
9
10
11
12
13
14
15
16
17
18
19
911
I:•
BOH
COMMENTS:
GM (SANDY SILTY GRAVEL)
SLOPE
WAS GROUND WATER ENCOUNTERED? NO
SI I E PLAN
SEE SITE PLAN
x
IF YES n WHAT DEPTH? -
L
GROSS TIME
(MINUTES)
DEPTH OF WATER AFTER MONITORING: 12'
DEPTH To
WATER
(INCHES)
NET DROP
(INCHES)
DATE OF MONITORING: 6/5/19
P
1' OB
1
E
10
4/816
2
2
11:52/12:02
10
4/8LO4
;.
3
12:03/12:13
10
4/816
3
4
12:14/12:24
4
4/86
46
5
12:15/12:35
10
4/816
5
ter: •.
12:36/12:46
10
4/816
416
7
8
9
10
11
12
13
14
15
16
17
18
19
911
I:•
BOH
COMMENTS:
GM (SANDY SILTY GRAVEL)
SLOPE
WAS GROUND WATER ENCOUNTERED? NO
SI I E PLAN
SEE SITE PLAN
x
IF YES n WHAT DEPTH? -
L
GROSS TIME
(MINUTES)
DEPTH OF WATER AFTER MONITORING: 12'
DEPTH To
WATER
(INCHES)
NET DROP
(INCHES)
DATE OF MONITORING: 6/5/19
P
1
E
10
4/816
410-
16
DATE
READING
GROSS TIME
(MINUTES)
NET TIME
(MINUTES)
DEPTH To
WATER
(INCHES)
NET DROP
(INCHES)
2/21
TEST HOLE PRESOAKED PRIOR TO TESTING:
1
11:41 /11:51
10
4/816
410-
16
2
11:52/12:02
10
4/8LO4
LO
16
3
12:03/12:13
10
4/816
46
4
12:14/12:24
10
4/86
46
5
12:15/12:35
10
4/816
416
6
12:36/12:46
10
4/816
416
PERCOLATION RATE: 2.3 (MIN/INCH) PERC. HOLE DIA. --§---(INCHES)
TEST RUN BETWEEN: 2 FT. and 3 FT.
PLAT NO. 67- 124
PALATERRA SUBDIVISION
BLOCK 3
46,385 S.F.
DE ARMOUN ROAD
b
in
N 89°56'00"E 165.08'
A.C. PAVING
01
O
n
WELL �`01%I�
EXISTING BUILDING
40.9'
+ 51.6' I Oat
IiiI
(c . .
51.5' o� M 31.3' -
e
o a.2' 1.8'
r j. Qk.,' 90. .�
•
O a�`� O1 s
SEPTIC SYSTEM O 1* A11
� h
.3<21.8'
CNIN
A o
O 3 '0, 28.8'
O x `N �� A.C. BELOW A•C. PAVING
O Q _ Y
O sr
�. ° U
0
O o
z0 2 O .
Q • Z - O
Q TEST
, v
HOLE o 0
NI:
Q a a
a w
a.
a
7
4.8' � 8.8'
UpofR /
&/ ,/
R aF
ckS
BUILDING DETAIL
SCALE: 1"=20'
N 89°56'15"E 165.05'
1 „ _ 40'
AS - B U I L T I HEREBY CERTIFY THAT I HAVE SURVEYED THE
GASTALDI LAND PROPERTY DEPICTED ABOVE AND THAT NO
SURVEYING, LLC ENCROACHMENTS EXIST EXCEPT AS INDICATED. lois 11■It
IT IS THE RESPONSIBILITY OF THE OWNER TO ��4 OF A ••
JEFF A. GASTALDI, R.L.S. DETERMINE THE EXISTENCE OF ANY EASEMENTS, ,`p .••'''..'''••.'9
2000 E. DOWLING RD., SUITE 8 COVENANTS OR RESTRICTIONS WHICH DO NOT ••Co : • ')\ :sem •��
ANCHORAGE, ALASKA 99507 APPEAR ON THE RECORDED SUBDIVISION PLAT. a• *: 49T—" �� '
PHONE 248-5454
UNDER NO CIRCUMSTANCES SHOULD ANY DATA ••.r •• • A; ''d' /
GRID DATE HEREON BE USED FOR CONSTRUCTION OR FOR / '�
ESTABLISHING BOUNDARY OR FENCE LINES. 4"--,,..
di co • Jeffery A. Goslal•.
SW2939 10/11/2018 LS-6091 : i
vl s- •. 10/11/2018 : �,
ANCHORAGE RECORDING DISTRICT, ALASKA . Pap•.........•'� c°`
F.B. JOB NO. . r0fessionol\-o��4�
18-03 PSBLOCK3 NOTE : NO CORNERS SET THIS DATE ��,,",.*
11/20/£3 10:37~ A~CHOR~GE ~ELL ~. PU~P 1~07~43~742 p. C2
Pump Installation Log
~reel Id~ntlficatloa N amb~r ~ .~_ .....
Pinup ImstMlation Pat~: .., / /
Pump Intake Depth Be ~ w Top ~f W~tl Casl~g:~,.>~ leer
Pump Mat ufacturor's Name:
Pump Model: ~_> /
Pm~lp Size ,.~1 hp
Pttless Adapter Bttrint l)ep~h: ...~ feet
:'ideas Adapter Installer:
Method ol'Di~in f~cltoa:
Jll~.lalt,2r Name:
Anchorage Pump & Well Servide
~30 F_ast ?6th AYenue
Anchorage, Alaska 99518
Phone: 907-243-0740
Fax: 90?-24343742