HomeMy WebLinkAboutLot 08Mark Begich Mayor Buildin9 5afe?y Division On-Site Woter & W~stewotcr Program 4700 Brogow StraeT P.O. Box ~96650 A~%ho,'~ge, AF: 9951.9-6650 (907) 34.%7904 Pump Installation Log Well Drilling Permit Number: SW Date of Issue: Parcel Identification Number: Legal Description kc4'/:o Pump Intake Depth Below Top of Well Casing: Pump Manufacturer's Name: ~ iv~.~J~s('l~$~ I } Property Owner Name & Address: I 10330 n~,t e.o . feet Pump Size ~/~hp PitlessAdapter BurialDepth: ]~ feet Pitless Adapter Manufacturer's Name: Pitless Adapter Installer:.~/' Well Disinfected Upon Completion? [~Yes [~ No Method of Disinfection: Comments: Pump Installer Name: Anchorage Pump & Well Ser¢i~e 330 East 76th Avenue Anchorage, Alaska 99518 Phone: 907-243-0740 Fax: 907-243-0742 Attention: The pump installer shall provide apump installation log to the DSD within 30 days of pinup installation.