HomeMy WebLinkAboutMICHELLE Lot 67 Well Decommissioning LogMunicipality of Anchorage
Community Development Department
On-Site Water and Wastewater Program '
4700 Efmore St.-• P.O. Box 196650 Anchorage, AK 99519.6650 • http://www.muni.orglonsite • (907) 3439904
Well Decommissioning Log
Legal Address:
Subdivision /k-CCtkd{I>✓ Biock -- Lot 47
T 13 if R 3 v1 Section 33 Lot 6 7 oat all '
Dn-site Water & YWas?ewater Program certifiedcontractorperforming the well decommissioning:
Name: Signature:
,.linCKK.
14,410 ii,/ CS
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Company: '
Pret''b&R'C taL44"0111? S[q( ICE
Well decommissioning date 3— /3 `!S Method of decommissioning AMC 15.55.060L1 a. El b. c. L i
location: Use the space below to provide a arguing of the property showing Inn, tOe owing items.
• North arrow
• Decommissioned weir.
• Otter water wells on the property.
Two separate swing-lie distances for each well shown on life drawing.
Note: The swing-tie distances shat; be measured from either permanent structures or the property comers.
E
Itt
W t.,u Sryg
1 — t Lo-i. st•se
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4
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E. 52J Ave,,
GACommunity Develep nentlbevetopment Sswipes \Bui!ding Satety!Uf