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Home My WebLink AboutCHARLES SMITH #2 BLK 1 LT 5Mark Begich Mayor Development ~ervices Deportment Building $(ffety Division O~-Site W~er & W~s~ew~ter Program 4700 Elmor~ Rood P.O. Box 196650 Anchorage, AK 99507 ~.muni.org/o ~ife (~07) ~42-7904 Well Drilllng~Permit Number: SW Pump Installation Log Date of Issue: Parcel Identification Number: Legal Description Pump Installation Date: ~--/~/~.__ ~ump Intake Depth Below Top or.eli C~ias: ~l feet Pump Manufacturer's N.me: ~ ~~~ Pump Model: ~ ~ Pump Size ~p Pitless AdapterBurlal Depth: ~eet ~ o~ c~ Pitless Adapter Manufacturer's Name: ~ Well Disinfecte~ Upon Completion'? ~ Yes ~ No Method ofDisint~ction: ~~ ~ Property Owner Name & Address: Ar,. clq$o$ Comments: Pump Installer Name: ^ncnorage weii& rump u 330 East 76th Avenue Anchorage, AK 99518 Phone: 907-243-0740 Fax: 907-243-0742 Attention: ~'e pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.