HomeMy WebLinkAboutPARKWAY ESTATES BLK 4 LT 6Parkway Estates
Block 4
Lot 6
#014-121-14
,/
Mark Begich
Mayor
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program
4700 Elmore Road
P.O. Box 196650
Anchorage, AK 99507
www,mu~i.org/on$ite
(907) 343-7904
Well Drilling Permit Number: SW
Parcel Identification Number:
Pump Installation Log
Date of Issue:
Legal Description
Proper tY Owner N~lm¢ ~Addre,st~q~%/r-o~'e~'
II rFo p ¢
II
Pump Installation Date: /~" I''/"
Pump Intake Depth Below Top of Well Casing: ~ feet
Pump Manufacturer's Name: ~ y risc D orite
PumpModel: ~30 ~"OVr~! ~
Pump Size V~t..hp
Pitless Adapter Burial Depth: /O feet
Pitless Adapter Manufacturer's Name: /
Pitless Adapter Installer: ~ ~t'
Well Disinfected Upon Completion? ~Yes []
Method of Disinfection:
comments:
No
Pump lnstaller Name: /<~ChOel~q~.. t~/~,ll <~~*q'l~O 51~l(,t/l~'
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation,