HomeMy WebLinkAboutBELLA VISTA #1 LT 20Bella Vista #1
Lot 20
#013-051-19
bevelepment Services Department �t-j "51 lot�
acmeBuilding Scfety Division O
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On -Site Water A Wastewater Program
4700 Bragaw Street
P.O. Sax 19665050
Ma/ic Ee;ich
Anchorage, AK 99519-6650
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1907-j 343-7904 -
Pump Installation Log
Well DrMine Permit Number. SW_ Date of Issue: PJ5-
U%
parcel Identification Number._
Leal Description Property Owner Name & Addrns:
jt'WArJ JACoAe,-
fjeIloA V�5ta #� LZO 4,yy rAsf•. //.
Pump Installation Date:
pump Intake Depth Below Top of Wen Casing. Jap feet
pump Manufacturer's Name: j esl jAek:agk
pump Model: 14 311 eWS/2VD
Pump Size BIZ hp
Pitless Adapter Burial Depth: % feet
Pitless Adapter Maaafacturer's Name: P;P ak• 14—
Pitless Adapt;r Installer: ✓SKU£ l , .4 ej' eel.40?5
Nell Disinfected Upon Comole,oa: 'yes M No
Nlechod of Dsinfection: dAf6ev W ?eff�a
Cornmeal:
WIII .s /SO
Pump Installer Naiae:
A
Attention: The pump installer shall provide a pump icrallatiau log to the DSD wits 30 days of ;L --p irstallatiom-