HomeMy WebLinkAboutPARKER LT 7Development Services Department
Building Safety Division
On -Site Water & Wastewater Program a
4700 Elmore Road '
Z
P.O. Box 196650 "
Mark Begich Anchorage, AK 99507 s a E T Y
Mayor www.muni.org/onsite
(907)343-7904
Pump Installation Log
Well Drilling Permit Number: SW Date of Issue:
Parcel Identification Number: (909•- 03� Z ��
Legal Description Property Owner_ Ngme & Address:
1V r4
Pte'�er�' L o f 7 �g 3 G ��
Pump Installation Date: ?116,/1
Pump Intake Depth Below Top of Well Casing: So feet
Pump Manufacturer's Name:
Pump Model: & $ I ;?,
Pump Size �Z hp
Pitless Adapter Burial Depth: G feet
Pitless Adapter Manufacturer's Name: ']F�4KEF\
Pitless Adapter Installer: A v2�7 5
Well Disinfected Upon Completion?KYes ❑ No
Method of Disinfection:
Comments:
A7,,D r 5 -. "'"+s;., ANCHORAGE WELL & PUMP SERV.
Pump Installer Name: 330 EAST 76TH AVENUE
r ANCHORAGE, AK 99518
PHONE: 907-243-0740
AWPS.COM
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.