HomeMy WebLinkAboutALPINE VILLAGE BLK 2 LT 10.1V4 G7 -. IQ.•J,: C' +111l,I IVI My 1v CSI J( 7 U I I1FJ VVI vv :. it QV i `-F4 p..:�
Pump Installation Date:
Punip Intake Depth Relow Top of Well Casing. /�feet
Pump Manufacturer's Name.
Pump Model: Z
Pump Size `l:p
I ( FIs
Piiless Adapter Etari:al Depth--'* /feet
Pitlem Adapter Manufacturer's Name:
Pitless Adapter 'Installer: ,
Well Disinfected Upon cumpfeziou.2` 'ves ❑ Ne,
Method of Disbifection-
Camments: r
Nmp Installer I ume: rh j f
1 ` /
ftm
Attention: The pump install: stall p:o,ride a pump irt-SUl lation log to the DSD within 30 days of pump irstafl2ation.
R.r.y!.^;; n'!
P.O. 2,o:t 196650
,Vark Beyich
rrchc'ra e, r'NK 99501?
Mayor
s��:-v.ru;l c�cns tw
Pump Installation Log
Well Drilling Permit Number: � V4'�
_ Date of Issue:
Parcel Identification Number: ON- 132-2&
Legal DescriptionPropertl
--ii
Owner Name &Address,
2
L 10
z,
Pump Installation Date:
Punip Intake Depth Relow Top of Well Casing. /�feet
Pump Manufacturer's Name.
Pump Model: Z
Pump Size `l:p
I ( FIs
Piiless Adapter Etari:al Depth--'* /feet
Pitlem Adapter Manufacturer's Name:
Pitless Adapter 'Installer: ,
Well Disinfected Upon cumpfeziou.2` 'ves ❑ Ne,
Method of Disbifection-
Camments: r
Nmp Installer I ume: rh j f
1 ` /
ftm
Attention: The pump install: stall p:o,ride a pump irt-SUl lation log to the DSD within 30 days of pump irstafl2ation.