HomeMy WebLinkAboutROSEWOOD PARK ESTATES BLK 3 LT 5 ROSEWOOD PARKDevelopment Services Department
Building Safety Division
G� &L
On -Site Water & Wastewater Program
4700 Elmore Road
P.O. Box 196650
Mark Be9 ich Anchorage, AK 99507
Mayor www.muni.org/onsite
(907) 343-7904
Pump Installation Log
Well Drilling Permit Number: SW Date of Issue:
Parcel Identification Number: 01 y -13 5- 05
Legal Description Property Owner Name & Address:
R�se�oo� � k E's4-a- g3 > 5 RosEwco6 PAR -K
21120 � 7 Y F -b
Pump Installation Date: 3-1-11
Pump Intake Depth Below Top of Well Casing: S Z feet
Pump Manufacturer's Name:
Pump Model: I ( V
Pump Size 3 hp
Pitless Adapter Burial Depth: 0 feet
Pitless Adapter Manufacturer's Name: 1110,
Pitless Adapter Installer: IA4_
Well Disinfected Upon Completion? �esOo
Method of Disinfection:
Comments:
Pump Installer Name: *P)#ey AA a,A�')
ANCHORAGE WELL & PUMP SERV.
330 EAST 76TH AVENUE
ANCHORAGE, AK 99518
PHONE: 907-243-0740
AWPS.COM
Attention: The punp installer shall provide a pump installation log to the DSD within 30 days of pump installation.