HomeMy WebLinkAboutSHELL #1 LT 11Shell #1
Lot 11
#015-112-07
_ Lev.lopment Services_ Depart'rnem
Buiidinc Safety Division
On-Scite ' c.+v-•• 7 Wastewater Proyr'=n-t
4700' Bragew 5trezt
-0. Ga?. .90 00'.
Mark Sagich Anchoroae.Ar 99519-0050
Mayor w-mv.mun,. ora; onsite
(407)343-7404
Pump Installation Log
-67
Well Drilling Permit Number: SW_ Date of Issue: _ 61 5
Parcel Identification Number:
Legal Description
® 7— / I
Pump Installation Date: 6 - a; 0`1
1
Pump Intake Depth Below Top of Well Casing: g5%/feet
Pump Manufacturer's Name: q y tnC b6rl A L�
Pump Model: a 3o 75-V 34 3
Pump Size -TA hp
Pitless Adapter Burial Depth: /0 feet
Pitless Adapter Manufacturer's Name: —'
Pitless Adapter Installer:
Well Disinfected Upon Completion? 21yes ❑ No
Method of Disinfection: C'LOQlr7C
Comments:
Property Owner Name & Addre
�Rnl�ST�NF Rg��rr�y
/061cp,a -rA#o o4AEf r-4-
A0G{to4Ar10.1r4K C1RS67
A.Y. MWDONAoLDiMFG. CO.
23075V3L6
Date D13
7 GPM 3/4 HP code:
230 Volts 1 Phase
D
rl
4G J
Thstalled By: A W rrS
Attach this nameplate to pump control panel or other
equipment related to the pump in the well.
Anchorage Pump & Afell Service
Pump Installer Name: 330 East 76th Avenue
Anchorage, Alaska 99513
Phone: 907-243-0740
Pax: 907-243-0742
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.