HomeMy WebLinkAboutDAS ACRES LT 1ADevelopment Services Department
Building Safety Division
„'. On -Site Water & Wastewater Program o '
2 K'.
��r S 4700 Elmore Road '
Z 7-
P.O.
P.O. Box 196650 a
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: 01 5 - a7 1 - �°I
Legal Description
� 0.s Pro erty Owner Name & Address:
Pr cre s �- 1 � ��
3 e
tj
Pump Installation Date: Z/3/10
Pump Intake Depth Below Top of Well Casing:?((? feet
Pump Manufacturer's Name:
Pump Model: $57 1
Pump Size I hp
Pitless Adapter Burial Depth: feet
Pitless Adapter Manufacturer's Name: 6A -e` tom'
Pitless Adapter Installer:
Well Disinfected Upon Completion? Yes ❑ No
Method of Disinfection:
Comments:
x'0644i, ANCHORAGE WELL & PUMP SERV.
Pump Installer Name: 330 EAST 76T" 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.