HomeMy WebLinkAboutUS SURVEY 3201 LT 7 T10N R1W SEC 10Development Services Department
Ey Building Safety Division �£ e
f On -Site Water & Wastewater Program o P
4700 Elmore Road
P.O. Box 196650 -
Mark Begich Anchorage, AK 99507 s n 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: 090 ` () Z1
Legal Description Property Owner Name & Address:
US, Svd U'z`i -326/ 0, 7 SGiZAAWC L X 0tJAJ L
Pump Installation Date: _�s =t, 3 1 S ONI K Soares 1 OAb
Pump Intake Depth Below Top of Well Casing: 6d feet t� R-0 C 2E�K
, A r 5 YO
IPump Manufacturer's Name: ed ,rC,%C,f
Pump Model: o- S 1'Z
I
Pump Size 2 hp
I Pitless Adapter Burial Depth: 9' feet
IPitless Adapter Manufacturer's Name: v L/�
IPitless Adapter Installer: 014
Well Disinfected Upon Completion? Rryes ❑ No
Method of Disinfection: / /� PZV-'�
Comments:
IPump Installer Name: •��� V
V-R_ ANCHORAGE WELL & PUMP SERV.
330 EAST 76TH AVENUE
,,,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.