HomeMy WebLinkAboutMAGNIFICENT MT SLOPES Block 8 Lot 2
COCATION OF .WELl. (Pissed complete either ta, lb or lc,)
OlBTANOEAND DIRECTION FROM ROAD
NTERSECTIONS
% Streol Addres~ end Area of Well Eocotion
MUNICIPALITY OF
· ,, , DEPT, OF HE~
........................... RECEI
I$,?WATER WELL CONTRACTOR'8 CERTIFICATION:
Feet Below
Surfuce
WATER WELL RECORD
STATE OF ALASKA
DEPARTMENT OF NA~URAL RESOURES
Division of Geological [~ Geophysi¢ol Surveys
Drilling Permit No.
A. D~L. No,
Section No. TownehlPNL--~ Rcnga EEl Meridian
sL-J wE]
~. OWNER OF WELL:
Top Bottom
NCHORAGE
4 WELL DEPTII: (final) 5.
/
Y_" . 75 '" - '~'"'/
S. [DC°hie fO01 ~'~otary []Drivan [] Dug
CJ Auge~ ~a,,~d [] Bo~ad ~ O,har;
7. USE: [] Bomeetlc [] Public Supply [] laduslry
[] Irrigation [] Recharge [] Commorlaol
~'~ Test Wall ~ Other;
8. CASING: [~ Threudod [] Welded
7
dlam._~r'~'___ln, to.~__.' fl. Oepth Weight lbs./ft
f
9. FINISH OF WELL:
S,o,/~ae~ S,,a: '~'" L..¢,,: / ;~ ¢ "- 1¢5'
Set between / ~)" ft. and ~' ff.
8ackflllln~ Gravel pack
,o. STAT,C WATER 'EVEL,
[] Above or [] Below land surface Oata
Equipment
Il, PUMPINO LEVEl. below land surface and YIELD
_____fl. uftor____hrs, pumping _ ~l.p,m,
I2.GROUTING Well Grouted: [] Yo~ [] No
Material: [] Neat Cement [] Other:
PUMP: (it available) tiP
Length of Drop Pipe ff. capooily g.p,m.
[] Subrn. [] Jot [] Cen/rifleal [~ Other
I4. REMARKS:
[DF []c
' T!li~rwe.(l was del;lied' fi~dq? .~y-jur[~dlGllon and this report is true to lhe bee o my know edge and be ef
Form Off-WW~
HEMICAL & C )LOGICAL LABORATORIEs, OF ALASKA, INC.
TELEPHONE (907) 562-2343 ANCHORAGE INDUSTRIAL CENTER
5633 B Street
Drinking Water Analysis Report for Total Coliform Bacteria
/ TO BE COMPLETED BY WATER SUPPLIER
WATER SYSTEM: [ I I I I I ] (') See h on back
I,D, NO,
Water S~tem Name ~one
Mailing Address
City State
Mo. Day Year
SAMPLE TYPE:
E~ Routine
[]' Check Sample (for routine sample
with lab ref, no,
[] Special Purpose
Zip Code
[] Treated Water
[] Untreated Water
SAMPLE
NO. LOCATION__
,~ ,~-~ ~,.~ /~/i'~c el""
1 J .~,,,2~C .~,~ .'~':-'4
Time Collected
Collected By
TO BE COMPLETED BY LABORATORY
Analysis shows this Water SAMPLE to be:
J~ Satisfactory
[] Unsatisfactory
[] Sample too long in transit; sample should
not be over 30 hours old at examination to
indicate reliable results. Please send new
sample via special delivery mail.
Date Received
Time Received
Analytical Method:
W-/7-
[] Fermentation Tube
~ Membrane Filter
Lab Ref. No. Result* Analyst
I
L J
I C'I-I
* NO ol corome$/100 mi or NO. of Po$111ve porl,on$
06-1220 (b)
Re¥,1O63
BACTERIOLOGICAL WATER ANALYSIS RECORD
READ INSTRUCTIONS
BEFORE
COLLECTING SAMPLE
Membrane Filter;, Direct Count
Verification: LTB BGB
Final Membrane Filter Results" ~ ~1
/
Time:
TNTC = Too Numerous To Count
Collform/100ml
Collformll00ml
D.m.
0~(~6~-9Z)~