HomeMy WebLinkAboutHEMLOCK LT 1Onsite File
Hemlock
Lot 1
#075-031-25
Mark Begich
Mayor
Well Drilling Permit Number:
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 Elmore Road
P.O. Box 196650
Anchorage, AK 99507
www.muni.orq/onsite
(907) 343-7904
Pump Installation Log
SW
Parcel Identification Number:
Date of Issue:
Legal Description
Property Owner Name & Address:
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533 Ceeto c(ll w R>
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Pump Installation Date: c:1/43/14
Pump Intake Depth Below Top of Well Casing: —
Pump Manufacturer's Name: /'/> 5p Ctci C
Pump Model: 62.11 95'9—
Pump Size tfahp
Pitless Adapter Burial Depth:
feet ToeoP
feet
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Pitless Adapter Manufacturer's Name:
Pitless Adapter Installer:
Well Disinfected Upon Completion? es ❑ No
Method of Disinfection:
Comments:
Pump Installer Name: A W V" rc
Attention: The pump installer shall provide a pump installati'Sn log to the DSD within 30 days of pump installation.