Airmont Meadows Subdivision - Hydrostudy - SKV-1

[~-F C 0 2 Z~ ,~'" --~ County O, f 'Loudoun ' Division of Environmental Health L b V' 20177 ees urg, irgtnia Office (703) 777-0234 Fax (703) 771-5023 Inspection Request (703) 771-5808 WELLNVATER Permit # 750258260001 Owner Name: DOUGHERTY, GAIL G ET ALS TRUST Permit Active Date: 2005-11-22 Owner Name2: % SCHNADER,HARRISON,SEGAL & LE Pin #: 614469655000 Owner Address: 1600 MARKET ST STE 3600 Tax Map #: /42////////93/ PHILADELPHIA PA19103 Construction Purpose: NEW CONSTRUCTION Applicant Name: DOUGHERTY, GAIL G ET ALS TRUST Permit Purp: WATER Fl'VV Applicant Name2: CJO EMERY & GARRETT Structure Type: STRUCTURE TYPE Applicant Address: P.O. BOX 1578 System Type : IIIB MEREDITH NH 03253 Home Phone: Work Phone: Ext Subdivision: Lot: ~~3 Page 1 of 5 DI~eCttOnS to property : Rt 7 W to Rt 719 5 then turn left onto Snickersville Turnpike property is about 0.8 miles on the left New X Repair _ Abandonment _ Upgrade _ Hydrofrack _ Well ID # ~ ~ -- Based on the application for swell/water supply system construction permit filed in accordance with Chapter 1040. Codified Ordinances, a construction permit is issued to: DOUGHERTY, GAIL G ET ALS TRUST DESIGN NOTE: INSPECTION RESULTS Water supply, existing: (describe) Water supply location: Satisfactory yes ^ no ^ To be installed: class IIIB Drillers Report (G.W.2) Received yes ^ no ^ Cased and Grouted to Bedrock plus 10' or a minimum Well Construction Approval yes ^ no ^ cased 60' Grouted 60' whichever is greater Sanitarian Date Well Location. See Page ~` 3 Well Driller Lic # Pump Installer Lic # 1. If well yield as determined by 30 minute airlift test is less Chemical Quality Data Received yes ^ no ^ N/A ^ than 5 gallons per minute, a pumping test must be performed pumping Data Received yes ^ no ^ N/A ^ as follows: As built sketch on page A. Pump and related equipment shall be installed and the static Bacteriological Sample Received yes ^ no ^ water level measured. Water System Approved yes ^ no ^ B. Pumping shall begin at a rate of withdrawal greater than 5 Sanitarian Date GPM until water level drops to a point close to bottom of the II. Criteria for approval of well and well yield are as follows: well. The well must produce a: C. At this point, the pump rate shall be adjusted so the water level remains constant. A. Minimum of 1 gallon per minute for 6 continuous D. Measure and record the volume of water discharge and pumping hours after the well has been pumped out water level (electric tape) at 15 minute intervals throughout according to Part 1, Sec. B of this permit. the test. B. The pump test can be terminated early and well yield E. Discharge water at least 50 feet from the well and sewage considered adequate if: disposal area. 1. The well cannot be pumped out as stated in Part 1, F. Interruption of pumping longer than 15 minutes shall require Sec. B of this permit. extending the pumping time that amount of time. 2. The well yields 2.5 GPM or greater for 3 hours of continuous pumping after Part 1, Sec.6 of this The well/water system is to be constructed as specified by the permit are completed. permit X and attached plans/specifications. _ C. Sufficient storage and yield may be considered for approval. null and void if (a) it i ti D. Person conducting the pump test shall collect a sample on perm s This water system construc conditions are changed from those shown on the application to be analyzed for constituents described in Codified (b) conditions are changed from those shown on the Ordinances of Loudoun County Title 4, Chapter 1040, comstruction permit. Appendix III. E. Replacement wells are exempt from this requirement. ~ Date: 2005-11-2 Issued By: ~ This Construction /~ Permit Valid Until ~ Date: 1 (~ Reviewed By: ~ 2006-11-22