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1~ ~ <br />' ~0~~\ COCNpY` <br />o` 'per <br />s. <br />Y <br />175 7 <br />Page 1 of l0 <br />Owner Name: <br />Owner Name2: <br />Owner Address: <br />County OfLoudoun <br />Division of Environmental Health <br />Leesburg, Virginia 10177 <br />(703) 777-0234 Metro (703) 478-8408 Fax (703) 771-5023 <br />Automated Inspection Request (703) 771-5331 <br />WELVIINATER Permit # 740187410008 <br />ROCK SPRINGS PROPERTIES LLC <br />%ARTHUR B ALPHIN <br />700 N HEREFORD LN <br />MADISON IN47250 <br />~ Applicant Name: ROCK SPRINGS PROPERTIES LLC <br />Applicant Name2 <br />Applicant Address: P.O. BOX 3126 <br />LEESBURG VA 20177 <br />~ Home Phone: 540-668-6460 <br />Work Phone: 703-787-8979 <br />Subdivision: <br />Lot: <br />BIdB/Floor/Unit: PROPOSED LOT 2 {2 iCS <br />r~~'yJ L~ 1 2G04 <br /> <br />Permit Active Date: 2004-09-29 <br />Pin #: 283152408000 <br />Tax Map #: /90////////36C <br />- Construction Purpose : NEW CONSTRUCTION <br />Permit Purp: WATER FTW <br />Structure Type: RESIDENTIAL SGL FMLY DETACHED <br />Site ID <br />New ~ Repair ~ Abandonment <br />Based on the application for swell/water su^ I s stemacons^truction permit filed n accordance with Chapter 1040. Codified <br />Ordinances, a construction permit is issuedto yROCK SPRINGS PROPERTIES LLC <br />DESIGN i <br />Water <br />To be installed: class IIIB <br />Cased and Grouted to Bedrock plus 10' or a minimum <br />cased TO' Grouted 70' whichever is eater <br />Well Location. See Page ~t <br />I. If well yield as determined by 30 minute airlift best is less <br />than 5 gallons per minute, a pumping test must be performed <br />as follows: <br />A. Pump and related equipment shall be installed and the static <br />water level measured. <br />B. Pumping shall begin at a rate of withdrawal greater than 5 <br />GPM until water level drops to a point close to bottom of the <br />well. <br />C. At this point, the pump rate shall be adjusted so the water <br />level remains constant. <br />D. Measure and record the volume of water discharge and <br />water level (electric tape) at 15 minute intervals throughout <br />the test. <br />E. Discharge water at least 50 feet from the well and sewage <br />disposal area. <br />F. Interruption of pumping longer than 15 minutes shall require <br />extending the pumping time that amount of time. <br />The well/water system is to be constructed as specified by <br />by the permit I,X[or attached plans and specifications ^ . <br />This water system construction permit is null and void if <br />(a) conditions are changed from those shown on the <br />application (b) conditions are changed from those shown <br />on the construction permit. <br />NOTE: INSPECTION RESULTS <br />Water supply location: Satisfactory yes ^ no ^ <br />Drillers Report (G.W.2) Received yes ^ no ^ <br />Well Construction Approval yes ^ no ^ <br />Sanitarian Date <br />Well Driller Lic # <br />Pump Installer Lic # <br />Chemical Quality Data Received yes ^ no ^ N/A ^ <br />Pumping Data Received yes ^ no ^ N/A ^ <br />As built sketch on page <br />Bacteriological Sample Received yes ^ no ^ <br />Water System Approved yes ^ no ^ <br />Sanitarian Date <br />II. Criteria for approval of well and well yield are as follows: <br />The well must produce a: <br />A. Minimum of 1 gallon per minute for 6 continuous <br />pumping hours after the well has been pumped out <br />according to Part 1, Sec. B of this permit. <br />B. The pump test can be terminated early and well yield <br />considered adequate if: <br />1. The well cannot be pumped out as stated in Part 1, <br />Sec. B of this permit. <br />2. The well yields 2.5 GPM or greater for 3 hours of <br />continuous pumping after Part 1, Sec.6 of this <br />permit are completed. <br />C. Sufficient storage and yield may be considered for <br />approval. <br />D. Person conducting the pump test shall collect a sample <br />to be analyzed for constituents described in Codified <br />Ordinances of Loudoun County Title 4, Chapter 1040, <br />Appendix III. <br />E. Replacement wells are exempt from this requirement. <br />Date: 2 4- 9 2 Issued By: `'rif ,~jv ~- <br />This Construction <br />Date: (~ Q Reviewed By: ~ ~ Permit Valid Until <br />~ 2005-09-29 <br />