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Well/Water System Construction Permit Page -/-- Of <br />Loudoun County, Virginia ,. .� Health Department 146 FPI 96 <br />Division of Environmental Health Identification Number <br />777 -0234 Metro 478 -8408 Map Reference ®IRREPPRP <br />General Information <br />New Repair ❑ El Upgrade Well ID.# <br />Based the application for a well /water supply system construction permit filed in accordance with Chapter 1040, Codified <br />Ordinances, a construction permit is hereby issued to: <br />301 -986 -7260 <br />Owner BONDY WAY DEVELOPMENT CORP . Telephons <br />0 <br />Address8401 CONNECTICUT AVE, CHEVY CrIASE, Y.U. <br />For a well /water system which is to be constructed on /at MELT AT Lkl%T~S TfiTATM C'TTTB Or1 LOGrES IS= BL <br />CALL JIM MC CAP.ROt1 FOR DIRECTIONS <br />Subdivision Section /Block Lot 4 <br />DESIGN <br />NOTE: INSPECTION RESULTS <br />Water supply, existing: (describe) <br />Water supply location: Satisfactory yes %n ❑ <br />To be installed: class <br />Drillers Report (G.W.2) Received yes O ❑ <br />Cased and Grouted to Bedrock plys 10' or a minimum <br />5 6� <br />Well Construction Approval yes no ❑ <br />��Gt/ <br />cased _ ��D Grouted - whichever is greater <br />Sanitarian < Date <br />Well Location See Page Z 3 <br />Well Driller Lic 8 <br />Pump Installer Lic # <br />I. If w II yield as determined by 30 minute airlift test is less <br />Chemical Quality Data Received yes ❑ no ❑ N/A ❑ <br />than 5 Ilons per minute, a pumping test must be performed <br />Pumping Data Received yes ❑ no ❑ N/A ❑ <br />as follow <br />As built sketch on page <br />A. Pump a related equipment shall be installed and <br />Bacterialogical Sample Receiv d yes ❑ no ❑ <br />the static ter level meas re . <br />Water System Approved yes ❑ no ❑ <br />B. Pumping sh I begin at a rat ithdrawal greater <br />Sanitarian Date <br />II C iteria for approval of well and well yield are as <br />than 5 GPM u it wat e e s to a point close <br />to bottom of the ell. <br />folio <br />C. At this point, the u rate shall be adjusted so <br />ins <br />The w I must produce a: <br />the water level rem constant. <br />D. Measure and record a volume of water discharge <br />A. Minim of 1 gallon per minute for 6 continuous <br />and water level (electri tape) at 15 minute intervals <br />pumpin hours after the well has been pumped <br />throughout the test. <br />E. Discharge water at least feet from the well and <br />out accor ' g to Part I, Sec. B of this permit <br />B. The pump t st can be t r irIed early and well <br />sewage disposal area. <br />Yield conside d adequa f <br />F. Interruption of pumping Ion er than 15 minutes <br />1. The well ca not u ped out as stated in <br />shall require extending the pumping time that <br />Part I B of thi r it. <br />amount of time. <br />2. The Well yield .5 gpm or greater for 3 hours <br />of continuous p ping after Part I B of this <br />permit is complete . <br />The well /water system is to be constructed as specified <br />C. Sufficient storage and 'eld may be considered for <br />by the permit` or attached plans and specifications ❑. <br />approval. <br />D. Person conducting the p p test shall collect a <br />This water system construction permit is null and void if <br />sample to be analyzed for onstituents described <br />(a) conditions are changed from those shown on the <br />in Codified Ordinances of L udoun County Title <br />application (b) conditions are changed from those shown <br />4, Chapter 1040, Appendix III. <br />on the construction permit. <br />E. Replacement wells are a mpt from this <br />requi ement. <br />7 <br />Date: / _ �� Issued by: <br />This Construction <br />s#"'ta"a <br />Permit Valid until <br />Date: I L Reviewed by: f'�"' <br />l�- — j �J % <br />soemwy sanitarian <br />Original / Health Depa0ent Copy / Applicants Copy <br />ED <br />Sv' <br />6rl)J; 1 <br />