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HomeMy WebLinkAboutBuilding Miscellaneous 2001-11-6 11/UU/ZOOl lZ:17 YAX ~41 955 7199 SDU SPRINGFIELD IgJ002 . UNDEP,GROUNO INJECTION CONTROL. REGISTRATION Single.Family StoflT'lWate( Ois~h8rge & GeothenTIal Heating Systems ~ ~ ll'.lE OregoD Dep.rtment orEn~lronmenlAI Quality (see Ptl. 2 (or detaDed instructions) OEQ USIi: ON~ r kqtsnLicn.' file ,~ hf&i11D~2JII9' DOC Conr.; NOI-- WUS~ONLY I\c;ei...cd- DlND DOOM cUle: N....- \. LeSal Nam.: SOny Disc Manufacturing 3. FaciliryPhy.icaIAddrcss: 174 Oeadmond Ferry Rd. Springfield, OR 97477 City. State. Zip Cod.: S. Latimde:~degI<C' ~minule.1L.econds 6. FaciliryConlactNamc: Facilities Engineering ConI8OITelephOl)'#: Manager Fax II: 988-7499 988-7420 Ric.e House I" F.cilily M.Hing Address: 123 International Way Ciry. State. Zip Code: Springfield, OR 97477 LenSitude: 1 ~ deB'"'" 1 _ ",inute. 34 _ seconds 7. Re'ponsiole Offici.1 Name: Tom Costabile Addloss: 123 International Way City. Swe. Zip Codc; Springfield , OR 97477 B. FACILITY DESCRIPTION (ATTACH DOCur~Erns AS NEEDED) t. Lauduse1Al!lillsoffacitity; OlDdustrial Oc......~.~. OP..sidcrnia' K]Olh""ClllIltlUS Industrial 2. Orinking...lor SOUT<e: Monthly ayenge usare (aalJday): ~ b Publie water 0 _ Well 3. Deplll .. will.... high WIlier table: _ rea If DOl ayailable. .ver3&" dcplh to groundwa<<r: ~ r... 4. WIW olher m.....1O dispose oflhc water.... """Iaole to you? (e.g. city stormwater) No"e 5. Distance lo neareJ[ domestic/public W3.tm" well ~.........__.... 6. so....OrUU..tioD wat.r(ch..k one): QlI Roof 0 Pa_ed.... (dri~eway or ._,) 0 Shop/G.ruge OOrber 7. Well Type: o Geothermal Heat Districts or Building DtyWell o CIOJed Loop Hea' Pump Return - R.osidential U'e ll!I 5tonnwalCr (SUlOp. dlywell, roof drain) 8. Wen s..tus: 10 Acti-. 0 Under CODSUUetion Installation o.te: August 15. 2002 9. 10. Well Depth: 8 II Well Diameter 10 II.. Iryou ha1re mo..1banone well, pI.... explaiD here; o Floor Drain . o Specill Dralftase: Water o OtherWeUs o InactiveINo~ in use o Oc:commissioned (closed) ft 12. Li'Unyotlw:rDEQ or public '8= permits applied foT ori'SIlcd.. rhis racility: Building \,,,rmit 01-00536-01 sitQ dQvQlopmant, trGG felling>> land and drainagG alteration I hereby certify that the Information contained In this regIstration Is true and correct to the besl of my knowledge and beUof. OEQIWQldoeumenl # U1COEO-IOO4 (01/01) SVP Ooerations. SOny Disc Manufactur1n~ Title I( 1~1ot / l n.l< lof2