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Rd ~" ~?.o!>i '" "I(.- <f 10th $t ~ m 1111 S t "3 1 ;l: '* ~ ~ e G- Stl1 St ~ ... ("~ .. a: ! :r: I. e (Z, 1? H,(kf~n flWI Rd .. en 1~1 51 Q'- ..... * ~<{~ . ArtilUIi3 /' A!'tadiii W -:<... ~..'<z". (~~ Florence f.t ~\ ~- tv ~ Il:" t' .:/ <) <. ... tS C? F ~ .... u.' l:I ?,;- ~? .9 - ". I - {} 9,' (HI Rtf :z. o ~~ ~~ g !!{ .- ~GIen Cmre S 6th $t f.tk-r '}!!iTtc -j"fifnh;,;,,"~rrt-1 ~~t.iZt."r~ ~~h~ ~'?IlCM MllpQu~,r.tlm; 111~,; @ 2no~ GOT. In~ 8IL1igJJJ:~.IjiJ!!H~.'~_~Q.,JJ$~_SyQjec~-1~1!~~n~'-:~Ry[i--9-t!t I ~~R.Lsg~-"~ :N^VTfOi Krjlli__:~~;~ This map is informational only. No representation is made or warranty given as to its content. User assumes all risk of use. MapQuest and its suppliers assume no responsibility for any loss or delay resulting from such use. PdYR;;:,y.E.oji.;,y &L.~ii2.U.>J.Qti5&~ @ 2004 MapQuest.com, Inc. All rights reserved. http://www.mapquest.comlmaps/print.adp?mapdata=p5kqyoo6yZJx8Zu Y AZjLnNOtREw... 10/1/2004 http://apps.ecy.wa.gov - Map Output Page 1 of 1 Recorded well 10 s near the Sam B ant Site I , \ \ r-l _~-_......~j r ,~.r-' - , l [ CI /o"{i ;;r:~;::lt.Ch' b~)l~jl\~ .,.o- r;( 0 s]~",-,C',~, Ld.i;s<;'. '1 ----#~.... _ "C::'~ --,",_",,',""~'-"'" ~-- Ip 0 0 0 lJVell Log Lm:.alions >~l;}mf . f. , ~ o Wal~r SUj;I;;!y o III R!losolJt~ P"-11i>cli'.1l1 DacommiJ;1Obmld '0; 0 0"", , o. '0 f,J o [J o o 0 IJ . Muni;Js W~i! Tyi'"'!; :0 o . . .0' 0 . d.' o 0 o 'b i ~ .~ ~~- j -~~3 ~2, ;if Major Roads Streets Sections Citie5 Counties- 'N.ater Bodies 0 R9Sg1Volr 0 i3le,:;~r 0 r...i'J!:>li 0 R'Jcl;. 0 Islell':! 0 'W<lisor /',/ Streams . 'r? -ct-... 0' '0 . ..,.....,0....', c c,.. ~ ' ,-" -. .0 'A"'c . 0 ;..'-' ; ~~ ""j/;fl '0.':' .:-\.0 ,',0 ,.c'" ,Pi .!:1. ~ Z,,_ ::; ; .f-'.'; "_~-; ":"..' \r~~~c=t:~~..n " .. '\ ,. , .,l~" 0 i · - ..'1! .X-if 0\ p'. , l ", '. ' --..o'ld ; 'Q \\ii tJ ~"1~~~;: <ft 0- 1f;J)J~!Lrr -~ , ~ 0.' i J , ~ 'cr CoN' t! c [J o 0: \ ... /' I, Mi1p Ci-cgt{:j &1' the ","IF.. &;1tc Dc-pic.f E::ob,jf \), http://apps.ecy. wa.gov/servletlcom.esri.esrimap.Esrimap?ServiceName=state _ ov&ClientV... 10/1/2004 l:;ellOnQ UlPY-UWJ1er'S Copy 'l'hird CoPY-D~ller's Copy L t~c:-4 T/(};J\l n-/ .....a..........&.. ff.&:.f.UU ..."~EUAJ. Z1o",j.IIUtid.IoJ,UJI .1'l1U. '''''~'''''''''''__'''''_''''''n STATE OF WASBJNG'l'ON Permit No, ..., ............._..._............ (1) OWNER: Name...J~.db_L.!9.r..$.a.A.L_....__._..._.._.._.. Ad~_.L...=rl..~ ?.....c.-..._-~~t~Af..s.~~ . ......... .. (2) LOCATION OF WELL: CounUr_... ..!:ff~r !:..tf!.N . ...__..__...~........_ N..e.....~), /JI~..~'t Sec.J..t:...... rr3.0..:N.. B,,,.L... Bearing and distance from seotlon or subdlvlsitm corner (3) PROPOSED USE: Domest!a ~ Industrial 0 :Municipal 0 Irrigation 0 Test Well 0 Otber 0 (4) TYPE OF WORK: ?iITne:~ ~u::.be~e~~:7'~]~___.......~_.__ New well .g :Method: Dug 0 Bored 0 Deepened 0 Cable 0 DriveD 0 :RecondlUcmed 0 . ~ 0 Jetted D (5) DIMENSIONS: Diameter o! well -"-"~-''7 bu:hes. Drllled-...OZ.l____.ft. Depth of completed We1L.._-2.L.--ft. . (6) CONSTRUCTION DETAILS: CaSing instaUed:_..__._." Dlam. from ..::..___ ft, to ___ It. '1'hreaded 0 ---" D1am. from ....__._._ ft, u. __ it. We1ded1i!l __...._.. DIam. from ___._ ft, to ........:.__. ft. Perforations: Yes 0 NO'11 '1'ype of perforator usecL-_.__...._...._.._____ SIZE of t)el'lorations"_.____ In. by _.___..._ in. ---- perforations hum _~'__'_ ft. to ____._. :ft. .. perforations :from __..__ ft. to ___ ft. --'''-- perforations :from --'__ ft. to __._._ u. .Screens: Yes~ No D ..... I.,~. _~ .. I ' Manllfactmer's Name..~~ 'J.'Ype....;.,-- . Model No.. . I .. DJam. ..2.-- Sklt me _.!.!L- fIom. .ILL..... ft.. to ..::"J.L- ft. :DiIun. '_ Slot aiz(! _'_ from _. ft. to -.-: It. Gravel packed: Yes [J NO-5 Size of gravel: _.M__ Gravel plaeed from. _..__ ft. to __ It, Smface seal: Yes'W No..o 10 w~ d~~7 ....1.-,,_ oft. Materlal used In _, k.AJ IJ.N. , l.!:t!!. Did m:IY mala contain UDUSIIble wated Yes CI No~ Type of watu?_ Depth of strata Method ot sea1lDg mata ofl___. (7) PUMP; ManlUaeturer'S N~" ..~: . ,BoP (8) WATER LEVELS: ~~-:e&e~::~..._~ Static level ~~ off. below top of wen Date.,;J..#~ Arle3lan pressure 'Ib;. per' square b1ch Dab> Anes11U1o water 15 contfoUed by (Cap. v.&1ve, etc.) (9) 'nn:'.T T mElC!TS: DrawdoWll is amount water leve1fs 'f'f.l:l&.ll.l ...~ lowered below static level Was a pump test made? Yes 0 No 0 If yes, by whom?____.__._ Yield: raL/mln. with It. drawdown alter hrs. .. Recovery data (fJme taken .lIS ftrO When pump turned oR) (water level meastl%'l!d frolll well top to water level) :l'tme Wam Letl.E I 'l'm.e Water LlI1Hll 12'ime Water LaDet -.-...........- .-......-...-..- ......-.-..- -..-...--...-. -.....--..- ....-..----....-. -.........-.. .....................-...... ..--..........- ............--..-.- -.......-.... .........-..--.............. _._....ce&......... _.............._................. ......_..._.... _.._..____..... ..........._... .__............,._._... Date of test -_...~_.~.._-- I BaUer ~_ga1Jmin. w.lth1.b ..--ft. drawdown 1Iftet'-__Ms. Artesl.an fto'W_,_~_ I.P.m. Date-. Temperatul'e of water..:.::t...1.... Was a chemical analysis made? Yes 0 No-p (10) WELL LOG: Formation: Describe by color, chGra:cteT, me 0/ materlaland stMtctun:, and ahoto thickneu 0/ aQutteT" C7il:l the kind and nature 01 the matenal in I!:lJeh smrtum penetrated. with of least one entrJI tor each chAnge of fonllatiol\. MATERIAL nOM TO SAJld I 7/ -~ .J.J q. ;1 .... L_ ,- "'<"..2 7( .-- . -- ...... ~y l.. .L") _ . ~... , i- f t ~ ~:I' " . "" '.. " ~.: .... - .;.. i Ji;iA j) . (j 1.Q,." "',. .:,;::..;J41;o;-:... ;":":: 1_ .... ., ".- -':_~ Jfa1~~=-t~ -r~~ l> ~""'l'i.. . - 'r ....:l:i~Jlii-~! .-.....:,. ,.... . "'. :" ~I .... "-.Ii:. " Work atafteW::.l' ~ . 1Bn Completed._~::.~..._, lli2 WELL DRll,T.RIt'S STATEMENT: This wen was drilled under my jurisdiction and this report is lrne to i2 best of my know_ and heBe' . NAME._'AJi....IJ.I1~s.Ji.r::...JJl~(Lln-'.Uf#.,'.........,_. (Penon, firm,. or corporation) (TJpe ~t) =.~~___._~~:.::..~.~:/<!S (wen Drmer) License NOh~ ~a::.'-.._._..~~m".~. Dafe.,~ .~~.........""... 19.7.7 JOCY 1J!j~1-20 (USE ADDITIONAL SBE!i:'1'S II' :NECESSARY) uepanment ot EcolOgy ;' Ii f :,(1 "71 ///J "".j!' W ATJjf.K WELL REPOD'T Second Copy - OWner's Copy iL> ~ -" "- - - .Dr Third Copy-DnUl!r's Copy ~ STATE OF WASHINGTON Permit No. .,.. ..........._.."............... (1) OWNER: Name..PLl#.f.::.....,.t:.u:tt:.,c...~_.._=_:.____~".:.:..:..~:~....u Add1'9S.bl...~.....fJ.fZ..:.,~A:.l!..~I!t!jJ.t;.Ni_................_.~.................... (2) LO~ATION OF WELL: cDunty_J.~4~..__~~..........__....:-......__...- ..AL&-..5.MSec_.Jo.. T~3..~., R"/.i!w,M. ~e_urlng 9nd dlstanoo from sel!Uon or sUbdivi!;lon t'ornl!r ,'. (3) PROPOSED USE: Domestic M Industrial 0 MunicipalO (10) WELL LOG: Iu!gatton 0 Test wen 0 OUter 0 I~'tr.~~.~;=~"': .0; ~~:"o . . . '.. ....., t..t~'r7~~.: :~. :': ,,;.. 41 . I ....:.-;,; WOl'k ~~~.:. . .19a CDmpletelLdZ.......;....._, I';SL.' WELL DRILLER'S STATEMENT: ~ ..' . . ........": ~~.... ;".. - '". . This well'was drilled under'my jurisdiction and this report is.. true to the best o~ my ~owledge and beUef. . : , '. -.~ '.. ." ':"~i'''~' '," . NAME..C:l.fl.gl1fJ..Jl)d!.L..l):lJil;.6....1ii.&I_.._,_.._...~"._.._.u.,... '. . (P~n. linn. or vorporatlclI,) (1':Ype or .print) ,. ..... ..... "-. .,..... " Addre~P4/!.t!:~.f.-~e;'!!4~A'h.~..!i.t.al.A!......._.,- , 1'_'7~' ;d~-':' lfi..../Nl\. rsigried]._.'-!~M,_~~.....!.n.~._....ud!/l:1....,..,... . ,. . :., ~.': '. .'. -(Well DtUler) II AAIJ,. ';AJjiZFit:.n~';j::~1~" . .:"" .' . -License.No..~.:~a:.V3l;:r:~;;;:,iL...:..:' Dntc.~~'.7.........,............ '1972. . -Hi~t~1i'I~ ~~j/' IUSE ADDITIONAL SHEETS IF NECESSARY) (4) TYPE OF WORK: ~~~ ~g~b:~e)~ ~~l~.......,",......__..._._. .New wen 'iii Method: Dug 0 Bored D Deepened D , t'. __ ........,.. n Recondittoned D RIA. Rotary fJ Jetted 0 (5) DIMENSIONS: Diameter of well _4!........_~..,_ Incbes. DriUed.J$i...."..___...ft, Depth Q~ completed wen2.1!--.._....-ft. (6) CONSTRUCTION DETAILS: .f I ft A~ (; ~ - - C~ installed:-.:"'~".::.Dtam..fro1n ....i>......... ft..to..:lJ.,['f&. ' 'Tbreaded"O ..:.:S::!..... Dlam. frOm _UL ft. to 26..~ 'It. Welcled.fiI __.m" Diam. from ..__._.._ U:1o ......._ ft. Perforations: Yell 0 No J,ji Type of perforator used-._.._____...._......_._........___ SIZE of perfOl'aticms ___..__ in. by .....__._......._.__ in, ,,____......... parforations mm __.._._.... ft. to _............._ ft. _....'''' perforations 1l'crn _~.,...._ tt. to '_""_'"_'''_''' :ft. ..-:...-.......... perfOl'ations from _......._ ft. ,to _._..__' ft. Screens: yes.hr.. NO"O .fi ' . ManUfaetum'SN~~.A8J_...._m.J.Ht.:..__.. T7Pe-CllfJ..IR...ku..~ftJ...\.._ 7ltNO--;;;w-- Diam. .crt:-- slOt si%~ .l....~ from.. : . ft. to/J.3.L-.ft~..: ~Iarn. ___...._ Slot'sl%e .____ from _ it. ~o _'_ ft.- Gravefpac.ked: Yes D N1f!;r SlIe of l1'avel: _ ._ Gl'bvel plaf:!ilc! troni .....:.---.;.._._..... ft. to ______.__". it. S~face. ser:l: Yes .N~ n ;0 Wh~t ~ept!1.r .11__ ft. . MaterIal'used 1~ seaL..~~~li<<....1t..~_..._.....;.: DId aoY- strata eontam unusable wa~7 ; Yes 0 No" 'l'ype of wateT? _' Depth of atrata____,;. . Method of sealing strata off___.-:......_._,___,_. -:. . ('1) PUMP: M~ulaeturer'S Name.~_.___~_:_ '.-.. '. 'bJ)e: .___~ BP'--':':'::___." (8) WATER LEVELS: . StllUC lne1 I ~ _.. '. ~ '- '. (capr;ar~ etc.) "-'-', . (9) WELL TESTS: . &". .. Was a pump test I!!llde' Yell 0 Yield: gal'/min. 'W1th DrawcloWll 15 amount 'Water level1s lowend below statl!: level . No'fil If :I''es, by Wh~mt.._.~.."..,_...._ ft. drawdown after' . hTs, .. " ..' Recovery datil' (tlme taken a.%et1J when trimlp turned off) (water Iavel. mellSUl"l!d from wen to}) to WBte:r.Ieve1) . :7imc Water LallllltTima ,~:W~ Lavel ! Tim':, Walei'ldtIe1 . . . .,: ~. . ...&Or...'I................. .........-..__...__ ..._......__ ..-..........-..... ~_......._.- -..--....-.-... : ...............--.... ....-..-.-..-...- ......---.... ...-..-............-- -_..~._............- .-.._~.................. _..............:. ..._......._.._41... ........._ ......................_.._ ......-...... ..__.._..~............_... . Date ot test --... ::'1('-- ~ ' J ~er tes'....:.:l.Il.._gal./min. wtth:.~ . . drawdown llUef~.._ltrs. Arteslan fiow__ . lr.p.Jl\. Date....-......._.___. Temperature of water_.y____ Was..a'd\emical, ~ made? Yes 0 NO"Ji! Applicatton No. ................".......,........ ~nnatlon: Descrlbe bv. colOJ'. ehaNcter.. me 01. material and stTUcture, an!! sh(l1l,l tlnclmeB6 of aguifers anll the kina. ancl1Sature of the material in each malum peneb'4tinf. Wfth at Je~t onlf en~ for each change oI1<mn!ltfon. NAn:RJAL FROM TO -..~ - '. '... ,j I. .1 .' :. } .' .... . .. , .-~ ~~'~~~ff:~', ,oj.. ,. . L - ..--. .. . . 4 ,:," ~... .- . ..- . , . -"0( .- '1 " _of .. .- . ::'.' .... ..- -..:.: . - . . ... . ... -' -. "_... .r ..:.:- ..~. ;.:~ .- ..... . . -1/' .< '--/'-'-'" -' Y~".!I''''--'''''''''' 'I............... "'''.a:.I.a.V.l.'''''' .o:M:CCJ~ \.fUpy - uwner'l"S copy L { /~.-;/.';'; ;::.;: /J'i k~ i ThJrdCo~Y-Drll1er'sCopy , ~ -, . STATE OF WASBINGTON ~ . (1) OWNER: Name..:E.L.I1...__._WbJ..t~ .__ Addf:ess::f!t X-.... ll'LJ!.~~&1.l.1LJ.l.J__......._.__... (2) LOCATION OF WELL: County-.-Je_~ ._~..s.P ~..:..~........~_......-j,..f._'J!4~I.l._ ."'~ Secl'-__. T~..rO_N., R__L.. .. - ..:~ ;"-3,...., '- ;.. ~ -.. ._a .. I. -.~ ~ - ~~ "'. ., . :~. .... '. :;,.' '.~~J~.[} po.. '. .....- '..:...p ..~ ... '''"",:.,.:~::~:--r.Jf;f.-;.. ." -,' ....~ .- M~' 7rli ;;,t:.~~. f .. . ., ^.~ ..;,;~ ff. i ~ .. ,.. . . .., I, -. ~ -.." il ..../.. . O' ,,_ -....-- ..1N.-': jIt/.l.~-:~~q:Jl","'''''~/(}... -;,..,;;I;......:.:~ivr .. ~.~,y"-""-,,,. .;. .,,~ ": .~:";~l~,.!._..:..;: :....:..:..t~~ ,,~fj:;rlJ.~.~f:rr4. ..(";..... ...... .. _-a W~lt ~:~- JRi' ..... JH?4io;:.)i~~~. 'WELL DJUl.,:1ift'S 'STATEMEIi~?Cf . Ilearlng and distance frmn section or subdlvjslon carner (3) PROPOSED USE: Domestic TJr. Indust.rJal CJ Municipal CJ !rrfsat1on CI Test Wen 0 other ".0 (4) TYPE OF WORK: ?;';:::~ ?n~b~:,:~l:~.._........._..",:,_...__~ New well -fa Method: Dug D l!ored D. !leepened 0 Cable CI Driven 0 :Reco1ld1t1oned 0 Row,. 0 ' oTetted'O , (5) DIMENS~NS: Dz:Uled-.."" __.....ft. Diameter oi weu _._:.:.~~__.... 'inches. Depth of completed welL-75 ,::;;,,--it. '- -~ (S) CONSTRUCTION DETAILS: , . ';0' :.:' Casing. . IDS' taUedo - ~ .. ....-- __ -I "'._' -"'7-:;' ... .. --.Ji:;t..._ .L,._a....,," ~Um _.--..-._.. ..... "" ____ .....c .. Threaded 0 _~._" >>Jam. bum _"....~_ :ft. to ___ ~ Welded_ ___.._" Dfam.1rom .-..-- ft'i.to _:-:_. #,. . .... Perforations: Yes 0 NO" . . .~,.. "r,.:" Type of perforator used--......____._.---..:.:.~_.-:-_ ::.. SIZE of perforations _. _.__ In, by _._..____,__ m. ---- pezforatlons fnlm __....__. ft. to _'_'_"~ ft. --_ perforations mm __. ft. to ..--::.:.._:-;:.. ft. , -- perforations fnrrn ~_..__ ft. to ~_~-:.. ft:. . ScreeDS:, Yes" No [J _I .. Manufacturen Nam~Ii~ S () iV_. .. -. "". T7Pe ,. __ Model No~" ~ '. Dl8m.:.L- Slot me..l5...... from _'7L...:"ft. to ~.ft. Diarn. ---: Slot sIze ____ from _ It. tCl.-=-- fL- Gravel packed: Yes [J No~ Size of snwe1; --,..._'__ GrAvel placed from ft. to ..' f!.... Surfaee seal: yeswp No g '!t wb~:~' ~.i~~__ fi; Materla1' used tn seaL..~:n.N. f ~ - . ' . DId any tItt'at4 contain unusable wBter'.. Yeito NO~- T7Pe Of 'fttu? Depth at ~;-,.. ..--:..:-~ Method of IlI!81iDB Nata 0" - . -=::-:- .. .. (7) PUMP: Mamlfaabaer's:Name.. Tn\e: . .. - (8) ~ IUI'IPD T ~~.' .I.8nd-surface e1MtFon'~. . - ~.I_ -..~;.' :. un.~ .u.ElyAl.K't. , above:mean sea 1~;-;,... o' ~.L.'. ~ '.~'~:. : StAtic level _l"l ~ below top of well D '.. '. .'1.:;. Artesian pressure 1'bll. per ~ inch ~, ._~" .:_ .' Artesian water Is conUoUed hy__ ___.. . , .' (~p, valve. ete.) . .~".l.r. . .... .... Drawdown is amoimt-:w8ter level Is lowered below statle ]lM!J ..' NO,J If :yes, by Whom1~';;"""_~::':-,:",_ fl. drawdown:~, .' .. hIs. .. ...,.... ...... (9) ~ TESTS: Was a P1mIP test made? Yell 0 Yield: BalJmID. with .. .. Rec0vet7 datil (time tBkllD as zero when pump tumed aft) (water level ~d from well top to wate:r level) .,~~:_- -~::"Z::~3' ...~~:~. ~~:"~::~1~~- .:~:~~u ..._......~.....- -....-............-........... <<..........-.-..-..... .-.."..-...........--. ......-.-... ..........-.-.-......... __'._t..._ ..............._...... ._._........_... __...._._...~...., _...___.. ...._.._.._.._....._... Date o.f ~ _.. u . / Ballflt" test.:lt2. . .aalJmjn, witb-4ll__.ft.. drawdown after__.__Jus. ArtaIan floW -r.p.m. nate..______ Temperatu1'e of water__ Was a chemtaa1 analysis made? Yes CI No 0 --r....-""....-"'.,.. ....."'. ...u.........._..............a.. PermIt No, ... ..; .._.........._..:.........._. (10) WELL LOG:- . .- .-..,. Formation: De.!Crlbe by CDIo;. e1l4rm:Ui'. size oj mllteri<<lllRa ~tmcture, aTld ..how thic1mes" oj ~en an4 the ktnd and t1tlture oj the matetfal in eaall #f'i1ftLm penetl'llted, unth at least one 'e1It71l f'"' each c1umge of fornudicm. '. '" ~ FROM ,'.TO ~ ~'. ~--I.:. 'tl.,=- ,:Lr..;,:'; 7.~ <S;":..uA :,_'_ . I .Cj 1>. u-J..~ :-., . . ~ ... - . "_0# _ " .. .. ....... .. . -. - ..~. -. .. -... .' --.... ....~.. ..~ -' o '. ~....... --- :. - '. ......'1~...~. ... ...~-"'__.._. ..."'- 'j;' . )-ItOoI' '~4:-' ~ "'-. - ...... .-- ......-:.... ... ~ '. -..... .. .-: . '-. -' ....~ ..... : ... ....:'. .:. . -.- " - -. ..: , 1S~2!}: . This well was drIDed under my jurisdiction and this report is true to the best of my knowledge and bellef. NAME..~ lu-'L~.._.~/IId!12r{ll!t~.~.... I!!i. _. M ......._ . ......";;;]'r- ;=~&~~~~..~~k~ (Well Driller) I License No_o..'l.B:le..._._..._....... Date.~_/.L,~_.._........ 19.Z? FC:Y 115fi.,.2tj (USE ADDl'1'IONAL SBEETS IF lG:C!:SSARy)