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HomeMy WebLinkAboutAquifer Recharge 974600002 WESTECH COMPANY Envlronmentel Consulting -lite Pennitlin8 July 27. 2006 Ms. Mo-chi Zoe Lindblad Jefferson County Oep.-trnent of Community Oeveklpment 621 Sheridan Street Port Townsend. WA 98368 Dear Ms. Lindblad: As per your recent .....1 of July 25. ttne main fadora support our report findings as follows: 1. The horizontal distance from the well on lot 2 to the contaminated well and to Discovet'y Bay indicate a low probability of contmnination. 2. The vertical diltance from the bale of the well on lot above mean sea level indicate that no contamiMtion can occur without significant subsurface pressures which do not appear to be preIent in this ... (e.g. artesian effects). 3. Based on geographic and geological data which we reviewed. the well on lot 2 and the c:ontaminated well app.. to withdraw ground WIder from separate aquifers. Please note that. monitoring progr8In W8S recommended for a two year period to further Iubstantiate theM findings. Such. program could be included in the pennit conditiona and ........... in our report. If there are 8Ubs1antial ctw1gea in the weirs water quality. the findings would be re-evaluat8d. We did not .....rd\ 1he water rights iIaua. which might not apply to this private well. Our findings on 1he specific points above do not .aggat that this well is contaminated. The findings also do not suggest that this well ~II detrimentaUy affect neighboring water supplies. PIe88e feel free to caY or emaiI if you need additional information. Thank you. Sincerely, c/ .;S p~~_ G. Bradford ~~p~ REA Wtliam Payton, loG., LE.G. P.O. 80IC 2876 - Port~o WMhtngton'" - Telephone: (_) "'1_- Fax: (MO) 4SM701 .......: .......IIforwwd.oom I I I I I I I I I I I I I I I I I I I WESTECH COMPANY Environmental Consulting - Site Permitting AQUIFER RECHARGE REPORT MOUNTAIN VIEW VISTA LOT 2 ASSESSOR'S PARCEL #974600002 JEFFERSON COUNTY, WASHINGTON RECEIVED JUl! 2 lOBS JUffRSlJN COUNTY Den July 2006 G. Bradford Shea, Ph.D. Bill Payton L.G., L.E.G. Submitted to: JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT 1820 Jefferson Street Port Townsend, Washington 98368 Submitted by: WESTECH COMPANY P.O. Box 2876 Port Angeles, Washington 98362 P.O. Box 2876 - Port Angeles, Washington 98362 - Telephone: (360) 565-1333 - Fax: (360) 452-6708 email: bshea@tenforward.com I I I I I I I I I I I I I I I I I I I AQUIFER RECHARGE REPORT MOUNTAIN VIEW VISTA LOT 2 ASSESSOR'S PARCEL #974600002 JEFFERSON COUNTY, WASHINGTON July 2006 G. Bradford Shea, Ph.D. Bill Payton L.G., L.E.G. Submitted to: JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT 1820 Jefferson Street Port Townsend, Washington 98368 Submitted by: WESTECH COMPANY P.O. Box 2876 Port Angeles, Washington 98362 I I I I I I I I I I I I I I I I I I I CONTENTS CHAPTER/SECTION Page No. 1.0 INTRODUCTION 1 .1 Project Site 1.2 Project Description 1.3 Regulatory Background 1 1 1 1 2.0 METHODS 2.1 Sampling Methods 2.2 Methods of Analysis 5 5 5 3.0. EXISTING SITE CONDITIONS 3.1 Hydro-Geologic Setting 3.2 Topography, Drainage and Surface Water Bodies 3.3 Geology and Soils 3.4 Groundwater Characteristics 3.5 Well Locations (within 1,000 ft) 3.6 Groundwater Recharge 3.7 Potential Impact on Groundwater Recharge 7 7 7 7 8 8 10 10 4.0 ANALYSIS AND FINDINGS 4.1 Water Quality and Transport Analysis 4.2 Spill Response and Containment 4.3 Best Management Practices (BMP) 4.4 Monitoring Program 12 12 12 12 14 5.0 CONCLUSIONS AND RECOMMENDATIONS 5.1 Conclusions 5.2 Recommendations 15 15 15 6.0 REFERENCES WW970MtviewVistaLot2. TOC/0711 06/xmk I I I I I I I I I I I I I I I I I I I TABLES Table 1. Water Quality Test Results Table 2. Individual Well Data From Well Logs 9 13 FIGURES Figure 1. Location Map Figure 2. Vicinity Map Figure 3. Parcel Map Figure 4. Site Map Showing Lots and Well Locations 2 3 4 6 APPENDICES Appendix A - Site Photographs Appendix B - Lab Results Appendix C - Well Logs A-1 B-1 C-1 WW970MtviewVistaLot2. TOC/0711 06/xmk ii I I I I I I I I I I I I I I I I I I I 1.0 INTRODUCTION 1.1 Project Site The property described as Lot 2 of Mountain View Vista Long Plat, (Volume 8 of Surveys, Page 40) in Jefferson County, Washington is a 3.03 acre parcel of land owned by Michael and Letitia Thompson. The property is located in the SE quarter of Section 8 of Township 29 North, Range 1 West, Willamette Meridian (Figures 1, 2 and 3) and is described as Assessor's Parcel #974600002. The owners intend to apply to Jefferson County for building permits for a single family residence and associated septic system. The property is presently accessed by the access road to the Mountain View Vista subdivision and by a lateral access which serves lots 1, 2, and 14. There is a well in place on Lot 2 which is intended to supply drinking water for the planned residential use. That well has been tagged by Washington Department of Ecology (DOE) as well AHR308. The well is intended to serve lots 1 and 2. That well is 182 feet in depth and the wellhead lies at a surface elevation of approximately 240 feet above mean sea level (msl). 1.2 Project Description The well on Lot 2 has been surveyed and has been determined to lie at a distance of 868.14 feet from a known saline well (located on Woodman Road on the west side of State Route 20, near Discovery Bay) (Wood Surveying, Inc. 2006). Jefferson County regulations require that wells located within 1,000 feet of a known saline well where salinity appears to result from saltwater intrusion are subject to Critical Areas regulation. Specific regulations and requirements are discussed in the following section. 1.3 Regulatory Background Jefferson County Unified Development Code Section 3.6.10 part E (Jefferson County 2001) specifies requirements for preparation of Aquifer Recharge Area Reports. Similar content requirements are for Aquifer Reports for saltwater intrusion as per applicable portions of Title 18 of the Jefferson County Code. These reports include such items as a project description, a hydro-geologic evaluation, contaminant transport analysis, proposed Best Management Practices (BMPs) and monitoring program requirements. WW970MtViewVistaLot2,RPT/071106/xmk 1 I I I I I I I I I I I I I I I I "2 'is. :3 "2 -;;; c: -;;; 'is. ~ E c: "' 0'0 .2 u 0'0 oS ~ ~ ~ a:: ~ " :5 '+ 0'0 ~ >- '^ 0'0 .... :5 > " '^ " 0 0 0'0 0'0 ~ " "' '^ 0 0'0 0 > 6 ~ ~ " 0 0'0' 0 0'0' 6 " ~ u.. c: >- c: g 0 0'0 0 c:: :8 "' " 0 0'0 0 0'0 -;;; " " 1 :E '0 0 6 c:: 16 "' " ~ 0 g 0 '0 > '" '^ '0 '0 0 0 -;;; c: ...: 6 IX ~ :E '^ ..0 '0 0 0 11 c: 'S: ~ ...: 11 .. E ..0 C 0' C o' "' 0 0 :;; 6 " " ~ &I ~ E 0 0 0 ~ ll: ~ ~ c -;;; D- -;;; c:: c ~ u s: ~ !:!!. c: '" c: c: Iii '^ '0 .. 6 6 c: ] c: 0 ~ 0 .i 1l a:: .Q '0 ';0 C c: s: ~ 16 :J i .c ~ '6 'lil ~ 'E 0; " 0 .. ;S 0 ;S 'l:I >- c:: :IE 0 :E .... <5 .~ IX u z <5 oS i ::::; &I I I III 'lil II . Ell a .. i Co 1 'l:I .. II . . . !!i I c .. Cl II . . . 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I I I I i I i' I I I I , i i ,l.... l ----"'--- / -- i i ---- -~ Ii I \ I ~ 0> , I i, " i 0> \ I \ I. \. .. i 0> I c: ~ \\~ \ \ ; 0> i I I i I I \ I \ .. -,/ -----'---- ~ --..,-'''---_f-...........-// t \'1 li;--r--.,\,._..~../~ I ,I I I I I <:> '\, \ 'lj ~ .... 0> (I) :!:::: en \, \, \. \ ~.' ~J..~-- I 0> " \.,~...-"--""----""--- i .,. I .... 0> ~ ,... 0> I 0> I i I i I .,. I i ~. l s ! -I- ~~ l~ i .1 lit i i CD CD 00 00 N N >.(1) c: en as as 0- ..0 E jg o as (,)0 ..c: 0- () as ~~ en (I) ~ .5 c: o .z. c: ::J o (,) c: o ~ ~ (I) ...., ~ ::J o en 0- as ~ ~ as 0.. M ~ ::J .2> u. I I I I I I I I I I I I I I I I I I I 2.0 METHODS 2.1 Sampling Methods Water samples were taken from on-site (Lot 2) and off-site wells (Lots 14, 4 and 5) (see Figure 4). Wells without pumps were sampled with a 2" x 36" plastic bailer with a ball- bearing sealer. The bailer was lowered into the well on 300 pound test fishing line using a rod and reel. Upon filling with water, the bailer was reeled up and water was transferred to an 8 ounce laboratory jar which was sealed, labeled and placed in an ice chest for transport to the laboratory. Well depth was ascertained using a well depth meter. Chain of custody information was kept for all samples. Samples were shipped via Federal Express Priority Overnight service from William Fairchild International Airport to CCI laboratories in Everett and Twiss Laboratories in Poulsbo, Washington. Samples were analyzed for chloride ion content and for conductivity. 2.2 Methods of Analysis Laboratory analysis utilized USEPA Method 300.1 for chloride and 120.1 for conductivity at CCI Laboratories and Method SM 4500-CI-E for chloride and SM2510-B for conductivity at Twiss Analytical Laboratories, Inc. Analysis of well logs, mapped information and other data was carried out by standard analytical methods for data analysis. U.S.G.S. Quadrangle maps, aerial photographs and information on the Jefferson County website was used as appropriate. Mapped locations of wells on the County and State websites were cross-checked against well logs and field locations and measurements. GPS measurements were taken of each wellhead used. WW970MtViewVistaLot2.RPT/071106/xmk 5 - (J) o c: o CD z o :::+ ::r ~ ~ o 0 roro ...., 0 ::J ::r ---4() ~ 0 ~ 3 0"0 ::::!. l>> CD ::J 0'< ~ ~ 00 00 01 C>> - - . ~ CD r o o l>> ... O' ::J o - - - - - - - - - - - - - - - - <:l I t a i "~J ~ ~ ~ ",.0. NDIt1H lOfIE i , o :;:a: l/I ;= ~ ~ S' ",' \ ~ t} y~ ( ~ --- --- ~ 'TI cO' c: CD ~ (J) ;:::;.: CD ~ l>> "0 (J) ::r o ~. ::J <0 r o ... o l>> ::J a. ~ CD r o o l>> ... o' ::J o -- -- ....... ::!~ k'" .... CoO ~ ~ <0 ~"'O OI~ g@ 0- .....'"'= .j>. <0 """'0 .j>.l\l 01..... g@ 0- ~'"'= .. yo ... ! '" . ,.t '" it.... / / , / / / -'" ( / ~~ I r t.... I ... I ~ 1 "" 1--- I . I -- -- ---... it ~ -- ~'" .. - -- co ti -- ~ ... ~ .... ~ -- -- lID ... t~ -- ~ ,.~ "..... ... lOt co ill... ~., ~~ ~~ ~ ~a: It.... ~ -- .... ~ ill.. Q ;:: ~ N Ot'.fO'2SH C Q) l() s Ot'2,'4J" W 65J.J5 I I I I I I I I I I I I I I I I I I I 3.0 EXISTING SITE CONDITIONS 3.1 Hydro-Geologic Setting Hydrology of the Site is that of a low hill which drains westward in the vicinity of Lot 2. Groundwater is present due to infiltration and seepage of storm-water as well as from long-term storage. The watershed of the hilltop lying east of the Site is relatively small (less than one square mile), however, at the project elevation, groundwater could affect the Site from higher elevations to the east and south. 3.2 Topography, Drainage and Surface Water Bodies The Site is located on a west-facing slope of a 380 foot high hill which lies on the east side of Discovery Bay. Elevation is roughly 240 feet above mean sea level (msl) at the Project site. The Site vegetation is composed of typical second growth forest, however, the bulk of the Site is now low grasses and brush due to clearing within the past two years. Natural forest and wetland shrub-scrub vegetation remains in the wetland and wetland buffer which comprises the eastern portion of the Site. Surface water on the Site drains to the west and south. Site surface soils are of the Alderwood-Sinclair Association which are moderately well drained gravelly soils underlain by glacial till. The main soil type is Alderwood gravelly sandy loam. The Soil Conservation Service mapping (SCS 1975) shows this soil as 0-15 percent slopes which is accurate for the well-head area, however, slopes on the western portion of the parcel are steeper, indicative of 15-30 percent slopes in some areas. The main water body in the area is Discovery Bay which is located approximately 1,200 feet west of the wellhead on Lot 2. Discovery Bay is a marine water with salinities typically in the 25-33 parts per thousand range. 3.3 Geology and Soils Underlying geologic formations in the project area consist of Tertiary age shale and mudstone bedrock (Tg) , including inter-bedded siltstone and sandstone. This unit is overlain by Quaternary age Vashon lodgement till (Qvt1) from the Fraser Glaciation. The till is a compact mixture of boulders, cobbles, pebbles, sand, silt and clay, generally overlain by 1-5 feet of ablation till. The total thickness of this till unit may reach 100 feet. Additionally, there may be a layer of Vashon advance outwash (Qva) lying stratigraphically between the till and the bedrock. This unit typically consists of well sorted, well stratified sandy, pebble to cobble sized gravel. In some places, sand predominates. The unit generally contains minor amounts of silt and clay. The coarseness frequently increases from top to bottom, the thickness ranging from a few feet to 150 feet. WW970MtViewVistaLot2. RPT/0711 06/xmk 7 I I I I I I I I I I I I I I I I I I I Soils on the Site are of the Alderwood soil series (SCS 1975). These are generally moderately well drained soils that have a very slowly permeable cemented layer at a depth of 20-40 inches. The specific soil type at the Site is AIC (Alderwood gravelly sandy loam 0-15 percent slopes) as mapped by SCS, however, AID also appears to be present due to the presence of 15-30 percent slopes on the Site: Tukey soils lie to the north of the Site and a more gravelly variant of the Alderwood soils (AmD) lies to the northwest. Wetland soils on the Site appear to be Casey silt loams. 3.4 Groundwater Characteristics Groundwater flow is determined by the characteristics of the sub-surface geology. In pervious units, groundwater flows between soil particles or through fractures in bedrock, under the influence of gravity. In impervious units, water flows laterally, following the orientation of the unit. When impervious units occur at the ground surface, runoff occurs. Surface water and groundwater flow generally follow topographic variation. In the vicinity of the project the groundwater gradient can be expected to be to the west southwest following the topographic lines. This apparent gradient is confirmed by geologic mapping of pervious and impervious units near the project site (WDOE 1978, 1981) and the observed surface water runoff characteristics on the site. In the study area, units TG and Qvt1 are generally considered to be impermeable, while unit Qva is considered to be permeable. Groundwater discharge in the study area, therefore is expected to be generally westward toward Discovery Bay. Groundwater quality is not well known in the area. There is a known well which has experienced saline water intrusion from Discovery Bay located west of the Mountain View Vista subdivision. That well is on Woodman Road. The well owner has had to install a desalinization system in order to comply with County and State requirements for a potable water supply for a single family residence. Various water quality samples have been taken within the Mountain View Vista subdivision wells. These samples have been analyzed for nitrates, chlorides and conductivity. Test results for these parameters are shown in Table 1. 3.5 Well Locations (within 1,000 ft) A number of wells are now located on the Mountain View Subdivision site. Wells have been located on Lots 2, 4, 5, 6, 8, 9, 11, 12 and 14. Some of these wells are intended to serve two or more lots. The well on Lot 2 is intended to serve Lots 1 and 2 (Figure 4). There is a saline well located on Woodman Road within 1,000 feet of the wells on Lots 2 and 14. This well has been surveyed at a distance of approximately 868 feet from the Lot 2 wellhead. WW970MtViewVistaLot2.RPT/071106/xmk 8 I I I I I I I en I- ...I ::J I en w a:: l- I en w I- > l- I ::J e:( ::J a I a:: w l- e:( ~ I . "'" W ...I I co e:( l- I I I I I I (1)- _...I LO LO LO LO :S~ I I I I I I I I I 0 0 0 0 I I I I I I I I I I I I I I I I I I .- E v v v v z_ ~ - '>~ ..E 0 0 0 0 co v 0 ....... CJ CJ I I I I I ...- ~- I I I I I LO co co 0 0 co LO N "en I I I I I co V co co v co co c.:. ...- 0 0 (I) :2:J 0 LO 0') C") co C") ~~ ....... co N V N co ....... ....... ...- LO co ...- LO C") N co co co ...- v ...- LO V ...- LO co ..c_ o - - as as as as as as as as (,) (,) (,) (,) (,) as as as as (,) (,) as (,) +=- +=- +=- +=- +=- +=- +=- +=- ~ >- ~ ~ ~ (,) (,) (,) (,) ~ ~ (,) ~ +=- +=- +=- +=- +=- ..c as as as as as >- >- ~ ~ as as ~ as as c c c c c c c c ...I <d: <d: <d: <d: <d: as as as as <d: <d: as <d: c c c c c en en en en en <d: <d: <d: <d: en en <d: en en en en en en en en en .~ .~ .~ .~ ~ (.) (.) (.) (.) .~ .~ (.) .~ l- I- l- I- (.) (.) (.) (.) l- I- (.) I- :a: LO LO LO - ~ ...- ...- ...- v v - - - N N V LO N V LO 0 ...- v v v ...- ...- ...I ...- ...- ...- LO LO LO LO 0 0 0 0 0 0 co C 0 0 N N 0 ~ ~ - - 0 - ....... ....... ~ ~ LO LO N N ...- ...- - - ...- a. - - N N - co co co co co co co co E 0') 0') ...- ...- LO 0 0 0 0 0 0 0 0 "0 "0 "0 "0 "0 - - - - - - - - as as as as as as v v v v v v v v en Q) Q) Q) Q) Q) ...- ...- ...- ...- ...- ...- ...- ...- - - - - - - - - J: J: J: J: J: co co co co co co co co ~ ~ ~ ~ I I I I I I I I ~ ...- N C") ~ ...- N C") v <d: <d: <d: co co co co 0> ~ E ~ <0 o ..... ..... r-... o - ..... ..c <<l I-: ~ o -l <<l - II) ~ Q) ~ ~ o r-... ~ I I I I I I I I I I I I I I I I I I I 3.6 Groundwater Recharge Groundwater conditions appear to be seasonally saturated on much of the surface of the Site, resulting in perched wetlands formed in silt and clay soils above the glacial till. These wetlands result in both surface water runoff and groundwater recharge through infiltration. The Mountain View Vista subdivision is based on a Wetland Delineation and Wetland Mitigation Plan, both prepared by Westech Company during 2005 (Westech Company 2005a,b). These reports resulted in adoption of conditions in the Final Subdivision Map preserving the wetlands and therefore the groundwater recharge resulting from these natural systems. Due to the very slow permeability of the glacial till "hardpan" layer, groundwater recharge resulting from winter and spring rains is spread out through dryer summer months. Additional groundwater recharge may result from other hills to the east and south of the Site, from points in the watershed above the elevation of the Lot 2 well. The base of this well is at approximately a 60 foot elevation above mean sea level, but can intercept groundwater traveling from other strata above that elevation. Since the gradient is apparently to the west, locations east of the Site are most likely to contribute recharge to the Lot 2 well. The Lot 2 well water level during initial installation (according to the well log) occurred at a depth of 83 feet (elevation of 157 feet msl) during May 2005. Measurements made during sampling in June 2006 found water levels of 25 feet (elevation of 215 feet msl). This significant increase in water levels indicates an increase in hydrostatic pressure and presumably quantity of available groundwater during 2006, possibly due to wetter than usual winter and spring storm-water conditions. 3.7 Potential Impact on Groundwater Recharge Saltwater intrusion from marine environments has become an increasing problem in several north Puget Sound counties including Jefferson County and Island County. Island County has initiated a three-tier risk-based system with low risk indicated by chloride levels at or below 100 mgll, medium risk between 100 and 200 mg/l and high risk above 200 mg/l. Moratoriums are placed on parcels above 250 mg/l in Island County. Jefferson County requires reporting on Aquifer Recharge in critical Aquifer Recharge Areas within 1,000 feet of known saline wells. In theory, placement of new wells could result in a drawdown of the aquifer and a consequent increase in salt-water intrusion into the aquifer. Such an increase could potentially cause negative effects on nearby wells. WW970MtviewVistaLot2, RPT 10711 06/xmk 10 I I I I I I I I I I I I I I I I I I I This Project (use of the Lot 2 well for residential drinking water purposes) will result in withdrawal of approximately 125 - 200 gallons per day from the aquifer based on general residential use. Use of low-flow devices within the household will help minimize water use. This usage rate will not significantly impact the rate of infiltration of surface waters above the aquifer due to the nearly impermeable till layer. Placement of all of the wells within the subdivision could draw the aquifer down, however, effects of such drawdown are anticipated to be relatively minor, given the apparent high levels of both surface and groundwater at the Site. Groundwater recharge from groundwater sources is difficult to measure without periodic monitoring of water levels and drawdown from all wells in a given area. It is not anticipated that such monitoring will be necessary unless water quality is found to deteriorate with time in the on-site well for Lot 2. WW970MtViewVistaLot2. RPT /071106/xmk 11 I I I I I I I I I I I I I I I I I I I 4.0 ANALYSIS AND FINDINGS 4.1 Water Quality and Transport Analysis There are no known contaminants presently on the Site. The subdivision will not result in the introduction of any significant contaminants except on-site residential drainfields. These will be placed a minimum distance of 100 feet from any existing wellhead as per Washington State and Jefferson County requirements. Thus no spill of contaminated substances is anticipated and no transport analysis for such contaminants has been conducted. No discharge of septic waste is anticipated, provided that drainfields are installed and maintained according to Jefferson County Health Department requirements. Saltwater is considered to be a potential contaminant of groundwater supplies within 1,000 feet of a known well affected by saltwater. Since the Lot 2 well is within approximately 868 feet of a known saltwater intrusion well, a qualitative transport analysis has been carried out by examining known factors relating to geology at the site, coupled with sample results from water quality testing. Water quality test results are shown in Table 1. Lot 2 had been previously tested by the landowners with a result of 170 mg/L chloride content in September 2005, with a landowner retest showing 41.9 mg/L. Tests carried out by Westech Company found a value of 56.6 mg/L as analyzed by the same laboratory (Twiss), and 34 mg/L as tested by CCI Laboratories in Everett. Conductivity measured 484 uS/em by Twiss and 460 uS/em by CCI. The secondary drinking water standard for chloride is 250 mg/L as is the MCL for environmental effects. The State of Washington has indicated a level of concern for conductivity when concentrations are above 700 uS/em. All test results are well below these threshold concentrations for chloride and for conductivity on Lot 2. 4.2 Spill Response and Containment No spills are anticipated. Potential contaminants from on-site drainfields are contained within these systems. There is no reason to anticipate any spill, provided these systems are designed and maintained according to Jefferson County requirements. 4.3 Best Management Practices (BMP) Well depths are shown in Table 2 along with static water levels as indicated from the well logs (see Appendix C). The well for Lot 2 is at a depth of 182 feet below ground surface, or a depth of 58 feet msl in terms of elevation at the bottom of the well. Static water level indicated in the well log occurred at an elevation of 157 feet msl, or 83 feet below the surface at the wellhead. WW970MtViewVistaLot2.RPT/071106/xmk 12 I I TABLE 2. INDIVIDUAL WELL DATA FROM WELL LOGS I Unique Estimated Well Depth Well Depth Static I Lot # Ground Surface Elevation Water Level Well 1.0.# Elevation Cmsll (msll (below top of well) CATD) I 2 AHR-308 240 58 182 85 4 AHR-314 235 -46 281 178 I 5 AHR-312 23 -152 382 168 I 14 AHR-343 265 163 102 28 I I I I I I I I I I I I WW970MtViewVistaLot2, RPT/0711 06/xmk 13 I I I I I I I I I I I I I I I I I I I The well log indicates that most layers encountered were clay. Clay is mixed with gravel at 1-3 feet and 14-19 feet in depth and gravel was found at 3-7 feet in depth. Shale was encountered at depths of 67-69 feet and 85-88 feet. Silt stone (water bearing) was encountered at depths of 34-58 feet. This confirms the general geologic mapping in the area which indicates that impermeable layers exist below and at the base of the well (Tg formation) with some water-bearing and other permeable strata (Ova) at intervals among impermeable layers (Ovt1). The proposed Best Management Practices (BMPs) to minimize exposure of permeable surfaces to potential pollutants and to prevent degradation of groundwater quality are as follows: 1) The well on Lot 2 does not appear to be contaminated, nor is it contributing to contamination of other wells or of the aquifer. The best way to assure that contamination does not occur is periodic sampling and reporting. A monitoring program is outlined in Section 4.4 below to accomplish this. 2) Wells on adjacent lots (14) which are within 1,000 feet of the off-site saltwater contaminated well should also be sampled to indicate whether any physical or chemical changes are happening which may relate to potential contamination. 3) If large drawdowns are noted or suspected, wells should be sampled to ascertain water levels as well as water quality. 4) Drainfields should be designed as per Jefferson County regulations and should be 100 feet from any wellhead as required (downgradient if feasible). Implementation of these BMPs is anticipated to off-set potential impacts from the well on Lot 2. 4.4 Monitoring Program A periodic monitoring program should be implemented for a two year period to ensure adequate data on the lack of contamination. The homeowner should sample chloride and conductivity on an annual basis in order to confirm lack of contamination. Any significant increase should be reported to Jefferson County. Test results should be sent to the County at the conclusion of the two year period along with a letter of comment by a water quality professional. Water levels should be noted on at least an annual basis at a fixed time of year (preferably August). Any substantial drawdown (greater than 25 feet below the well log depth) should be noted and reported. Sampling should also be conducted on adjacent wells if feasible. The other well (Lot 14) within the 1,000 foot limit should be sampled on the same basis as Lot 2. If increases in salt content are noted by taste or through laboratory result, sampling frequency should be increased to a quarterly basis WW970MtViewVistaLot2. RPT/0711 06/xmk 14 I I I I I I I I I I I I I I I I I I I 5.0 CONCLUSIONS AND RECOMMENDA liONS 5.1 Conclusions The well on Lot 2 appears to be underlain by an impermeable layer below the base of the well (below 58 feet msl) according to geologic mapping of the area (WDOE 1978, 1981). This impermeable layer appears to separate any potential aquifer at or below sea level from the well. In addition, groundwater would need to rise 60 feet against the prevailing gradient in order to reach any portion of the Lot 2 well. There is no indication of artesian pressures which could accomplish this in the vicinity of the Site. The aquifer which Lot 2 intercepts appears to be substantial in terms of groundwater quantity. The well is also nearly 60 feet above mean sea level and appears to draw from a separate aquifer. There is no indication that the Lot 2 well could draw down neighboring wells in order to increase saltwater intrusion. Water quality testing did not show substantial contamination of the Lot 2 well. All test results were well below the secondary standard of 250 mg/L and the highest reading (163 mg/L) appears to be substantially above all other readings for this well, indicating a possible sampling or laboratory error. Conductivity readings are also below standards. 5.2 Recommendations We recommend that permits for use of the well on Lot 2 be issued, subject to the Monitoring Program discussed in Section 4.4. The drainfield for the parcel should be designed as per Jefferson County regulations. WW970MtviewVistaLot2.RPT/071106/xmk 15 I I I I I I I I I I I I I I I I I I I 6.0 REFERENCES Department of Ecology (DOE). 1981. Geoloav and Ground-water Resources of Eastern Jefferson County. Washinaton. Olympia, Washington. Jefferson County. 2006. Jefferson County Unified Development Code. Chapter 18, Land Use Districts, Section 18.15.375 Aquifer Recharge Area Report. Department of Community Development. Port Townsend, Washington. Munsell Color. 1994. Munsell Soil Color Charts. Gretag Macbeth. New Windsor, New York. Northwestern Territories Inc. 2006. Site Map Showing Well Locations. 2006. Port Angeles, Washington. U.S. Geological Survey (USGS). 1953. Quadrangle Map of Port Townsend South, Washington. 1 :24,000 Scale. Published 1953, Photorevised 1981. Boulder, Colorado. U.s. Soil Conservation Service (SCS). 1975. Soil Survey of Jefferson County Area. Washinaton. U.S. Department of Agriculture. Washington, D.C. Washington Department of Ecology. 1978. Coastal Zone Atlas of Washinaton. Volume 11, Jefferson County. July, 1978. Olympia, Washington. Wood Surveying, Inc. 2006. Letter dated May 17, 2006, indicating findings of well locations on Assessor's Parcel #901084015. Port Townsend, Washington. WW970MtViewVistaLot2. RPT /071106/xmk 16 I I I I I I I I I I I I I I I I I I I APPENDIX A SITE PHOTOGRAPHS WW970MtViewVistaLot2.APPAl071106/xmk A-1 I I I I I I I I I I I I I I I I I I I 1) Lot 2 near well-site 2) Surface soils profile near Lot 2 (roadside ditch) WW970MtViewVistaLot2,APPAl071106/xmk A-2 I I I I I I I I I I I I I I I I I I I 3) Surface soil profile on main road in northern portion of subdivision. 4) General topography to the south of Lot 2. WW970MtViewVistaLot2.APPAl071106/xmk A-3 I I I I I I I I I I I I I I I I I I I APPENDIX B LAB RESULTS WW970MtViewVistaLot2.APPB/071106/xmk B-1 I I I I I I I I I I I I I I I I I I I TWISS ANALYTICAL LABORATORIES~ 1Ne. 26280TwelveTreesLane.SuiteC PouJsbo, WA 98370 TeJephone(360) 779-S141 FAX(360)779-SISO INORGANIC CHEMICALS (lOCS) REPORT ,System ID No: Private Lab/Sample No: 010.35781 Multiple Sources: Date Received: 9/1512005 Date Prepared: County: Jefferson Sample Location:' Well Head Lot 1 q - / ~ Send Report To: Aqua Pumps 6962 Old Olympic Hwy Sequim, W A 98382 System Name: Date Collected: Sample Type: Date Reported: Date Analyzed: Malamute 10 9/1412005 B 9/1912005 9/1512005 DOH Source No: Sample Purpose: B . Supervisor: ST Analyst: KW Group: Bin To: Method I Analyst .Trigger? MCL? Notes: SRL: Trigger Level: (Stale Reporting Level), indicates the minimum reporting level required by the WashingtOn Depm:tment ofHcalth (DOH). DOH Drinking Water response level. . Systems with compounds detecredat concentrations in ClltCCSS of this level are JeljuiR:d to take additional samples. Contact your regional DOH office for further infonnation. (Maximum Contaminant Level), If the contaminant amount exceeds the MCL. immediately cOntact your regional DOH office. (Not Analyzed), in the JCSUlts column indicates this compound was not included in the cum:nt analysis. (Not Delectcd), in the results column indicates this compound was analyzed and not detected at a level greater than or equal to the SRL indicates Ibe compound was not detected in the sample at or above the concentration indicated. MCL: NA: ND: < (0.001): Comments: L !tJf Irj/~ Twiss Laboratory Number: 60556 [J Page ORIGINAl: I I I I I I I I 1~!~Q/200o l~ Of rPoX ~9Qf{~~loO 'W~~~~^Nf.~Yll~~L.~-~_M~n ~..... ........ TWU,R A N A T.YTlf:A J. T.A nOR A TORTF:S, 1Nr 26280 Ty.-elvc T.re:s Lant, S"li<: C Pou1300. w.... 9B.i70 T~leJlJlor.e (360) i79.514 1 FAX (360) 779.5150 Th'fO:Q.C.AltIIC cmMICJlLi (IOCi) rmnonT 2ynttn ID No: Prfvato l.fl8)gf1nt~lc !olo: 010 420i 9 Mulrlple SOllIT.es: . . ; _ Dare R.eCeivecl:_~~~ 12!27 dQOS . j Date Prepared: ! _ COunl:)': l j S~'lltom Name! &C611 Delutltl Lo! ;;e ... T D6!~ C~I~t~i-_- 12'271:2005 ..1. DOH ~~Nu:...._ __. Sample Type: B . ' Sample Purpose: B ,i ....... - - .--.---------- -- --- -- .1- .. ?-~~ Reponed: . !~"30;~~O.? . . SUpt~~~I2-_... ST ..,(~ ~~t~ luwyzed: 12..-27J2005 Analy~~~W __'_ _ Gro~_.._.._ Sample Location: Send Report TO: Jefferson Well Head Aqua Pumps 6962 Old Olympic Hwy Sequlm, Wi>. 98382 Bill To: -,DORffl ! SRL ! Trigger; 1vlCL j Rlceeds ,- "-o.'Jli;-;' '~"""I ..' . "iill:21 ...~ - . i ,~,;.jii::io'1.:'::.i;k,~(;.i' . " ,~.. ',~..'.If;,;,', rrl~er, I ftrCL? D. i 5 10 ; I Method I Analvst b~~~;~. '.;~:~tl1.!~;\Zt~i:~ ~~-"~f.:.j ; SM4S0D.N03 F i K W ; ~f.~> "'f~~~~~~\~:;' ." /~!;}~ .~~ ~~:-- ,./,;;"J ~.!:...~~;,..~.\ ,i~~~' 2] i ChlorIde Met? ~M45(J{J.C l:: KV..- ; I No~; SRL: Triu~ Le'I'~I: I I I I I I I I I I IVlCL: NA: ND: < {t'U)O Il' (SII1!.e lkpllTting l_~;\), indh;llltr till minimum :eponinllll!\'l!l required by lIle WoshiutUlll Dc.'I'W'lme.'1t oflleallh (DOH). DOH Drinkin= Wa;er rcsponsc lcvel. Sy..t~lS wilh compound. delected 31 coucentration; inel(cess of Ibis le'o;l Nt Jeq\li~ Kl a:ke edd.li-,j!1Ill'$;;rnplc;. Cor.racr \o'oor rerrionill DOH office for funllCl' infonuatioll. {l'o'1B.'(!m~' I..liniamtnilPlu..-eJJ_ It tne COl11.aInIlUmt llIllOWll cxcc.:ru we Hx;L.lmrn~~liJleI) contact )'O!:J J'Ciionai OOJ~ om~~. (Nol AnIlI)'2<<i), in tile T~U".. column lm!ltatiS mi. etJmpoulld ""lIS not includ((! in the cutletJl a.'\a1p;is_ (Not Deli':Cll!d), in th!: !'e5UllS collur.n mdi.:ate5 Ihiscom;>ound WlIl' _l~~ and not :lCle~ltd at a ii>\'e1 ~r tban Of equal 10 IIle Sll in.1icaw !IIi: c(:mpollnd "'iI$ "t>' cl:w;:w;J m thc sample at 0: ab:>.e :h~ f;'Q~~nlriltion ir:dicli.ed. Comm~nJ." 1\viss LaboratoryNumbt:r: 62869 Page 1 I I I I I I I I I I I I I I I I I I I 12/30/2005 12 OS FA~ 3807795150 TWISS@ANALVTICAL.@-6_N0A @ 003/(1(;4 ,.~~ w: TWISS ANALYTICAL LABORATORIES.1NC. 26280 iwt:lve'rr= !..anc, Sl.:iteC PouIsbo, Wi I. 98310 T~leph,,:lC (3~O) 779-5141 FAX (360) 719-5150 INORGANIC CHEl\fiCALS (lOCS) REPORT : S)'=mIDNo; __~rivate 'SystemName: SeDttDobs~~~t#4 _______ ! Lab/Sample No: 010 42021 .. -- -- - Date Colle~: . 1212712005 DOH Source No: f Multiple SOUTee5:- - -. -. --- -, Sa.'npie T)'p~B" . I . Sample p~~ r DAte ~~~Ncd: -. 12.127120'05---' -J Date Reponed: 12,'30/2005 SupeIVis~~ . Date !~pared: _. Da~~YZid: 12(.27/2005 __ Analyst: i Coumy: Jefferson ________._._ . . _... __ Group.: I_SiW!I?le Location: We)) Head ____....___ _ _ .. f Send Reporr To: AqUZl. Pumps BiU To: 6962 Old Olympic Hwy L_. _. _~__ S~quim, WA 98382 :n~= =-:=~=~ ~- ..-. -- KW I - I - DOH ,il --- ---,-- --- l\ICL? !deL? NOles: SIU.: TriSJCT Level: (Slale lepartinll 1.eYeIj, Ind~ the minimum tepC!tlin: te.-d mJ1L:mJ b)' die Wi5hiDgronDepanment-oflfcalth (DOff). DOH Dlio~ Water ~~ lrvd. S)IJt;ms --llb co::lJltlwclsde-lel:led It CllUCllrarions In excess oflhis I~I are required 10 taU actdilwll&l $8IIIpl;$, Conta;t your l'teiOllal OOH office {or further lntonn:ulon. (MiPlimllRl COlJl2mlDlRt l.evcl). If die COllt!lnlnanl amount t.=d! tile MCL. lmIl1edimely COlIIlir:! your ~gional DOH offic:e.. (N&l1\lla1}2tlI). in the rBUII:J t:DJum~ inliicates this compound WBli nar: in:lu~ in me Clln'ttIl: IlIalysis (NOI Dtreered}.in Ih= r6ull!; column ineieatc.; this :ompOu;ld was analy.md lIn~ no: ~c~ III a level !rca!Cr than or equal [0 the SR.L inlli"~; ~ COI1I~lUtd ~ Df)1 dele~d in tile ilmp~ at or abol't the ~QIl mdi;1&d, MCL: NA; NO: ~ {O.OOl): Comments: Twiss laboratory Number: 62870 Page 1 I I I I I I I I I I I I I I I I I I I 12/30/20Q5 12'08 FAX 3607195150 TWISS9ANALVTICAL.@-e_M@A III 003/004 TWISS ANAL \'TlCAL LABORATORIES, INC. 16280'fwt:l\'cTrce. L.ane,SultcC Poulsbo, WI\. 91370 Ttlepho."le (~60)71p..S141 FAX(360)779-5J50 INORGANIC CHEMICALS (IOCS) REPORT .~-.- ---.. . --.. .----..--..... .. - -. .-._.. ...... : s)..ttem ID No: _.?rivate ; System Name: Scott Dobson Lot ##4 I /1 Lab/SampleNo; _ OlD 42021 _ . :.:~~~~~ Data_~ollected: ~~~~71200S' - -~~- DOHSou~~~~ B ~... -._ .=-~-=.~=__ .. j Multiple SO\1l'Ces: I S!l.'Uple Type.: B I Sample Purpose: r- DAte ~~~ivcd: . 12,12712005----. . -JDate Reponed: 1213012005 . --.l_s~ervis~~ - ST '_~~. -- - ----..~. .~ ~_~pared: ... _:_Da~_~~y2ed: 12~'27t.2005 __ Analy~: _ _ KW __'__ __. _. j I COW1ry: Jefferson. _______._.. . . . ... ___~UP..: . . ._... _. __.. _.. .. . __Sany>leLocltion: ~!IJHead ___....__.__.__._ . ___._____ Send Repol1 To: AqUl! Pumps Bill To: 6962 Old Olympic Hwy S~quUn. VV.~ 98382 1__. .. NOleSl SRL: Triggcr~el: (SlllIe Reportinll LeveJ), In6iC&:e5 The minimUR\ ~oning level rcqui~d by ~ht WasruDglDn Department ofHCIIlh (DOH). DOH Dlin~ W~a- resporl:iC Icvd.SyJt~ms WItll compounds deJeCted III concentrllTlons III excess ofthilllc:vc) are required to [W lddiliunnl $8ITlpl~$. Ctmtact your reaiDnal DOH office for further lnfolln~llon. (Maximum COllllmlnlllt J.cvcl). If me commnltlant lImCJUnl =X~lb the MCL.. immediaJeJy COlliDe! your regional DOH office. lNOI JUial)z.td), in the mlllts CD II1mn IndiCates fills COMpflUlld WII5 llDl incllldcd in' The ~Ul'l'ttl! !Itla1y3is (Nol Deltaed). in lJJ:, ll$ulls column jn~calC,\ this CO~DlGld ""8$ mm1ymd and not cletcclcd It II level !n:Blcr thM Dr equall!! the SRL illliieal;-$ t1K: llClI'IlpoUlld was not dclllmd in tbr .ample at or ebo\lt the concentration indj~l~,' , MC1.: N,",: !'liD: <: (O.OOI): COB1IDCIIU. Twiss Laboratory Number: 62870 ~el System ill No: Private Lab/Sample No: 010:35781 Multiple Sources: Date Received: 9/15/2005 Date Prepared: County: Jefferson Sample Location:' Well Head Lot 1 Send Report To: Aqua Pumps 6962 Old Olympic Hwy Sequim, W A 98382 1-' 1 1 I. 1 1 1 1 1 ...;. ...-,. TWIss ANALYTICAL LABORATORIES, INC. 26280 Twelve Trees Lane, Suite C Poulsbo, WA 98370 Telephone (360)779-5141 FAX (360) 779.5150 INORGANIC CHEMICALS (IOCS) REPORT System Name: Date Collected: Sample Type: Date Reported: Date Analyzed: Malamute Ln 9/14/2005 B 9/19/2005 9/15/2005 DOH Somce No: Sa.nwle Pwpose: B Supervisor: ST Analyst: KW Group: Bill To: Notes: 1 SRL: Trigger Levl:1: MCL: I NA: ND: < (0.001): 1 Comments: 1 1 I I ----E-xeeeds----1 . - Method I Analyst Trigger? MCL? Trigger? MCL? (State Reporting Level), indicates the'minimum JepOIting level required by the Washington Department ofHea1fh (DOH). DOH DrinkingWater response level. SyStems.With compounds detected at concentrations in excess of this level are required to take additional samples. Contact your regional DOH offiCe for further infonnation. (Maximum Contaminant Level), If the contaminant amolDlt exceeds the MCL, immediately contact your regional DOH office. (Not Analyzed), in the results column indicates this compound was not included in the current analysis. (Not Detected), in the results column indicates this compound was analyzed and not detected at a level greater than or equal to the SRL indicates the compound was not detected in the sample at or above the concentration indicated. I 1 Twiss Laboratory Number: 60556 1 o Page I ORIGINAL I I I I I I I I I I I I I I I I I I I 05/1~/20Q6 08'05 FAX 36Qf(~~1~Q IWL~~~^N^LTI~, ~L.~-e_M~~ IB= vv II ..,..... . 'TWISS ANALYTICAL LABORATORIES, INC. :ZffZ80 Twelve 'IRes Lane, Sl,lil~ C Poulsbo, W A 98370 T;jq1i1~ (360)7?9-~ 14 i f.AX (36Oj 779-:H 50 1 Private - I System }~ame: 010 $153]1 DateCDllected: I Sample Type: j/l/'2boii Date Reportto.: i . -j Date Analyzed: I . - . Jeft'CIjSOn ~i!I~ead Pan:el #974~~02 Scon'Dobson 4"'...2 ~iscovery Ridge Rd Port taWDscnd, W A 98368 I - Analytell INORGANIC CHEMICALS (IOCS) REPORT ; SY$1em 1D No: :- LflbiSample No: 1 Multiple Sources: ; Dau: Received: :. Date Prepared: ~01lJlty: : Sample Location: 1.. ! Send Report To: 1 Thompson ;11/2006 B 5i512oo6 5i312006 . _.-r~ Source ~Q: Sampl~ Purpose: 1- Supcrvie\)r: . J Analyst ! Group: B ) sf . {I---'" J<,W - ----.. . --' ! .-" I -J Bill To: NDte$~ SR.l.; Triggt:' Level: (Stllte Rcporti Level), indi~,tct :he: minirr.um ~ning levei rcq\.ifCd by tile Vlashir.glOD ~attmml ofHealLl, (OOHi DOH DrinKing tier ~pOD~ l::vd, Syslllm~ with .COllljlMlJ'l.1lt d:teCkd II conCllolllrtltiOns in exce3. of this level an; JCqllirtll to rekz; ~dditionw sBmples. CocraGt)'Oll! 'ooal DOH oilicc follllt!:her in1ormet!DU. (MUimUlll loam Levell, l!'Ebr ccntamlnam fIn1cunt ~1!Cdl; Ute MCL, imlllCdiAttl)' contact)lO\lr ugiolllll DOH oftIce. (NOl.lU1aiyzed) in rr.i: resuI!5colWlllI inClieales this t:oDl\lc,und was nOI ineludcd in Ihc CWTOIIllll'W,m. (NOt Deu:cted). un the mults ~unm ill4icales this compvund _ IWmyzed Ma lIOt ~tod III i ltl-e1 UtlltCT man Or flqllilllO It.e SJl'~ indiCll!eS !be. ecjnpDIlno Wil5 lIor deltCtec In the SMlplilll1 ('If a~ rot COnccnnlllion indica;ed. . I i j i 1 I MCL: NA.: ND. <:{tWOJ): Comments: I I I T~~ Labomory NlIDlber:l6611 S I I 1 I Pag~ 1 Jun-Zo-08 01:SZpm FrDm-CCI Analytical LaboratDries. Inc 4253582828 I I eel ANALYTICAl. LABORATORIES, INC I I I I I I I I I I I I I I I I I T-DSB P.OO2l008 F-Q1B ,"::;-F~~'<,:{-i:;:t0~~r~G.:~;'*~'!i:i:t*,.tli.d:~j~?;>~r.M;:!ii€E-R; .,' ~~nF::lSNAt. . . r!f.4;~+:~;'i::::::~:6Wj.~,:B/}f.iJY'+.~:::,::.~Ji;~:;;t,i;'MS.~ CLIENT; WESTECH COMPANY P.Q, BOX 2876 PORT ANGELES, WA 98362, CLIENT CONTACT: CLIENT PROJECT 10: CLlENT SAMPLE 10: ceIL SAMPLE #: DR. BRAD SHEA MT. VIEW VISTA WW970 0/1412.006 9.20 A1-LOT1~ .01 DATE: CCIt JOB #:: DATE RECEIVED: WOOE ACCREDI1A1ION #: 6/2012006 I 0606081 1 611512006 , C142 } I I f I l I . ';~t iit1'-.s'.~,~;~::;:(;':~:A:~~;0:f.;;:;c~'lr::~>:;::'~:~,:..~~S~X~,i;:;~":?::~<i.;:;~~i.~~~~::?i{~i~ i Af'JALYS'" 'NALY~IS DATE BY I 6" 6/2006 RAB 6/2012008 HJK I I i I I j:.'~:~~~+~~::;;i~X~t~:;~.:;;~~ft:~::~;~~:.:~~i~l~~:~ifit~~~\::t~~~~~q~:~l~:~:ft7:~:L~. ' AN"l VTE Cttloride Conductivity METHOD EPA-300.1 EPA.'20.1 RESULTS. UNITS'. 52 850 MGIL UMHO/CM . "'NO" 1~;CATe.; ~ YTE /t;P4N.V'Z.i.O ':OR.8\1t NM lEtt(:T!O AT loi"ELADOVE RPO...,iNO LIMII. RiP-OWllhte tNl1lSava.lN _AMNT,t!!E6. _ ""'iTS 'O~..u. NI'~ UO~ID 3.......1$ ~ REI'ln'TED ON ~ llR'!'WEIC>IT 8AS1$ 8620 Holly Drive Suite lOU Evt!lcn, WA ~tl~U!l APPROVED BY: cfJi- page 1 4H !I 5(. l:!c,tlO . r AX ,p '\ ~J6161.s "ir;'lllll'o >./'lri ~9Z-9r~V I I I I I I I I I I I I I I I I I I I I I Jun 20 OC 01l5~pm rrom CCI Analytical Lahofatcrl"1 Inc .mmmc T 050 r,OOJ/OOC r 010 eel ANALYTICAL LABORATORIES, INC ., ! I, '~~1~~~~,~lC:~~~~~r~r:;~~).i)JJ ::.~::~::il.;:i.(t} ~~-:;~~ii:~~i~~~::r.::~~~'~~: :~r:;~ 6/20/2006 i 0606081 ' 6/15J200S1 C14Z I CLIENT: WESTECH COMPANY p ,0. BOX 2876 "'U~T ANGELES, WA 98362. DATE: CCil JOB #: DATE RECEIVED: WOOE ACCREOITATION #: CLIENT CONTACT: CUENT PROJECT 1D: CLIENT SAMPLE 10: cell SAMPLE #: OR. BRAD SHEA MT. VIEW VISTA WW970 611412006 to:OOAZ-LOT2 "()2 ANA\. YTE Chloride Conductivity MF;THOD EPA-300.' EPA.120. , RESULTS. UNITS" ANAJ.t~l:' DAT~ .611.612006 6/20/2006 34 460 MGlL UMHO/CM . ...oa.,..........". aN., t II" ""'........._ . ... ...... . ,..., mrn IT 1'"11 ftll 111r nrrl fl\l'ml ddJ'l ,1tntnl Jftt" l IMl1' l'ililllFrtlN r'Mim"'i=. .. lIMITe 'OR 1Il.~ hi)" ua._ _.I,ANllO IIC>IOIITEIJ O'l A DIlY..~ICttT-_ APPROVEOEY: cfdl- Pay.. 2 F>A..'X 42j 3-~f.-"f17.(, _ SClIJ'tle 206 292-9~S9 I I I j I 1:\620 Hony Dri..-e SUii.of ~6 I:"'~'fCTt> WA P.8208 425356-2&00 I I I I I I I I I I I I I I I I I I I Jun-20-DS 01:53pm From-CCI Analytital Laboratories, Ine 42535S2626 T-058 P,OD4/DOB F-BI8 CCl ANAL VTICAL LABORATORIES, INC ~;~~~~:~~~:~.::f:~~::~~t:f:::~?:;*-~~~;~~~~~~~~~{~i1~\~:~~~~:J.1r~~;i~1~.t::~~;~~.~ . DATE: CCIL JOB #: OA TE RECEIVED: WOOE ACCREOITATION #: -6/2012006 I 0606081 1 6/15/2006 I C1421 CLIENT: WESTECH COMPANY P,O,BOX28-76 PORT ANGELES, WA 98362. CLIENT CONTACT: CLIENT PROJECT 10: CLIENT SAMPl.E 10: CeiL SAMPLE #: OR.. BRAD SHEA MT. VIEW VISTA WW970 6/1412006 10:40 A-3-LOT4 -03 .{C;::.tr0~,:;~:;;i','::.,:;,:;;':*,~':~~:;:':P;;':~'1~'F::;;:t~~";~-Si:l,:tii/t~~,~~!E.::~:~~i';:aAT:' .::'RE. . '.:'1!S7;;,~X::t-~'::.~,i.::<;;::~~;:,+:~;<:A~~t~::;":'f:T~f.N:;-;;1-:f:2J::i?b:~?:t',;-::;:! I ANALYSIS ANALYSIS ANAI.'ffE rJI~HOD RESULTS' UNlTS- DATE: BY' I Chloride! EPp...300.1 22 MG/L 5/1612006 RAB Conductivity EPA-120.i 660 uMHOICM 512~12006 HJi< . -..r ."IOICA'58 _"'1 AHtIl. ~2ED FO'< o.JT NOT oIfTECTtlI"T 1o.EVc. ABlMO .....ORlIIOG .io<rr.-;O:1'OiITI'oI>...ur <$-GlVEN" p~:&.$ ~ UIiITs-~ORAU. ..),,~ _...:.a aIlE Rl.o>oRfED ON" DRT ..EIIlrlf Ur.!18 APPROVED BY: CrJ- 8620 Holly Drive Suite 100 ~iige3 Everett, WA 98208 425356.2600 fAX425356.2626 I I I """, 206 "'.1" I , I I I I I I I I I I I I I I I I I I I Jun-ZD-OB 01:55pm From-CCI Analytical Laboratories. Inc ~2535B2B2B CCI ANAl. YTICAL LABORATORIES, INe 1-058 P,DOB/OOB F-818 H~M:~,:::::~!:~,~$,,*.;';;:~;:.;;:;:<~r~y~~j;.;,~:j;~'i(;;;~:;~;~Btft;i::~)~'?~HBeRT:i~lbAtl:;6f::~\:;~':;W~.~1-i:~~:\(;\~:<~i~1~i.iI~~''::~::>i:~2*'t!t;~~0i<~'{~~::r:~;~;;r~~ CLIENT: WESTECH.COMPANY P,O. SOX 2876 PORT ANGELES. WA 98362, DATE: CCll JOB #; DATE RECEIVED: WOOE ACCREDITATION #: Cl1ENT CONTACT: CLIENT PROJECT 10; CLlENT $AMPlE1D: CCIL SAMPLE #: OR. BRAD SHEA MT. VIEW VISTA WW970 611412006 11:15 A-4.l0T5 -05 :::'~:':f1.:~:;i.~:~t:..~;.::~:;jJr~~~i'~;::'~.{ :~~.~ r::.~~~~~:;:::.:::<i~~::.~:t:M:;'~~;"":~";::::':':':: ....; ~ . ANALYff Chloride Conductivity METHOD ~PA-300.1 EPA-120.' RESULTS' t:il1 800 UNITS" MGlL UMHOICM . 'ND'lND,rAT~S,.,.".,m--Y%ED FOR BIlT NOT DOT~CfED.AI L~VEl; NlOllf. """OK;1l'OC! L...... AEPOIIIIlIoCLI8l11 k~ C1~Ioj'" '.........I4IES, "uNl18 fD""'L IIQ~ LtQ.lID iAIo""-EI M,; REPOf',llD 0>111 ~". WiIGl,T ....BI3 APPROVED BY: ctJI- l-'21ye s 8620 Holly Drive Suite 100 Everett, W A 98208 425 356.2600 FAX 425 356.2626 612012006 0606081 6/15/2006 C142 : i , ANALVSIS DATE &11612006 6/2012006 I ANALYSIS BY: . I RAR HJ~ i I I I ~ I , I I I I I f ..,n!, '''6t92.tso I I I I I I I I I I I I I I I I I I I 08/18/2008 07:40 FAX 3807795150 TWlSS@ANALVTlGAL.~-~_M~A ~ OO;UOO;j I ~Pif\___ TWISS .4ALl'TICAL LABORATORIES, INC. 0 I 16280 Twelvi 1,..5 Lane. Suite q i'oul3bo. W A 9&370 Telephone (360) 719-514 J fAX (360) 779.51 SO System 10 No: Lab/Sample No: Multiple Sources: Date Received: Date Prepared: ~unty: S~ple Location,: Send Report To: , i INORGJJNIC CHEMICALS (IOCS) REPORT I System Name:- ".WW970 MtView v~ti Dat~Collected:'- 611412006 ' .OOH Source No; Sample Type: "0 S~ple Purpose: '.-1~epol!e~: '611712006 .Supervisor: Dat IAnalyzed: 6/1612006 Analyst: 1 " Group: n .. /r / Private 01055980 .~ B 81" KW 6/1 512006 Jefferson B-1 Westech Company P.O. Box 2876 PottAngeles, WA 98362 .__1 Bill TO: - - Exceeds Trlgler~ MCL~ MCL1 Notes: SRL: Trigger Le~I: I I (St~ Reponing Level), indiclIk' 111, minimurrl rqoltin8 I~el required by rhe Washington DIJlartment or Health (DOH). DOH Drinking Willer Jt$ponK levd, Systems ,irh compounds detected atc:onetntnltions In excess of!l1is levchre required 10 take additional samples, Conl1lct -your regional DOH offi~ for further infonnation, (Mallimum Contaminant Levcl},I! the contamirtBnf lIIllOullt clImds the MCL, immedlalel)' &:l)nta~ YOur rCjional DOH omu. (NoI Analyzed), in !he results column indicates this compQund -was -nOI included in the CIIlTentanlllysis. (Nor Detected), in the resulLS column indicates 1his compounlJ "'IS 1Il1llyzed and not detected II a level ereater than or equal to rhe SRL indicaleS the <<Impound was nor detected m-lh; sample-al or above the ~eemration iIIdieated. I MC!.: NA: ND: < (0.001): Commeats: I I I I I I I I I I Twiss Laboratory Number: 67550 Page 1 I I I I I I I I I I I I I I I I I I I 08/18/2008 07:38 FAX 3807785150 TWISS@ANALVTICAL.@-@_M@A Igl 002/003 System In No: Lab/Sample No: ~ultiple Sources: Date Received; Date Prepllle~: COWlty: Sam )e Location: Send Report To: I TWISS~ALYTJCAL LABORATORIES, INC. i 26280 Twelwe Trees Lane. Suile € POIJltbo, W A 98370 Telephone (360)779-5141 F A)( (360)779-5150 I I INORGt~C CHEMICALS ~OCS) REPORT. . Sys ,em Name: !,Yf970 Mt View Vista Date Collected: 6/1412006 DOH Source No: San\ple Type: D Sample Purpo~~; I . . 0-- . D8I~ Reponed: 6/1712006 Supervisor: Dat AmJlyzed: 6/1612006 Analyst: Lh oro.up: I 1 ~ Private 010 55981 6/1512006 :r ,~ KW Jefferson B-2 Westecb Company -P,O; BOl( 2-870 Port Angele~. W A 98362 Bj}JTo: Exceeds Trigger? 1 MCU . Trigerr? MeL? Nota: SR.L: TriSler uvel: i I I (Stale: R.eponing Level), indicllles Ole minimuril reponing level requIred by the WlShington Deplftment of Ht1Ilth (DOH), . DOH OrinkinE Willer Il:spome lev.el. S)'SleaQ ",ith .compounds dctcetCG at -col\oenlra(illl1S in exeeu -offms IcYeI are -required 10 lIIke addilionaf samples. COnteel )'Our r'iionlll DOH office for funher ihfonn81ion. (MllXimum Contaminant ~e1). If rbe conwnibanllllllOllnt exceeds the Met,immediately COnla~ YOllr reBionat-DOH offiee_ (Nol Aftlllyzed). in the results column IndiClleslthil compound was not iIlcludcll in lhe eurrtnllllalysi,. (Not Detected), in the results column indicates this compound was II1l1lyzed and JIll! deleck:d III a ~evel Bfeater dianor-equal to the SRL indicates the compound was not detleCtcd inth<< slImple .ror abonthe co\\cen1raJiOll-indieered. I MCL: NA: ND; < (O.OOt): Commelltl! Twiss Laboratory Number: 67550 Page 1 I I I I I I I I I I I I I I I I I I I Jun-Zo-OB 01:54pm From-CCI Analytical labDratDries, Inc eel ANAL ynCAL LABORA TORIES, me 4Z535Bzm T-05B P,DD5!ODB F-B18 ':t.~1{t:~r#it:f~~~~*~~~~;$t~t~~!~~fZ,~~~~:~t~~n~~~~t~~;~'iH~t'.:.-' ,. I :. A.tYS\St~,:f.if;:J,;j.}':;eX~;i#i~~'::;::;;,::~[,:;';:2:~:N{j:::ji1st;:~&:..'4/' CLIENT: WESTECH COMPANY P.O. BOX 2876 PORT ANGELES, WA 98362. CLIENT CONTACT: . CLIENT PROJECT 10: CLIENT SAMPLE lD; cell SAMPLE #; DR. BRAD SHEA MT. VIEW VISTA WW970 6/1412006 10:50 B-3-LOT4 -04 ~:~~1~-:-:-it~~~;:t~:tt~?H~~~~~~ :r~~t:;~\f:~~~?:.~~~:-(%~~:.c;;'~~1;f~~!t~;:~0:~~::~~f:;r:::.~~~ WR. AKALVTE Chloride CGnductivlly MEnton ePA~300.1 EPA-120.1 i i , I -sOL:i: ' '::;:~.:::~;;::"i;:J~l,'~~2,i:t:;~~:;-;;::'~'.:t~i:':1\FWdF1'~~;j:~W.;~?,;::j;~li~,;:;;:~:;h~ I ANALY&tS Byl RAB HJIk I I I , I DATE: CCIL JOB #: DATE RECEIVED: WDOE ACCRE.OITATION #: RESULTS' UNITS" MGlL UMHOfCM 17 650 . "ND',NOICA'TD"""" "'E""'" yZEO ,o~...-r hor OErlCTl:O.o.TLl\IEL AlIO\1i'l,JORTING .IM'T. ~~TIO'IC3 .oM,"8 GtlrEN IN'AlIItNltoE!lES. .'''MT8 FOR"'L r.tlNVQua...,.....ESIaFlE KiPORI'EO QNADRTWEIOMT UI&9 11620 Holly Drive Suite lUO F.vercu. W A 982U8 APPROVED BY: Ca/- Page 4 425 356-2600 FAX 425 356~2626 6/2012006 I 0606081 I 6/15(2006 C142 ' ANAL "$IS DATE 6116/2005 6r2012006 I I Scall.le 206292-9059 I I I I I I I I I I I I I I I I I I I I 08/19/2008 07:39 FAX 3807795150 TWISS9ANALVTIGAL.@-@_M@A ItIlJlJ l/lJlJ;j ~~lem ill No: Lab/Sam Ie No: Multiple Sources: Date Received: D~te Prepared: CQunty; Sample Location: Send R.qort To: TWISS ANALYTICAL LABORATORIES, INC. u:no TWelve Trees Lillie, $uilC d Poulsbo. W A 98310 T~lqlhollc (360) 779.S 141 F t\X (l60) 779.51 SO I INORGktC CHEMICALS (lOCS) REPORT I -s~ Name: WW970 Mt View Vista Dat~ Collected: 6/1412~~6 DOH ~urce No: SamPle Type: 0 Sample Purpose: Date\Reported: 6/17~006 Superv~sor: Date! Analyzed: 6/1612006 Analyst: -: Group,:, Private 010 55982 B '.~ 5T t:- .. _... I KW I .~ 6/1512006 Jefferson B-4 Westcch C-ompan)' P.O. Box 2876 Port Anseles, WA 98362 ~BmT' Eleeeds Trigger? MCLf TriIlIlU? Yes Yes NDtel: I I 1 I I I I {Stlte Repot\ing Level), indicNIS die minimunl repDning 1ev.1 required by the Wasl'linr.on Dep8rlmellt of Healtb (DOH), DOH DrinJcinl! Water rl!SpDn$l: level. Syllems r.ithccmpounds deltcled at conctntr<<tions in excess of this (;vel..,... requited 10 take -additional s8ll1ples. ContACt )'our regional DOH om~ for (wtJll:r irifonnation, (Maximum Contamillam Ltvel), If the eontamit\ant amount Cl(ueds the Met.. imlJledillelyconlact your tegil>>\al DOH otlice. (Not AnaJyzed). In the fI5tIIlS colllllll\ indicates -ibis compound was not included in lhe currenlllllalysis. (Not Delected), in-me RawlS column indiC8~ this compound wfI$ llIalyzcd and not delecled at a level greater Iftllll or cquBlro the SRL indiwlGi me tompoullll-wu f10t detected in the kmplc at or above ihe c:onccntrBlion indicated, I i J I SRi: TriBer Level: MCI,.: NA: NO: <: (o.o~l): Commeu1l1; Twiss Laboratory 'Number: 67550 Page 1 I 8---,- , o I I 11;; CD 11 o tn I"; J'; Ie <C = ~ I~ o Ij I I I Ql ~ Ql~ WLL. oc)co I g~~ !Xl' C\l c) C\l o I I I C\I COC\lCO !XllDc)lD O'l C'J C\l C'J o <C lDtOlD 1~3:_~~* i Ql ... c: Ql 0 >.c: !Xlwc.. i l.NOIJ.IQNOO Q009 NI Q3A1303l:l Sl:l3NI\f.LNOO :l0 l:l38VmN "- 0 1 .~ .c::) CD Q. CD ~ , ~ a: "", . ,. : ~l-;>n r~ '"7 "> '\ l ~ -..... ....":) ~.... '> Q;-, w' .,.... ~ ..:I: ~ e-'P''''''T( '1:> ....... 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I':' - I ,'!pI ", ..'1.1 r Cf)e~-'-' err_Will Cok CiI:1~ Qluuq: :r~~~~ _ ~Of1toD: OmIInIllllllWDI'wcTI(ir......~ - IAaIIaltJ.l.v.1141V.>>Ju4 s.c...a. ~ 1..1- MIl ~ 0__ :~~~~~= u IA~ IA_ & DJamelcraf-t1 \01 U r::; ~) LaaJDcI tcq MfnI$Ic , ,', . ~Of~wal" TUPlrcelNo. Q,l..l"'~ ,,(X~ fJ (:ONID't :JlVNDJn'AU .".,. v . '..,,',"', " ' , ~ ~, , - lQ..lJIIm."'--'l-.Jc.to~ .~~~IiLt........,. 1JaBtldJdi, ~erlalllW~" DJam.fa:n~to~ ~.._ar."'_liUI_llliII1Iim~ wlAat!eutC8l :'1"iITl18iW _~mam.flaII. 1t1lO-,",' fIlr"'-'--Ot~IIidkItsa1l-~ ~ ~ . 1ifiiB~,AL~JF~tuYJ ~CYIII~ I' .'.,'N.\1'IiftW. PJ.ON 1'0 ~~- -, - ISJZBd, '~, ,- ilL hv-JI,adllll or- rn.---Jt. tlJ---.Jt. .JCc ... "...' \ ' ('I oil. ~J1tt.. CNv DLPe · ~~ ..& I' . j, ~N..". I "-, ," ",' '.' .. . , "P\.Jf. I . It r ... :....~', i, ~ v t'" ~~ ~ U'l"'llt..,__,i,~ll4.!'JI. NIL.. 16 ""':1.~ fL I!li 1'\ 11\' ........... ::AI ~ j JU . ~ -.-.c'n I ...._ ".R... .. '~ It In ft. ,,'''''',- ~i ~~[jy;::~ni~;O~:,..~. l"trl,.. CC~l ,L ;ft- fA ~ '. - ~' ;'~'If+-~ IN>.., l4-'~'''''' ~" ~-r..~y ,',' '~ar__ M.axJI.(j~..orr- I.~~=~ .ltf, \\iA.~tim.s:~~~~1J-tMt tL ~~.~)'tnLb ,',.,. tLIletow1OJlClftItU ".~ {~"'I~" ~ ArI&iIfQ~ ,.' ,'..n...JIlI'f;IIiIiIt.. na. ~Wa~iI~~ l;t 10 )..1 J~ , ,,' (_Yalft...., ~,::r=..e:,1:i;:~~~~ldow..1evcl Yie1d~J--.'" , ' ft. dra9ido....lfter. . Jiq; YlIle " 'plhlin.WitJ, , ~-c1owR'" hr&. VIeW' ,." ilJlL(lIIID.'MItll "tt....w4oMl.. IDs. ltltitllW1il'(~""" IftwYJ""''''''''' ct/I1lWllltrmlltlMS1Ul4jnJm WrlJiilPt.~~) , , 1'1nleW'4*Uws1 Time WalcrLml 'nme W"1.awI1 DiiD"oftat I' - --.. - =urrtt ~~":m...at 4~5:':r~. A:IWIiu4? '" ""I.JI.lII.~ TlmPmtiireGt__Wea_lIlcllh..~rllllde"l Dyes ~ hllDiE'L..q~~~... 1~-,.,--o5 WBLL~TiwcnQN ClJrrJ:JtcADtJN; I ~aJlor IIlalptIlllpQllllbiKl;y tbrCOlll1l'lJCdDl1oftilve1l... ill'~wllh.n ~~:~~~~ flflnllDet,.....HGt!1 ~ .- . ~.& ~.. ~ ='JoIrt- 'Dale" rL-tB .05 ........ ...J..."~___._. ,~ A^'-....^^.... 4 I 1 I I I I 1 1 1 I I 1 I 1 I 1 I 1 I ? . QtL r'; .( " ! r::Ji. I ~ ~ o tI A T B R II B 1 1 II. R P 0 R T Start Card No. 178331 Unique tiell I.D. t lKS963 STATE OF WASHINGTON later light Permit No. ii)=OmR~=i:~;=DoBsoi=coHsmuciloH==============A~~;;====4ii=DIscovm=iiDGi=iD====poiT=ioBsDD:=n==98368~==============: lIr;=~~giio~gi;~L~i=~i~tl:~~!~r:~~::::;=;~=;:=:=~;~~=~=E4;;iB;i";;Je~=i===T-2;==B:~=i=ii- wi-===--==: =================================================================:::======================================================~ (3) PROPOSED lJSB: DOImSTIC(10) IfEliL 100 {4}=mB=op=ioRi~=========~jje~~~:i~~~;:~!~;;ii============ -~r:~~~f~~:~~ili;:ti:~~ti~h~:i~~t~~j~:-~~;~i:~~~- ===_~=~~~==============!;;~~~:=~~~;==============--======= ~d l~:~f~~f e~~mf~ir~h ~~;: ~rt~:arrg~~rated, with (5) DIMIlHSIOIS: Dia1lleter of lell6 inches u_uu_________________uu_______u_____uu_________u___ Drilled 42 ft. Depth of completed yell 42 ft. IATlRrn FRO!! TO =========================================================== TOP SOIL 0 .2 (6)COllSTRUCTIOlf DETAILS: BROn CIrAY 2 6 Casing installed: 6 I nia. from 0 ft. to 40 ft. BROlm CLAY IfID mm 6 28 . iRLDBD I Dia. from ft. to ft. BRon n SAB>> & GRAm 28 35 I Dia. from ft. to ft. GRAY.CLAY 35 42 lork started 06/07/04 Completed 06 08/04 {9r=WELL=TBSTS~=D~;d~;;=i~=i~~~t=;it;~=i~;~i=i~=1~;:;;d=b;i~;====,i1L=cONSTRUCTOR=cERTIFiCiTION~===========================, static level. I constructed and/or accept responsibility for con- fi~s a pump test mad~? 19 If yes, by whom? stru~tion of this well, ~ its eqmpliance iit~ all Yleld: gal./m nth ft. arawdolfll after hrs. Washington well eonstmctlon standards. Hatenals used and the information reported above are tme to my best knowledge and belief. Recovery data Time Water Level Time Water Level Time Water Level JIAml TIJ.1IA mL DlliLI1lG (Person, firm, or corporation)~ (Type or print) ADDRESS 367 S Bm PORi' ANGELES ISIGNlID) -;x~};/...;- A.;!I;.<; License Bo. 0868 v - --- . Contractor1s legistrationlfo. TIliLIIID043KO Perforations: IRS -1vDeof-perfoIator used PIRPORATRD SIZB of perforations 114 in. by 1 12 perforations from 3) ft. to 35 ft. perforations from ft. to it, perforations ,.from .. ft. to ft. ---------------------------------------------------------- Screens: 10 Manufacturer's lame !ype Model Bo. Dlam. slot size from ft. to ft. Diam. slot size from ft, to ft. ---------------------------------------------------------- Gra~~~!!~~!~~:~~~:~~_______~::_~~~~::_:~~::~_____________ Surface seal: YBS ,To what depth? 19 ft. Material used in seal BRNTOIITB nid any strata contain ,unusable yater? 10 TvDe of water? Depth of strata Method of sealing strata offBOIK (7)=PUMP~=M~~~fa~t;;;;~;=N~~~=======================;============ Type 10HR n,p. (8)=WATBR=LiVR1S~=============L;~d:;;~f~~~=~i~;;ti~~============= above mean sea level ... ft. Static level 15 ft. b~loY top of well Date 06/08/04 Artesian Pressure lbs.per square inch Date Artesian vater controlled by BOHR in. Date of test I l Bailer test gal/mm. ft. draidolfllafter hrs. Air test 7 ga17min, w/ stem set at 33 ft. for 1 hrs. Artesian flow g,p.m. Date Temperature of water Was a chemical analysis made? 10 ~o7" I'I~~ I AI Lt~ C) (!)I e tJ ~Z> W (l2 tP -qq c {p 2. j ft. ======================================================================================================================:==~=== Date 06/29/04 O'RAW SOURCE~ Source i/.~ m o Total CoIilDrm I 0 NEW CONSTRUCTION orRt:n~:II=lS ..." O,Feca, I Colli, arm . 0 OTHER (Specify) ,,' ,. _ '-'. . 1 I"l',.,~ ~USE, ;;..;;...,~" "~ o UNSATtSFAC}OFly,-t;6\iforms present ,"SFACTORY. ' , . COliformsabsent j .= ~::= ~::=" '.~ 1 OTHER LABORATORY RESULT 1 TOTAL COLIFORM _'100 ml E. COLI 11 j FECAL COLlFORM_I1OD mI PLATE COUNl'____, ml ANOTHER SAMPLE REQUIRED -..------ I . 1SS ANALYTICAL, INe. 26276 Twelve Trees Lane, Suite C Poulsbo. Washington 98370 (360) 779-5141 WATER BACTERIOLOGICAL ANALYSIS ,AMPLE COLLEG1lON: READ INSTRUCTIONS ON BACK OF GOLDENROD copy I If instructions are not followed, sample will be rejected. DATE COLLECTED TIME COlLECTED COUNTY NAME MD~ / ;:,V /:~ ~: ';,~M V.. _" 11YP, E OF SYSTEM IF puauc SYSTEM, COMPLETE :JPUBUC [[[[0]' ' o INDIVID.IJAL \1.0. No.1 ' CIRCLE GROUP (SIIfVK only 1 -..eel " .' A B I NAME OF SYSTEM I I .. I ~=:_,"""rou=o ~;: I SAMPLE COLLECTED BY: (Name) .. . .... t.... I.'" ; .t:':', EVENING ( _) If / ( SYSTEM OwNEAlMGA.: (Namef .' H . . .. 'l._. :. ~ SOUR'CE TYPE (J GROUND WATER UNDER SURFACE INFWENCE I 0 SURFACE DWELL, or 0 SPRING 0 PURCHASED or 0 cOMBINATION WELl F'ELP'NTERTlE ". or OTHER SEND REPORT TO: {Print FuU Name, Address and Zip Code) .,f..~ _.' _ . ,f.. : .. I ,i.L'- .( I:, v' t./ ...:.. , ' WASHINGlON I TYPE OF SAMPLE{check only one in this column) {J~lmI1.fGWATER o Chlorlnated (Residual:_ Total_Free) check treatment ) 0 Fdtered o Untreated or Other I o REPEAT SAMPLE Previous coliform presence Lab # 'Date_'~'- I 1\ 11 SAMPLE NOTTESTED BJ;:CAUSE: [) Samples too old o Wrong container o Incomplete IDrm o TEST. UNSUITABLE aECAUSE: , iOt:onfluent growth to TNTC o Turbid culture [) Excess debris i Ii i SEE REVERSE SIDE OF GREEN COpy FOR EXPl.ANATlON OF RESULts LAB NO. (7 DIGITS) DATE, TiME RECEIVED REC~VED BY 010 C; Ii, 1 ,~ I./....~ ( , '.;, , "'''' ':-.-.. I,. f~ LABORATORY: ..; I f~ j \ ':.- ~-: , . L ,...., " ,', '-, I) .... '.. _.--r t.. - I j 1 j j 1 t 1 i ; i I j . :, i ~ , 1 1 1 . :...:.:::t 1 1 j '1 ! :1 . t 1 i ,~ 1 L ot /'I~ . .j 1 'j '] ., i j I I i I I I I PROPOSED USE: DDcWatcr llJDomcstic o hrigalion DMuaicipal o 0Ibcr D JmlusbiaI D TcstWell I TYPE OFWORK: Owncr'sDlllDbc:r ofwell (If_than one) lZI~wcII DR=mditioncd Me1hQd:Dnug DBmed D Dccpcacd DCabIc IZI Rotary DlMENSIONS: Diameter ofwcll-L--inc:bcs, drilled 382 ft. Depth of Cl)mplctcd well 382 ft. CONSTRUcnON DETAILS Casin: IZI Welded ~- Diem. hu 0 IDstallcd: IZI Lincrinsla1lcd 1--- Diem.hu 11 o Threaded - Diem. hu Pcrrorations: Dyes IZJNo Type ofperforatorascd SIZE ofpcdS in. bY. in. BIldDO.. ofpcdil Sc:reeas: JlJyes DNo 0 K-Pac Location Manll&dwcr'sName PVC Type PVC Model No. Diam. 4 TNr.H Slotsizc mo wm352 llto 362 D1iiDL'd "'SlOtsizc ' ,', hull to GravcllFallcrpac:bd: Dyes IZI No DSizcofpvcVsand MalI:riaIs pIaccd fiom II to II I D DIm:n o 1el1ed I 11:. to 37 ft.10382 11:.10 I wm ft.to I SarfaceScal: IZ!Yes DNo Towlaat~ 18+ Matcria1uscdinscal BENTONITE ft. Did any sbaIa cODtain ""usab1e watcfl Type ofwatcfl Method ofscaIing strata off PUMP:ManufiIcbm:or's Name TyPe: Dyes IZINo Depth ofsllala I RP. I WATER LEVELS: l.and-surfilcc cIevation above mean sea lcvcl Statick:vcl 168 1I:.bclowtopofwcll Date 07/18/05 Artesian p.tllSSIm: Ibs. per squaxe inch Date Ancsian WIller is COlltroIIcd by (C8Il, valve, etc.) WELL TESTS: Dmwdownisamountwatcr lcvd is lowcmd bcIow Slatic lcvcl Was a pump tcstmade? DyeslZl No Ifycs, bywhooil YJc1d: alImin. with II drawdown after hIs. Yield: alImin. with ft. drawdown after Jus. YJc1d: aaLImin. with ft. drawdown after hIs. Rscmery diJlIl (time /aken <IS :zero when pump tumrul ojJ) (waJer I,."e! metlSllreJlfrom well lOp to _ultIPe/) TJIJIC Water LcveI II I I TJDle waleiLcvel Water Level TIIIIC I Datcoftcst Bailer tcst_gal./min. with 11:. drawdown after _Ills. Airtcst 112 ESTgal./min. withstcm set at 3721l fur 1 Jus. ' Artesian flow 1t.P.1D. Date Tc:mpcralDIcofwatcr_ Wasacbcmicalaualysismade? Dyes IZINo I I CURRENT Notice of Intent No. Wl86716 (9(0 ~-f. S Unique Ecology Well ID Tag No. AHR312 Water Right Permit No. ~~~ Well StreetAd 58 LOT 5 ANDERSONLAKERD Ci1,yPORTTO County JEFFERSON Location NWJJ4-1/4 SE 1/4 See 8 Twn 29 R 1 EWM 0 cirdc - - - €- - ~0- ( LatILong (~ t. rN LatDeg If fJ ~ Lat MinlSec ,., I. 2L '2 StillREQ~ LongDeg 122 ~ LongMinlSec~ 7 (l Tax Parcel No. 901084004 ) =..~ '( CONSTRUcnON ORDECOMMISSlON PROCEDURE FoImation:' Dc:sa:ibc by color. ~ size ofllllllmia1 and structure, BIldthc tind and D8IIIn: ofthellllllel:ial in each stratum pcnctmted. wilhaticast one eIIlIy filr each cbauge of iDbmatioo. 'CUSE ADDITIONAL SBEETS IF NECESSARY.) TO 2 14 40 42 52 61 75 77 82 84 87 93 95 98 101 108 109 113 245 276 281 288 382 WELL CONSTRUCTION CERTIFlCA nON: I constructed and/or accept responsibility for construction of this well, and its compliance with all Washington well consttuction standards. Materi.als used and the information repormd above are true to my best knowledge and belief o Driller 0 Engineer DTtaince ~~~4 Drilling Company AQUA PUMPS DrlIlcr/Engin=trraincc SiJ!l1lll= Addmss 6962 OLD OLYMPIC HWY Dri1lerorl11linccLiccnscNo.2252 Citr,Statc,Zip SEQUIM, WA 98382 11:. 11:. ft. II MATERIAL FROM o 2 14 , '40 42 52 61 7S 77 82 84 87 93 95 98 101 108 109 113 245 276 281 288 I I r~ DriIIcr's Liaascd No. Drillers S"JgIIlItun: fl. Il TOP SOn. BROWN CLAYWIIH ORA VEL ,GREY CLAY GREY'CI;AYWlTHBASALT GREY Sll.TY CLAY GREY sn.TY CLAYWJ.FRACTOREDBASALT GREY CLAY BllOWNSlW..E GREY WY GREYWYWITHBASALT ~1, " "'~$ILTYCLAY .GREY SJL'tSTONE BASALT GREYSll.TY CLAY BASALT GREYSll.mONE BASALT BASALT WlTH LESIONS OF Sll.TSTONE GREY CLAY Sll.TSTONE BASALT WIB BROWN SHALE Dale 07/19/05 Ecology is an Equal Opponuuity Employer. ECY 050-1-20 (Rev 3/05) The Department of Ecology does NOT warranty the Data and/or Infprmation on this Well Report. Start Dale 01111/05 Completed Date 07118105 I COpy. I I I I I I I I I I I I I I I I I I I 97L/- ~~~- ooJ . ~-;.. \~.& ,~ WATER WELL REPORT ......11.. no.. 0rigiu8l& 1" COjlY-:Ec8Joey,r' coPY-lnnler,3'" copy-driller It~.'ltJ11' II ECOLOGY ConstructionlDecommission ("X" in circle) EI Construction o Decommission ORIGINALlNST.ALLAIION Notice oflntent Number PROPOSED USE: JZI Domestic D 1ndnsbia1 D M1micipal Onewala' Dl:aigaIion DTcstWell DOIhcr Tn"E OF WORK: Owner'sDDJDbcrafwc1lfIf_tban lIIIC) IZINcwwel1 ORccondilicmcd MeIhod:BDag OBmcd o Deepeucd Cah1c IZIBDlary DlMENSIONS: Diamelerof)Wll~ indles,driI1ed~a Depth of completed weI1 182 a CONSTRucnONDE'1:AIIS Casing IZI Welded L--.: Diam.:lram 0 Iasblled: IZI LmerinstalJed L--, Diam.. fium 27 o Thn:aded . Diam. fimn PeriOralimu: DYes llINo Type ofpedixator used SIZE ofpcdS in. bY. in. and no. ofpd nom Scn.eus: '.IZIYes oNo DK-Pac LocaIioo. Manufiactun:r's NlIIIIC Type PVC 8CH.4O Model No. Diam. 4lNr.R SIatsize 010 fi:om 152 aID 162 DiaD>. "Slot size fi:om aID"" Gl"llVelIJiiJter pacluod: 0 Yes III No D Sizctof gmvolfsaud Materials placed nom aID Sarliaces..J: IZIYes DNo Towhatdcpth? 18+ M8b:ria1 used in seal BENTONITE Did any stmla CODIlIin lIDvsable waIcr'l Type ofWlllcr'1 !dethOd ofsealiug ~ off P.DMP:Manu1aclmer's Name Type: DDriw;I1 D Jelled aID 39 :lt1D182 all> aID a WELL CONSTRUCTION CERTIFICATION: I constructed and/or accept responsibili1;y for construction oftbis well. and i1scompliance with aD Washington well constIUction standards. Materials used and 1he infoIJDation reported above are true to my bestknow1edge and belief tiDriDer 0 Engineer 0 Txain= N~~ ~,D.fB,~ LER... DJiIIiJlg Company AQUA PUMPS Dn1letfEllgineerlI'rainee Signature ~, AddIcss 6962 OLD OLYMPIC HWY DriDcrorIrllineeLi=seNo. 2252" City.s-.Z;P SEQUIM, WA 98382 (~~ ) :-.::,.,~ it. Dyes .IZINo Depth of_ RP. WATER~: Llmd-surfiIccelevalionaboveDlCllllsealevel 240 EST a Static level 83 a below lop ofwel1 Date 06/29/05 Artesian pteSSUIe lbs. per squaIeinch Date Artesian _ is COII!IOlJ.ed by (cao. valve. etc.) WELL TESTS: Drawdown is amcnmt_1evel is Iowemdbelaw static level Wasapomp_made? DYes, IZINo Jf"yes,by-wbom? Y"Jdd: u1./min. with :It clrawdown after Jus, Y"1eld: 'u1./min. with a dmwdown after Jus. Y"1DId: u1./min. with a dmwdownafter Jus. &co.ery data (time Ia/cen Q3:tero...hen pump Iumed DjJ) (walU lePe171lJ!1mlredfrom well IDp to ..ater/nel) Tim<: Wala'Level TDIIe Wall:r LcveI "lime Water Level Date of test Bailer-test .Airtest 3 5 galJmin. with a drawdown after _Jus. gal./miD. with stem. set at 175 a fur 1 Jus. Artesian :Bow "p m Date TemperatureofWatr:r_Wasac:bemica1aoalysismade1 Dyes IZINo CURRENT NotieeofIntentNo. WE03734 Unique Ecology Well ID Tag No. AHR308 Water Right Permit No. Property Owner Name GARY CUMMINS Well Street Address LOT 1 BWY20 NEARANDERSONLAKERD Ci1y PORI TOWNSEND County CLAU.AM Location SE 114-1l4 NWU4 See 8 Twn 29 R 1 EWM D Qa:Ie - - J;,;;- -~0- ..t LatlLong (s, t, r IJ) Lat Deg f Lat MinlSec tJ /. (l-5 S1ill BEQlJIREDiv Long Deg~Long Min/Sec tfi. b 1'b J Tax Parcel No. 974600-001 a a a CONSTRucnON OR DECOMMISSION PROCEDURE l'omIaIioa: Describe by co!oI; character, size of :maIerlal1lllil.1lmcIIDe, and thD kiDdand JIatDre oftbc maIet:ial in each slmtmnpcactEated, wilb. atleast cme aUIy fur each chaage of infOJmUion. roSE: ADDmONAL SHEETS IF NECESSARY:) a MATERIAL FROM TO o 1 1 3 3 7 7 14 14 19 19 34 34 58 58 (j] (j] 69 69 85 85 88 88 122 122 132 132 158 158 182 a a TOP SOIL BROWNCLAYWIIH GRAVEL GRAVEL BROWN CLAY BROWN CLAYWIIH GRAVEL BLUE CIAY sn.TSTONE WIB GREY CIAY SHALE GREy,CI.AY ~lt~S1:lALE GR:EYCI.Ay GREYc.tAYWlTHBASALT :BROWNCLAY WIB tIGBl'BROWN CLAY Start Dale 06/28/05 Completed Date 06129105 .Date Eca10gyisanEqual 0pp0rtuni1;y~, ECY OSll-1-2Il (Rev 3105) The Department of Ecology does NOT warranty the Data and/or Information on this Well Report. IFRDM :OOBSON CONSTRuCTION INC FAX NO. :360 379 9040 OCT-AS-?AB5 83:34 PM AQU~_PUMPS.DRILLING Oct. 08 2005 10:20RM P7 ~j. 9 1 3~~ 6R3 5116 ~.~S I I I I I I I I I I I I I I I I Cl)JtJtI!:NT JliolJce efllltRt NDe '~ .722 Unlq\lDBcoloJ)' W.U 10 T.,No. ~LtL ,.... .-.. Weter Right Permit 'NO. liropony OWDer Name NORMA MABSBY Well S" Address TI.o/ 0lJ IIWY 20 NJLU AlfPBJtBCll ~ IlD WATER WELL REPORT ~",.",-"",.1"' ..._.......,....... ..... ('~H m drcll!) m~ . c ~Isslol 0/lIG11Ul.. /NSl'AlLfTlDN Notice tilM'lI1 ~,. ~7~tD1IIEl !~ fl.....w 81Momllpli Diy I'CmTTOWMSBND CDImly JUfBUON Cp,w_ I~ 'nil WIll &:lIht LotricID.!!!l~l'" !!oW SK' Twu.!!. a..!! -- C_ rtnlXt WDrtK:00IIrs__ot-'(It"""""'1JIIII) .. m- - IlJttandlOlal ..-IIrliaIf;B- C...... 8=- Ld.cm.Il (I, t, r t.e Ilea l.AIt MiDfSec PIQllIlUI " aIIIl III laIIlJ mHt."IIIONS: DJ.cs:r of.u.!.....- .... ckIlk4I ~ !. Stilt REQutuD) Long Dcg _ LoIIg MinlSec: bopdi er.....1nI1 261 It. COH5TIIIII:ltJON UI'.TAILlI Tax Parcel No~90IOlAl104 e.IIIt I~~'" 6 .......... 0 . "1ft 3Il .. tlwBllltdt LfMr~.. ' . JliIII.Il!I!ilI..lI...-.... K'l It. c:oNs1'iWC'I1OJl Oft HCOlcI:MJIISiON 'ROCJ.I>tU 'IbIaIJIad . DflaIl... .. II II ,-me.. tw.!tlM ~llIklt,---.....J....w-~ -'IMWM_ :1J rea IlJND 1IIiaInl at*'....... Ill................,.,.. '16". .... ...~ .... lid 0IlltIJC of 1YPa"'~1IN4 ...............,.... 1tI~ tU&1!:ADmr~tiHEET.51F N!lCIl.\.'iARY.l 41!!i!"'piort..~:.. "'___.5'. ""'.....ovfpdJ_1hlm a.", Il 'i,," '.,' rM1'I!Aw. FROM TO ....*"7' , ",IoU"''"' OWo en.". L-'- TOP son. q 1 ~."_ PVC ~CJWNQ.A y J 12 ~.JI~" .....'~..._..._. _Model No, tl 243 t1. (1IlIJYCLo\Y 12 J, ,~A.1NCI;l,,,,~,,,!,,,!~(lI.o ....,lllm;2.13. ", ..", "'t. 10 A. CUYSlJ.:'I'&1"ONB l5 ,4f, lliom. " , ' """Ilia ~tOiDIC ~......... ~Y. N.CSIIlIllfpdtsad BMWH BlWA 40 on JlIollollJ.~hift ' ',' . ft.., ~.._ .~._._.fL m~enJllll) lIA.W.T , 73 7'J ~....II"'HZll'1I .[]No, "Itl....r IIl+ a. (fRay $l1.'tI1'OHE 17 11;11 ."!~'~''''~~mmE , OkBY,CL\Y'wmU.lmONSIlL~ lQl II! ,.J.)iI ~tflaIIClII,,*.JlllitaAJi"'" CT. 1Zi~ , $":J"1'()l~iw.rrHLEStONSOF GREY ClAY . t1t . US '~I.lI'~' DIpllu,,-..... PJlBY..Q:A.V '."., " , liS ,". IU ),II~,ot~.lllIIIIl"'" 8ROWS BJlAU! " ", .. 122 .,"" 128 :l'!:tMPI~}If~;""" " ;J:AACT(1RI!01JJ&LT ," , t2fi ,,' 137 , '}iltf".';, : ..' ',.' _-,,;I'LP. - ijl\8"~Y " " i37 m ~,,~i.r.~ x.... da....aklV..IIIlIIO......1I R. fM(:I'Q~BAS4.LT . 138 " tjf! I ~It\.otJ,' ,.'.' 1M jI.l!tloWeopllF... EMt.Jl1till)!. . .Bl{OWJ{ SHALE 140 146 Niulaa pnt8W8 , ...,.. ",,-h1oh ' DIde ___ GJuiY~y 146 " 23' ~ _to eMmIllId.~ ;..:.. ...:;.~. ~ 1'R.'LcrunJ)8HALn WJlf ;;t.tJ~ ')[4::" ...-a.r. 'I'I.9I'8lnn~J,,,,,,ll'II!r"". ~ 1>oI....-.I.la.. . , I .....)lllllpftltIlllilo!Cy.RlNt If~_"" . "'~v.t1Il ' , . I.......... "". YIIlkl: ,1IIIlIalim.....__i.~....._..~. Trtldl ~..a."""".p__ _In, 1/1tawo",~ (11... -....,.. will..,.....,... tffi r-u''-''-Itffd/lml.tIJ IIl/ .,..,Ifr Ja..oI) TlJao W_I.eI/Il ~ Walr Uwl ~ Wa...a..,et - -- - - - -.._- - - .. .- - ~ - - - ~- - - Pete"'l adltr__ttl.lll!lbl.wIJb__ft.____..Jn : I AIIwI..L--~wiIIr __. ~ II. ... 1 bit. ! .~ ; ~tIIIIIllIllJII .t.p.III. DWe.._ I ; 'l'e....,. <I__'WIlI.~""'1IIllII'! CYls ~Ho- I . : SI8II De 07I01J1)~ ~fd 0.- C11/1tm ~ .... . WELL CONt'l'RucnON CER.11flC\T10N: I ~d flfJdJor llllcCpll'ApaDSilJility icr(Jl)llB!nr[lon ortl\ls wm lIlld i1Io ~mvJhlllce ~i1b a1l Wll.iIUnston well ~ l!tandmds. Materials Idcd DIbt r!lc in1bi1ulKion ~ IIbaw _~ 10 11\1 bc:Pt knowledge md belJer. ~ - Q~ aT....... ..,,~ ,HA~~}.e'l btIlIJoe c..".....,. r-2UA.'UMPS _ Dn!ltl/.__~s__ ~ AddmIn 69ll201.DOLYMP.lCHWY tlI;JJor-llt.....u.-No. 22~2 . <:it.J....~1p uqutM. Wi\. OJ31:l ~=.. .. ::'; . .J =..~ DIIll CTIfl IJO.S ~iJ,,"'I~~. BCTO!~He (~$IOJJ TM o.partment of Soology dgmg HOT warranty thD DB andlQr IhformllUon J)n w. Well R8port. I I I I I I I I I I I I I I I I I I I OCT-0S-2005 0~:~2 PM AQUA.PUMPS_DRILLIHG 1 ~60 6S~ 511~ WATER WELL REPORT . "i" . '''11 ~.JfI..>>-w..2"I__-__,3""J\f-"" 'e' 'In ~.... r~" inclrcle} fECoDmIctioo ClllecDlDmJukm OkJGlNAL lNSTALLAI10N NotIce ~11111>>f1 Mrmber J'JL01'OIIJ;D tSr IlIlMnmllD I:J 111!11111111 B'~ C Da'Walr[] lDiplila [JTCIIII: Well 0lIIlr . 'm'I.or~ 0-0'......0("'" (if__--l!) fi== 0..-....-- ~f8~ ~= 8= DII\I1:NSJON& DiPDlt..of_U L- iHhci,...1W -211.__, ft. Pop6 or ccmp\clod 11III 21 , t. CONSTIlUC1lON DJ:I'AILI C1Ie/IIfl ~WMed .1..-- a...fivtIl.L..-....~ ,......, " liAr..... 4.:..:::":':::~~ Di...ian-lL___Jt.lD 212'~-1l. ~ .. tiaiLtom .... II ~[JY.IilJNo T~9l'IIIl1vnIl9r_ .... 11lZhl'~ irL"" _m.MIlO.....p;rl\,___flvm.._,.!I.k. i. ...-.. IlIV. ONe> CK-PIlo t.-;.. lolIr~'. N.m P\IC T)1'llPvc ' "'arIoIl>Ic. Dioia..!UNCH ~ ",S1ll1eiPiO..Ql.(L_ fivm~t 'MW~1ItAL-_!. DiIlII. ' IItuill -&01 - a.M !, ~~,O\'m i:JNo Cl!aat~~ 'MPm!illpillllllltiD "..' ...', , ,,',' ',.'t..>> .....t..illlllIllT. CblG TlIwbltdoJ07 111+ MuIal.... Illllllll DENTONlTI! lllha,v_tJlIaIala.JiDIlIQ,I*wa't DVM R]NlI T)'Ilt~,,~ DeplhfMll .~.atNll!lie lIItIlaoll'____........-o._ i',I,IMIII""",,,' \,f/lll!Iir'mm', , ."",.,lIIl1t1Vl, Jypo: .'.' ,','. ".' '. R.P. Iw~LlVII& 1.td...rr..~dh1dl1ll\.h.ri,~_laveJ I~..."j I," ' '. 1._.........~.I_1 ..-~.. f ::::-:tol\li'tIIleIlllf .......~.... Dole,__~ , C""'.'VII....) '\\'ELL TI:R'I1i, 0.-..... is__lnd klmnmdldaw...., ~ w*....~..........,Cv"" IiZJNo 'r,..,~-...e ___~. Y"~L_._. _....t.llDlD. _ !l. 4llIwi!OWD afIl:r ltrI, Yield: aallmla. oriIll I. fIDWiIowa .. 1m. yJ.ild; .aoI.hnin._. .:_,_.,~I\,....-.__JJn. ,..""..".- r- -. m -"-"J"IIIIJ' IWft<<'fI!f) (lKlI"WPrt __JrUII_J IItptD ll'lIl6. jol'M) '!ImII WaerLe.-1i 'l'lw Weerl.fMl f...... 'WIIIlIr LewI .. OIleof~ Bdar111l~pl./mbL wid! t..lh.wdowlI.... _Ius. i AiztaIt~plJ_ witt. _",II 170 Ii. m 1--- I AneIItII taw I.'" DII!i I ~of__ Wlll&.....-.!-)'IIJ...., J:]v.. mHo P.01 ~y.1- CURRENT Notbol IDMt No. WB03893 Unique Bcoloey WeD m Tas No. AHRJ14 Wator lUght Permit No. Ptapartr Own... Name Mr\1.,,\MUre ABSoct\TES Well Street Adchss ~"')' MtItI!J:f) N-r. ,,~W V~~~ City JlOIiIT TOWNSliNO CoUllty JEFFIlRllON 1~ N\\1/H'" SE 1/4 See..!.... Tw;'.t~ I..!..... lID CJ.... .1Zl- l.I1I1.cq (I. t, r !At Deg _Lat Mh1lSec S'lillREQl1JRED) Long Dcg_ Long Min'Sec Ta Percel No. !lf46OOClO4 CONS'1JWaI01'f ORDl~ I'ltOCDVRIt I'GnuIIar. n.a.lI., ~...lrJr. ...... .. pf I1IIilnl .............. ... Jola4.... ~of"JII8lEaI ill t8ClI8'IIIlmJllllllP&Iilwla IlJEaIl6l1111)1ll1r.....or ~ tWm ADDmOHAL 1JiiEJ'S IJllGCEUUY.l tAATERlAl ~ o 1 6 J 21 ,~ 35 11 65 49 n Ii .18 ,91 TO ) , . 21 34 35 57 6S 'e9 71 I' II 91 . JOl; , Wll 135 137 112 200 2'10 2110 ,282 WELL CONSTlWCllON CERTIFICATION! J ~ bIidiar llQ~pt 11:Spl.lII&ibUity fOr cooslNl:tion <tfthis wtn. lIUd its ~limc;Q with 1111 Wash~ ....'e!\ camtruDilon IIt.endartk. MllfrrIe1! l1Ied i1l1iS the Ittfotmilri.oo ~ abtovi In true -to my bi:st knowledge an4 beller. .siDilIJf1tCl~OT~~.ff~ DriIIi11.!I~A9UAPUMPS ::JrilJ~='Tni=SJpatvn:_ '" ~ ,~OLD()I.,yMPIC HWY blI.IetetrtlueU_~ ~ City,--,ZiIo SBQUIM, WA 98382 ~.. -J =..~ t. '['01' SOlL ~'N CLA.YWlTUOIAVEL BASALT I!ROWN Cl.A y OItl:"\' CLAY At'lJ) OM VBI.. BASALT oREYCl^Y El.<\,.~LT (DEySIL'IBTONE ~T OREY, alL'TlltO.NE 'ClII!Y.cu." WJLIll)TOlm OF nIL 'J1)TQ)m 8AsAt.'l"i' , ~SILTSTONE lJA:OO..t .ora!Y $lI.TSTONl! aASAf:r (ilEY'SlL'J'S'WNE FlAcruItED BASALT" GREY SllillITOt-m &:R.OWN SHALE WIB BIl.CWN $HAU WfflJI$N,T lUfJ . 10. 13$ 137 118' 200 2i'{) so ft. " 8tII1 DItIt ()7l1f.t/i)S CMipII!IO PllIe 07J2V)' _lIIlo j. ;).d..~C)~ lltfllOI)'lJ tB &)ual~~. F,cy ~ll-1-2n (l\Qy '..~m Th& ~partrn(tnt of Ecology doea NOT 'Mlrrenty ihe Data Md10r Infonn.Uon an thla Well AItpOrt. LJ FILE WELL CONSTRUCTION CERTIFICA nON: I constructed andlor accept responsibility for constroction oftbis well. and its compliance wi1h all Washington well construction standards. Materials used and the information reported above are true to my best knowledge and belief: ~DriIler DEngineer [JTrainee ~~~ DrlJIiugCllmpaD.y AQUA PUMPS DriIlerlEngin-'Tminee signature' Address 6962 OLD OLYMPIC HWY DriIler or trainee LiCCllSC No. 22S2 City. S1al1:, Zip SEQUIM. WA 98382 r~ Driller's Licased No. DriDer's Sigaature I WATER WELL REPORT OrigiDal"" 1" copy - EcoltJ:y. T' copy - .......... 3'" copy -driB... I wllllin.. sun .<<r1l..'.' ., ICDI."J Constrnetion/Deoommission (":x" in circle) [!] Construction o Decommission ORIGINAL lNSJ'.AU.ATlON Notice of Intent Number I I PROPOSED USE: IZl Domestic D liIdustrial D Mmricipal DDcW__ Dbriplicm o TestWell o Other I TYPE OF WORK: Owner'sJllllDbcr ofwell (If_than ODe) IZlNewwc:ll D R.ec:onditioDed Methor1 :DDug D lloRd 0 DriVCll D Dec:pcm:d D Cable IZl RoIm:v 0 JI:IIcd DIMENSIONS: Diameter ofwell L- inches, drilled 282 1l Depth of completed well 28] 1l CONSTRUCIION DETAI1.8 casing IZlwddcd ~ Diam.tiam 0 IDstaJled.: . ',1Zl LiDeriDsla1led L--D Diam.:&om 14 o Thn:adcd D Diam. tiam PerloralioDS: DYes IZlNo T~ ofpcrfuratorused SIZE ofpcrlS----:in. by----,- in. andJlO. ofpcdS_fiom_1l to -'- SueeDs: IZlYes DNo OK......, LocaIion Manu&ctun:r"sName PVC Type PYC ModclNo. Diam. -4 lNr.H Slot size 01 0 tiam 251 Il to 261 Diam. . Slot size . tiam Il to GrndIFiller JIIId<ed: U Yes IZI No 0 Size ofgmvellsand MaterlaIs placed ftom Il to SurIioeeSeol:IZJYes DNo ToWhatdcpth? 18+ Matl:rial used in seal BENTONITE Did aDy Sttala Contain UIIIISlIble water? Typeof~ MethOd tiSOlliling sIraIa off l'IlMP: ~sNlIIi1e 'l'jpIl: I tl:.to40 1lto282 1lto I I il I 1l Dyes JZlNo Depthofsbala I HP. I W ATEllLEVELS: J.aDd..sadiI= elevation above mean sea love! il SlaIic 1evel 1711 tl:. below top ofwell Dale 07 f22J05 Artesian pessme Ibs. per square inch Date .Artesian water is con1To\led by (cao, valve etc.) WELL TFSTS: Dmwdown is 8IIlOUIII:_levelis loweJed below sialic lovel Wasa.pumptestmade?Dyes IZlNo If yes. by whom? Y1dd: ul.lmin. with il dmwdown afb:r 1m. YJe!d: ul.lmin. with tl:. dra.wdown afb:r 1m. Yield: I!lIl./min. with tl:."dIawdownafb:r hrs, RsCt11'eT'y dDto(ame IDItm as zero when pump tumed oJI) (water /evel1tU1l1SIITed from well lOp to water Ino1) TIDJe W__ Level TJlIIe W__ Level T"JIDll Water Level I I I Dale of test Bailerfesl_gal./min. with il cbawdown afb:r _IDs. Airtest 125 gal.Imin. withSllmlsetat 170 tl:. fOr 1 hrs. .Artesian flow Lp.DLDate TClIIIJlflIllIur ofwaler _ Was a.cbemicalllllB1ysismade? 0 Yes IZl ND I I I I CUBRENT Notice of Intent No. WE03893 ~{j) ~j.1 Unique Ecology Well 10 Tag No. AHR314 Water Right Permit No, Property Owner Name MAI.AMtJn: ASSOCIATES Well StreetAddress 4nmsetYmKYR:lIXm ltl) Nt. \l11=.kI :v.I5 1)1. urr ~~ City PORTTOWNSEND Coun1;y JEFFERSON LocaIion NWt/4-1l4 SE V4 See 8 Twn29 R 1 EMf Dc:iD:le - - - /f) - - ~0- t LatILong (5, 1, r pi Lat Deg If K Lat MinlSec 0 I. Z 2(g Still REQUIRE~ Long Deg f 2Z Long MinfSec~Oj .1o'J 8 Tax Parcel No. 974600004 it. 1l 1l CONSTRUcnONORDECOMMlSSlONPROCEDUBE Fmmatioo: Describe by color. cbanIclm; IIize of1Dlll:lial and sInJcture. aDd die ldnd aod _ of the matmialin each sUaIDm pc:udIated. with atleastOllC adIy fOr each change of iDformaIion. rusE ADDITIONAL SHEETS IF NECESSARY:) MATERIAL Il Il TOPSOIL BROWN CLAYWllHGRAVEL BASALT BROWN CLAY GREY a..A.Y AND GRAVEL BASALT GREY a..A.Y BASALT GREYSILTSTONE BASALT GREY SILTSTONE ~d.AYW/LESIONSOF Sll.TSTONE BASALt ,".'.,.,' .,' GREY,SILTSTONE BASALt GREY SILTSTONE BASALT GREY SILTSTONE FRACIUREDBASALT GREY SILTSTONE BROWN SHALE WIB BROWN SHALEWIBASALT FROM TO 0 1 1 6 6 8 8 21 21 34 34 35 35 57 57 65 65 69 69 71 " 71 85 85 88 1111 91 91 106 106 108 108 135 135 137 137 182 182 200 200 270 270 280 80 282 Start Dale C1T 120105 CompIeled Dale 07f21J05 1 =,.. A~ Date "7 - 2..2. ~ 05 Ecology is anEqual Opportuoity Employer. ECY 050-1-20 (Rev 3/05) The Department of Ecology does NOT warranty the Data and/or Infonnation on this Well Report I ;A;~ l'A\t\n ~-ts CURBENT ;@@ Notice of Intent No. W180l~ Unique Ecology Well ID Tag No. AHR313 Water Right Pennit No. Property Owner Name ANNMCLAUGHLlN Well Street Address HWY 20 NEAR ANDERSON LAKE RD I WATER WELL REPORT .......,....... OrigiDal & 1" copy-Ecology, r' copy-DWDer,3" copy-driller ."'.'.(11 ., lCOLOGT CoDStructionlDecommission ("x" in circle) [!] Construction o Decommission ORIGINAL msTAUA110N Notice of Intent Number PROPOSED USE: flIDomestic 0 Industria1 0 MmW:ipal DDcWater DIuipliOll DTestWc1lDOIhrz I I LD-l::8 City PORT TOWNSEND County JEFFERSON' Location SE 1/4-1/4 NE1I4 See 8 Twn 29 R 1 EWJ4 0 ciIde Lat/Long(s, t,r AJ LatDeg II Cd LatMin/Sec ~!)rzr,2t~ Still REQUIRED) Long DegJ.z.z!... Long MIDlSec '1&/, L)fJ 7 Tax Parcel No. 914600008 I TYPE OF WORK: Owncr'sDllDlbcrofwc1l (If_than ODe) flIN_weU DRecoDdi1ioaal MeIhod:DDog DBcm:d o DcC:pezd DCable fZI Rotmy DIMENSIONS: DiameterofwellL- inches,drilJed 242 ,ft. OepIhofcompleledwell 242 :ll CONSl'RUCTION DETAILS ,Casin& IZIWelded 6 . Diam.fimn 0 Iasbdled:~~iDslalledL-: == 14 PcrforalioDs: Dyes IZJNo Type ofpc:rfmalarused SlZEof~ in. by in.8IIdDO.of~ Screeas: IZIYes DNo DK-Pac Localioo Manufaclmer's Name PVC TypePVC Model No. Diam. 4 TNCH Slot size 01 0 1imn 211 :ll to 221 Diafu: 'Slot size 1imn' :ll to Gravel/1liJRrpllClood: 0 Yes flI No D Size of gmveIISlIDd Materials placed:from :ll to Sar&oceScal: IZJYes DNo Towlllltclepth? 18+ Materia1'1lSed in SCal BENTONITE Did'any _ coatain 1IIIIISlIb1e Vr.der'!' Type ofWIler'? Methodofsealing slraIa olf PUMP:Man~sNlIlIIe TYPe: " o Ddven o Jelled I 11:. to 40 :ll. to 241 :llto :ll it. it. I CONSI'RUCfiON ORDECOMMlSSlONPROCEDURE Formatiou: Desclibe by color, ~ size ofJD8ll:rialIlJld &lIllClllm.lID1i lhokindllD1i JIlIIum oflhoDlllll:da1 in each slIabImpenellab:d. wi1h lit least 0IIIl CIIlIyibr each chaDge of ;,m"m,.,;nn ({JSEADDmONAL SHEEiSIF NECESSARY..) :llto 11:. I 1imn TO FROM o 1 10 43 46 89 107 111 158 179 185 205 208 MATERIAL 1 10 43 , ",46 89 107 III 158 119 185 205 208 242 TOP SOn. BROWN sn.TY SAND sn.TSTONE WlTHGRA VEL BASALt GREY CLAY sn.TSTONE BASALT sn.TSTONE . GREY CLAY BASALT SILtsTONE BASALT FRACl1JRD SILTSTONE WIB ft. it. I 11:. 11:. I Dyes fZINo Depth ofstraia I , H.P. WATER LEVELS: Land-sudiIl:e e1cvaliOll above mc:ai1 sea level :ll Static: kveI 72:ll below top ofwell Date 07/19/05 AItesian pressure Jbs. per squano inch Dale AItesian water is controDcd by (can, valve. eIl:J WELL TESTS: Dmwdown is 8IDOIIDtWlller level is lowmed below static: level Was apump lest1D8de? DYes IZINo Jfyes.bywhom? Y"JCId: aalJmin. with :ll dmwdown after hrs. Yield: llll1Jmin. with it. dmwdown after hrs. Y"JCId: ul.Imin. with it. drawdown after hrs. RscoRl'J'data (lime Iabm as ZJ!1'O "hen pump IrlrneiI qff) (wale1" lepef meoSuredftom well tap to vDlerleveQ TJ1I1e WaterLevd lime WaterLeve1 TDDll WaterLevd I I I I Date of test BaiJer1eSt_pllmin. with it. drawdown after_hrs. Airiest 1.25 EST gal./min. withslemsetat 232 11:. for 1 hrs. Artesian flow a.p.m. Date TClIIpCJIII1Rof__ Wasachemica1aualysismade? Dyes flINo I Completed Dale 07/19105 Start Dale 07/18105 I WELL CONSTRUCTION CERTIFICATION: I CODslmcted and/or accept :respons1oility for construction oftbis weD. and i1S compliance with all Washington well construction standards. Materials used and the infcmnation reported above are tIUe to my best knowledge and belief. ~cr []Euginccr []Trainee ~~/ DrllliugCompauy AQUA PUMPS DrilJerlEugineerll'rainee Siguature Addn:ss 6962 OlD OLYMPIC HWY Driller or1rainee llceuse No. 2252 City, State. Zip SEQUIM, W A 98382 I ~~,.. DriIIer"s Big_ )~...~ Date 07/19105 Ecology is an Equal ()pj>ommily Employer. I The Department of Ecology doeS NOT warranty the Data andfor Infor:mation on this Well Report. ECY 050-1-20 (Rev 3/05) I /'A.~I....,\\n en I I I I I I I I I I I I I I I I I I I q 7/f -liDO -069 St-f. . r -.ttv V ~ 9 ~-~ yrv'~ f WATER WELL REPORT CURRENT Notice of Intent No. Wl86722 Unique Ecology Well ID Tag No. AHR310 WaterRight Pemrlt No. l'ropcrlJo-_~ Well Street Address r4T 119 20 NEARANDERSON LAKElID PROPOSED USE: 0DamcsUc o Indpstrial o :MJmiQpal City POlIT TOWNSEND County JEFFERSON DncwaIa" D~ o TestWcB o Other Location NElI4-1/4 SE 1/4 See 8 T"WD. 29 R lW EWM 0 c:iR:Ie TYPE OFWOBK: Owncr'ulI1mber ofwcB(ifmoR:1han one) -, - -d--,~IZI o Ncwwc:l1 D:RaxmdiIioned Method: o Dug DBORd o Drlw:D. LatlLong (s, t, r NLat Deg L./ ~ Lat "MiDISec' tit:! D Deepened o Cable 0Ro1my DIOll11:d 8 . DIMENSIONS: Diamclr;rofwe1lL- mdu:s,ddJled 263 ft. Still REQUlBED)u LongDeg ~Long MiDlSec Lf~ f t( Deplh of completed we1l 263 it. CONSTRucnON DETAILS Tax Parcel No. 901084004 Casing 0We1ded 6 - Diam.1i:um 0 ft.1D 38 ft. Jastolled: ~=:ned 4 - Diam.1i:um 17 ft. ID 263 ft. CONSTRUCI'ION ORDECOMMlSSlONPROCEDURE - Diam.1i:um ft..1D ft. l'omIlIliOll: Descriheby <:o1cr, cbaracter, size ofmalelia1 aadslnll:lme, IIIId the ldIld and PerioralioDS: U Yes JLINo - of1be JIIlIIIlIialin eachslmlllm peaeualed, wilh atleast ODe tmlly iilr each chmge of Type ofpedimltorused ;m;"",.,;"" (USE ADDITIONAL SHEETS IF NECESSARY:) SlZEof~ in.llY. in. aod DO. ofpedi; fiom ft.1D 11:. MA1ERIAL FROM TO Screous: 0Y... DNo o K-l'at Location TOP SOIL 0 1 Manufat:mn:r's Name PVC BROWN CLAY 1 12 Type PVC Model No. GREY CLAY 12 15 Diam. 4 INCH Slat size 01 0 1inm 233 it. to 243 it. 46 Diam. Slat size nom it.1D it. GREY SII.TSTONE 15 GnaveIIFiIterpadred: Dyes IZI No o Simofgcm:Jlsand BROWN SHALE 46 73 Materials placed from ft.1D it. FB.ACI1JRED BASALT 73 77 Sur&ce Seal: lZJY... DNo Towhatfll:pth?l8+ ft. GREY 8n.TSTONE 77 101 Mataial used in Sll8! BENTONITE '6Rl3Y" CLAYWl'mLESIONS SILTSTONE 101 111 Did any _ conIain'1IIIIISab1e waIef1 Dy... IlINo sn:.TStbNE"WITHLESIONS OF GREY CLAY 111 115 TypeofWaler? Dc,pth of_ ~.CLAY 115 122 Ml:thodorscaliag sImla off ~WNS1iALE 122 128 POMP: ManuliIClUrtor's Name '~BASAI.T 128 137 TYPe: ' H.P. QREYCI.Ay, " 137 138 WATEll.L~VELS: l.and-5urlac:O e1evaIion abow _ scahwel it. FB.AtJ:uREo BASALT , 138 140 statiC: hwal 169 it. belowtDpofwe1l Date (I'm 1 /05 BROWN SHALE 140 146 A11=ian pressure lbs. per square inch Date GREYCLAY 146 238 Artcsiaa water is c:antroIled by BRO'WNFB.AC'l'ORED SHALE WIB (ClII>. valve, etc.) WELL TFSIS: DmwdoWD is 1IIDOUDt_leve1isJow=<i below BIatic Ieve1 Was apamp testmade? Dyes III No Jf:ya, by,m.",a Y"2Cld: ul./min. with it. drawdown after bts. y"2Cld:---J8!.Imin. with it. drawdown aftcr bts. Y"JCld:---J8!.Imin. with il:. drawdown after bts. &coreFJI data (timJI taIam ar %111'0 when pump turMtI tdJ) (wale1' leveJ 1II8DSII1'Wl jiam-well top ID water leveQ TlIIlC WatorLevcl Time Water Level Time Water Level , - - - - - - - - - - - - Date of test Baila-test_SalJmin. with it. dmwdownafter_bts. Airtest 2 plImin. with stem set .260 it.1brl bts. Artesian :Bow lLP.m. Dale Tc:mpera1un:of__ Was a chcmica1 iIDlI1ysismade? Dyes fiNo Start Dale 07/07105 Completed Dale (11111/05 f7# ?1 WELL CONSTRUCTION CERTIFICATION: I constructed andlor accept responsibility for const:ruction of this well, and its compliance with all Washington well construction standards. Materials used and the information reported above are 1me 10 my best knowledge and belief: ~DriJIr:r OEugineer OTrainee N~~L DrlIIiIIgCompany AQUA PUMPS Driller/EngiDemrainee SigDature AddIllSs 6962 OLD OLYMPIC HWY . Drill.... or1r.liJlee Liccase No. 2252 Clty, s-. Zip SEQUIM, WA 98382 r" DrilJer>s Sipatnre ) ~"'~ Dale 07/11/05 Ecology is an Equal. Oppammil;y Employer. ECY 1ISO-1-20 (Rcv3/OS) The Deparbnent of ECOlogy does NOT warranty the Data and/or Infonnation on this Well Report. t==i1 rD. r Unique Ecology wenlD Tag No. Water Right Permit No. .. Property Owner Name 3etOtt ODb,c;crl Well Street Address fdLu.J;JD f1eQL:tbje!S~:il J.t-. City RH lI-'t~rri County:. -r-eflP ~E.'wM . Location SldLU4- 1/4 SEU4 S~ Twn.d9 R.!..ldl ~~e LatlLong: LatDeg Lat MinlSec (s,t,r still REQUIRED) Long Deg Long MinISec Tax Parcel No. . ft to --Y:Qft. CONsTRUcnON OR DECoMMIssION Pl~.oCEl)URE ft. to ..J...CJ;<-ft.' Formation: Describe by color, c:han1cter, SiZe of.material and structure, and thl: ft. to ~ kind and natme of the material in each stratum penetrated. with at least one entry for eaCh change' of infolID3lion., Indicate all water encountered. (USE ADDITIONAL SHEETS IF NECESSARY.) MA TERlAL ft. ....- rn ~l I ~lfi t Y"\ ~f y-}. H)}.ndhlP I . iN. I '\.t""\ ~ n j/;....J ft. IrDt t r In I 1 ft.. r:;v f)l-l /'lln f .:4 J) J If t'Odt' I ':"1t:. .J ' V ;<:'"'1 VBX' it." ,,..-\ .. Y1n C:::n I-J- ,.., f/l-- .. . T-J-. I I") 1.tJ" .h 10 1- ... c::;.a 1+-- .Jiir ",.. . \0 or ::: 0 \..J.,. I t J / P-. ;;;; n 1n ,. ..... 'fZ..rt 'c:..fl -.,-+- ~l. if) I =~n:~~u~~:c~:;:=0r:=~=r;:r1!~~Iif~~~=:n:~:t~~~~:::~:~withall ~Driller ~Engi,'" .ne~ OT~ee'N~(~) B, ~C, f'lt;&, r !~bje,ir' Drilling Company ). ~ . , I DriUer/Enghleerfframee Slgna11lrp. 1i5"$k ~~ Address \ r !4l brtUeror-Trainee License No. l:; City, Stale, Zip '- I 1\. - 1'1 Contractor's.V /V f I Registration No...~ -FPrtrttJiDate SS-..;tl- LJ-f .--' ,- " I I I I I CONSTRUCTION DETAILS Casing ./E.Welded ~. I . Install~Liner installed -.1.f--' o Threaded . . Perforations: D Yes iii No Type of perforator used n I SIZE of perfs in. by in',l!ll~"",f perfs . scr,eens: OVesbel'No 0 K~pac~~n Manufacturer's N~ ."P I Type Model No. Diam. Slot Size from ft. to Diam. Slot Size from ft. to I GravellFilter~cked: thes ~No D SizeofgtaveVsand Materials placed fnlm 7\ . ft. to Surface Seal: ~1s 0 No To what depth? f f<.J... ft MaterialS used' ~-13er~ tall -K: . . Did any strata contain unusablewater'1 Dyes ~o Type of water'! l1e~ of SlIata 'MethQd of se;Jling strata off PUMP: ManUfactilr(:i's Name Type: H.P. WATER LEVELjiLand-surface elevation above mean sea level '\ ....-.t j ft. Static level eJ. ?{ ft. below top of well Date 2r ' (9CJ=c...z::+- Artesian pressure Ibs. per square inch Date Artesian water is controlled by ATER WELL REPORT ,- , 'N'''&IL''o f~'~i Original & 1st copy - Ecology, 2nd copy - owner, 3rd copy - driller .ConstruCtionlDecommission (Y'in circle) t! Construction . . 0' Deeommission ORIGINAL CONSTRUcnON Notice of Intent Number PRO}jOSED USE: ~.Domestic 0 Industrial D Municipal jOneWater Dlnigation DTestWell Oother ~ OF WORK: Owners nomber of well (if more thlin one) ~ew WeD 0 Recondifibned Method: 0 Dug D Bored 0 Driven [jD~ .0 Cable ~Rotary D Jetted DfMll:NSlONS: Diameter of well {a inches, driUed to;{ ft. Depth of completed well I ('\;) it. Diam. from Diam. from Diam. from :JC3 from ft.to I I I I I I I (caJ),valve, etc.) WELL TESTS: Dmwdown is ~ount water level is lowered below static level. Was..II:.plJI!IPtestmade? DYes ~o If yes, by whom? Yield: galJmin. with ft drawg.own after hrs. Yield: galJroin. with ft. drawdown after hrs. Yield: @:alJmin. with ft. drawdown after hrs. Recovery data (lime taken as uro when pump tumed off)(water levelllleasured from well top to lvaler level) Time Water Level Time Water Level Time Water Level Date of test Bailer test. galJmin. with fL drawdown after_Ms. Airtest ~ galJmin. with stem set at qg ft. for J hrs. Artesian fiii? - 2;P.m. Date "'-empllrtiMrt(jrW~_was a chemical analysis made? Dyes 'JifNo , If trainee, licensed driller's CURRENT Notice of Intent No. . .~~"'" ~f. /<1 \A/ 11 '5 4dO <C~""'" r "". ... ..4~e~3 _::'~.P.'- . ,-~ ( olfJ-. ,-- FROM TO n .:J ...::> () f ^ Jl.. ,. U. l;jc; :JC:; ~ ~ U I LJ..:. LJ..::> ue;' qz:; t:;; l;~;~ iii~' Ih '-]-- ;? -"7~ J <; j 0, <=[ o>r C5?' Iii.:> .N ir:. . Start Date 8 - d~-D-iCompleted Date ~ -acl-a-) I WATER WELL REPORT OrigiDal &; 1" copy - Ecology, 'Z'" mpy -9WDer, r mpy-drilIer CURBENT Notice of Intent No. W186720 @/D <..0..;.. II I ...sslau.. Inu tt'A.&t_r It If Ie.LOCI CoBStrnc:tionlDecommission (Ux" in circle) [!] Construction o Decommission ORIGlNALlNSTALLA110N Notice of Intent Number Unique Ecology Well ID TagNo. A1l.R309 Water Right Pennit No. Property Owner Name JERRY SMITH Well Street Address LOT 1] HWY20NEARANDERSONLAICElID I I PROPOSED USE: fZ) Domostic o JiulusIrial -0 Muuicipal City PORT TOWNSEND Coun-qr JEFFERSON Dnewaler DInigation OTestWeD o 0Iha- Location SEI/4-1I4 NE1I4 See 8 Twn29 RIW EWMDc2de :n'P-E OFWORK: Owner's.lI1III1berofweD (If_ than one) - - - -- cr0 fZ)No:wweD DRccondit:ioaed Mabod :tlDug ,0 Bored DIlrm:a LatILong(s, t,r AI LatDe({t~Mm/Su;~1. ~ o Da:pcned DCabJe fZ) h1my D JCIII:d DIMENSIONS: I>ianu:tlrofwclIL- iDchcs,ddJled~:Ii. Still REQUlREDwLong Deg 1'2 , Long Min/Sec Ifll Depth of comp1c1ed weD 119 :Ii. CONSI'RUCI'lON DE'l'.AU Tax Parcel No. 974600011 Casiag , fZ) Wdded L-.- Diam. tium 0 :li.1D45 :Ii. Imllllled: '~ LiDeriDslaUed L--- Diam. fiom Zl :li.1D 119 :Ii. CONSlRUcnON ORDECOMMISSIONPROCEDVRE ThreadaI . Diam. fiom :li.1D :Ii. FODDaIion: Describe by colar, c:banclm; si2eoflDllllllial and sIrDl:tDre, aad lhdind and PerfonlioDS: OYesJiZlNo - oflht maIaiaI in eacl1_ peaetralIld, wilh aI lcasr oaeelllIy:lbr oach change of Type afped"omlDrused mm....mnn lUSE ADDmONAL SHEETS lFNECESSARY:) SIZEaf]llll'1i; iD.bY. in. aodJID. of~ fiom :li.1D _:Ii. MATERIAL FROM TO Screem: fZ) Yes 'ONo OX.,}'ac LocaIilRl TOP SOn. 0 2 Manu&cturer's Name PVC BROWNCLAYWllH GRAVEL 2 14 Type -PVC Model No. GREY CLAY AND GRAVEL 14 66 Diam. 4 TNr.H Slot siD: 010 fi:oml09 Ii. ID 119 :Ii. Diam. Slot size &om :Ii. 10 Ii. GREY" SILSTONE 66 79 GnYdlliherpado:d: U Yes IZI No D Size ofgmvellsand GREY CLAYWllH LESIONS OF GRAVEL WfB 79 103 MaIerlals placed fi:om li.1D ll:. GREY CLAY 1{13 122 SurfioaSaJ: 0yes DNo Towliatdeplh? 18+ :Ii. Materia1 osedio seal BENTONITE Did ,lID}'sIIaIa conlain UII1IS8ble waIa'1 DYes fZ)No Typeafwala'1 DcpIh ofs1mla Method of sealing SIIma off PlJMP:Maiti1lilctun:rs NIIIDll Type: , H.P. 'WATBRLEVELS: ~\llevalilRl above__level ll:. Sialic level 19 Ii. belowlop ofweD Dale 07I06/lJS Arti:siaa pressure Ibs. per squaRl ioch Date Artesian _ is c:onIrolled by (cap;1Ialvc, etc.) WELL TESTS: DrawdowD is lIIIIDIIDt _Ievcl isJowmed below SIalic Ievcl Was apumptestmade? DYes IZINo If,.,s. by whom? Yield: R8lJmin. with Ii. drawdown after hIs. Yield: aa1.Imin. with Ii. drawdown after hIs. Y1e1d: aa1.Imin. with Ii. drawdown aIler hIs. Reco""", dolO (timti /Q}am Q$ zero when prmtp tumed off) (WaIer level metlSll1"t1d.frc>>n ..ell lop to ....,/er level) TIII1e Water Level 1ime Water Le\IeI Tune Walm'Leve1 - - - - - - - - - - - - Date of test Bal1ettest_galJmin. with ll:. drawdown after _hIs. Airtest 7 gal./min. wilhslemsetat US :Ii. tor ] hIs. Artesian :flow 2.p.D1. Da1e Tcmpe:ndureofWater_ Was ac:bemil:al amdysismade? Dyes DNo Start Dale 06129105 Completed Dale 07/06105 I I(JI ~ LIt; I I I I- I I I I I I I I r"" DriDer"s SigDatare WELL CONSlRUCTION CERTIFICATION: I constructed and/or accept responsibility for cons!:.r1lction oflhis wen. and its compliance with all Washington ,welhlonstruclioo. -standards. .MateriaIs used and the infonnation reported above are true to my best knowledge and belief. 1l(DriIlcr 0 Engioecr OTraioee N~~ ~EBLE.B. I Drilling Company AQUA PUMPS DrillerlEDgioeerJTraioee Signature ~~ -:e; Address 6962 OLD OLYMPIC HWY DriIlerorll2iDee Liceuse No. 1252~ Cil;y, ~ Zip SEQUlM, W A 98382 )~s --,..- Dale om 1Jt)5 EcologyismEqual ~Employer. I I ECY 050-1-20 (Rev 3/05) The Deparbnent of Ecology does NOT warranfy the Data and/or Information on this Well Report. I ~ ~ rl'"""\", \\ n /.-r lATER I1LL lEPORT Startfardllo. 178331 I ;/ Unique iell 1.D. i US9'3 , /-" STATE 011 WlIIlGTON later light Pemit No. ~ iii'Oiiii;'j'o;;'oo;sOi'~"""""'::~;"'=ili=DiSCDiiii-'-iiDli-'-iD"'"iOii'iOiiiiBD;=Il'=9ii6i:.......,.....== I m;itji;~rdfonif:f=:=:~=-;=;~:lV,iJUiil!i.:iiin-== ============================================================================================================--~-==============: (3) PROPOSED USE: DODSTIC (lO) JELL LOG II (4)=TYPi=OF=;oii7==========~;;~;-i;ibe;=;f-;;ii================ -j~~ti~;~-D;;~;ib;-by-~~i~;h--~~~t;;~-;i;;-~f-;;t;;i;i-- (If more than one) and structure, and show thic eBS of a~fers and the kind I ====~=~,~=,===~~~~=== rl=,..:f~ ,~~= ~:.m:~ed. lith (5) DIMBiSIOXS: Diameter of lell , inches ------------------------------------------------------------ Drilled 42 ft. Depth of completed lell !2 ft. IIAmIlL FlOM TO =========================================____====== 'TOPSOIL 0 2 I (6) COISTRUCTIOI DrrmS: BRon CLAY 2 fi Casing installed: , · Dia. frail 0 ft. to to ft. BlOB CLAY IBD mm 6 28 mDBD · Dia. from ft. to ft. Blone 8m & GRllBL 28 35 I Dia. from ft. to ft. mY CLAY 35 !2 I I I I I I I I I I I I I I 1".... @+{~ ".., ./ -----------------------------------------------~---------- IIJ t{SO 0 (. ;01' uJ /2Zt> q "I. tjt,~ I perforations: IRS TvlJe of'perforator used PIRPORATBD SIZE of, perforations 1/4 in. by 1 12 perforations from 3) ft. to 3S- ft. perforations from ft. to ft. perforationsfromft" to ft. ----------------_.-----------------------------~---------- Screens: 10 Manufacturer's lame me Hodel 10. Dum. slot size from ft. to ft. Dia1ll. . slot size from ft. toft. ---------------------------------------------------------- Gravelpacked:JO ' Size of gravel Gfivel placedJrom ft. to ff. -.-- ---- -- ------- -- --- ...----- --- ------ ----------- ----------... Surface seal: ns " ,', To ihat depth? 19 ft. Haterialused in seal BmOBm ~ea~I~~i~~~ contain u1lll.sable ~~~?o'O strata Method of sealing strata off BOHR =========================================================;;====== (7)PilMP : Manufacturer's lame Type IOIR H.P. ==============================--================================== (81 11m LmLS: Land-surface elevation above mean sea level ... ft. Static level 15 ft. llelO1l top oflell Date 86/08/04 Artesian 'Pressure lbs. pet square inch Date Artesian water controlled by HOIR in. ft. lork started 06/17/04 Completed 06 08/04 i9r=iHLL=TRsTs7=D;:;d~;~=i:=~;~iit=;~t;;=i;;:1=i:=i~;:~:d=b:i~;====iiLL=cOBsiiuCTOi=CiiTillCArioi7==========================: static level. IconstIUcted andlor accept responsibility for con- Was a pump test made? 10 If yes, by thalli? struction of this lell, aM its cOll1pliance with all Yield: gal,/min yith ft. GraYdon after brs. lashi!19ton lell construction standards. lIaterials use and the information reported above are true to my best knowledge and belief. R.ecovery data Time Water Level Tillie later Level Time later Level mETILLn JELL D1UL1IBG (Person, fim,or corporation) (TJpe or print) ADDRESS 367 S Bill POlT lBGELlS ISIGHlID] ;:~/FI--:J/h~,.. License 10. 8868 Contractor's legistration Bo. nLLIID043IO Date of test {l Bailer test !fa IlI1ln. ft. drawdolIl after hIs. Air t~st 7 gal/min, wI stem set at 33 ft. for 1 hIs. ArteSlan flow g.p.m. Date Temperature of water las a chemical analysis made? 10 Date 06/29/04 ===========================================================================================================================: I OCT-eS-20e5 03:34 PM AQUA.PUMPS.DRILLIHG 1 36121 683 5113 I I I I I I I I I I I I I I I I I I .., WATER WELL REPORT ,,111 ,11'6 '.'lJ Orielhl& '-mpy-Wo&v.P 101I1-, _,JIII."._'rJiIr t.~~ ('XU lncil'~e) IDConauucdCfl o DeoommIssloD ORIGINAL 1NS1'1lLLAT/ON Notice if 1m,,,' Nun;b;r ~::. ~:;: 8:::: 8~ 1XPE DI' W01lKt OwIIllr's IIUIIIber .,r..2fl (It_ dmallllll) m, Neor,,',',' MIl,"" c~ """':BDq CIlcnI 8~ o ~ " CiIIlo IilJRlmy ......... J)lME."lllION8t~ofWl:llL- Wcs.4iiUcd 263 t. DIJl!lIlltCfllllJlllmd welJ 263 ft. CONSTUJOnON DETAIlS CalIDa ,MWIIrW L--" ..........!L-a.38 JitrlIllW. " ~1Id L--- Dbm..iuli.lL..-.... 2i3 'l1nd:d . DiIllIl.lIu& :It. to PmQraIlDlll= [J fa BJNr> 1Po/'~lIIlId 'br.<tpri_lIL "'_ia...vIll).~prriJ_thlm ......, ,'.'. KJV. CWo OK.... 'LeGI1iIIl "",~'INIIlI1I' we ~Jovt ModIl No. ~_UJolCJi._.61"'-...Ql.Q.__tam.%.lL__a. to 24~ Diom. Slot _ *ora tL III ,', ".~.',~'~~lllIlLI~",[:J~lIt..~aa1 ............ u. _ ..__.~.__ 11. ....L8aIli~Ya LJNo T01lIlrl dlpht U+ fL ulllllril1lalCdiauad Bmn'Q~_ . bid..,._coaflllUlD"~ 1'l1lB Ql'wmrt ~bl''''''''6M6If rtlMPl M~. "'- .'')1leri " ft.", CYM 121..... Dilplhm_ _.__H.P. .~1~."~VEfs:.~.4Ii6I~llIeMMt JhoeI I. 'lIIIko~l!&O alWlloY.o..t.fiW1l tlorH..IWl.1mL. I .AJlIII!lm jlmU8 lia. pIr IqlIIDt _ DIIw A!tilIIall MiIlr II CCIttoDId fly r_ -.....-;:;.;).. WEU. TR....81 ~~lI___IeW1"~ 1o.Iow_< lev. 'ti......_lIIIli.?tJy. IZlNo If,.,..,__., _ Y--~'lIi1h 1.~dIlr 1m. Y"eid; laII.iIIIIa. 1IiIlI *- ....drnnI... lIrs. 'Yilldt lIrII..Imla,lOilla a. ........ ....._ _._ _bls, """""~Iiml? 1lI-........ ....,......"""" lJUfUtl tf/l) ~1Io# _""tJ~ wi; 1iIJI"-'-l) TlIII! Wnr l.4VcI 1'IB 'WaItIt LrNel 'ItIlI6w_ ~d --- -- -- -- _...~-- -.- -- -- ---. ~ an., IllIIIIr ___88l./llIbI. wIII___ft.d:aWIloIY.natllr __Ilm. I AIMat:2 aWmIn. ";11I .... ell 1ll-!.6Il Ii. i>t ! lut. I ArIIIIia1l..... *-p.ltI. DIto. ] T........et__w.............,......, OVra C$fNl1 P.135 !-o-;' 9 CVRllENT NotlenUl1tmt No. W116722 Unique &0101)' Wen fD T'J No, AlOO 10 Water Right Ponnit No. ProjiOrty Oiimlll Name NORMA MASSEY Well S1nIel Address I.OT (I!ilHWY 20 NJWl JItND~ LAKE AD aty JI01T TOWNSBND Countv JEFFEUON l.oceticJII !!!lI-4-lf.f IE .,4 See..!.. fWD.!!. R IW BWY CJcIodt ~IZI- LIIl De,g LIlt MiBISee Lana Dcg_ Long MinISec Tax Parcel No. lllilO84OO4l l.ItII..oq (I, .. r Still J'eEQUDmD) :A. ft. t. CONBI'RUCIlON OJ. DECOJIBfISSION PROCEDURE F~ Dowh~llIlb,~_of-WMd__aDIl..ldad... ....... ,,'GalnllWl iD..lInItum~ 1IriIII81Jeul_mIr)'/lIraalllblnacot 'lIifl1madol!.fUSE ADDrl'IONAL tlHEB'J'S IF Nl!.CI!..Cj,,'lARn t. WtTERlAl FROM o 1 12 IS ,',46 ",'.. 13 17 101 111 m 122 . la. ',,', 137 ",' 1'" ,1.40 146 :2"3"" TO 1 12 U 46 on 77 101 III m /22 12. 1)7 III UO l.ui m :Ju=<. . WELL CONSTRucnON CERl'lFICATION: I constnK:ted MaJor eccept ~ll3ililliiy fOt'ClOOS!n.lCrion Qrthb welL tmd its WIlIplianl:e with all W eWngl<ll1 ~n tonatruclion !tandarcb. Materiala used and _ infurmatill[! reported above ere true 10 my best knowledge and hellef: ~ Dri.... QAu'- D Trm- N~C;~~_E~ DrlIUIJ!c..,..,., AOUAPUJdPS DIill~~~ _ Adllroot69lJ10LDOLYMJ>lCHWY_. 0riI14r.lIIIMcLkcucNo.~2 Ci'iY.-.7.lF SEQUIM, WA 91312 t==.. .. - J ="_M TO' son. BRQWH cv. y It (JUrCLAY Ji. GUY SIlTl>TONE '..,'. bOMiSHAi.E FItAcn)RmB.....~I.T ~ SIl,'!'81'ONf O~ CLAy WIT.HLESlONSSlL'lS'rONE ST.l.TSTONflWlTH LESIONS Of CUtE\' CLAY (Jll,By .CLA V ' '" 8R()WN SHAUl FJQ.C1'Q!WO BASALT . ',' O!Wi\CtAti' . . ',' .,.,'" .l'M.QTIllU3l) BASALT BROWN SHAl.E '. GREiYUAY AROWN Pi.'I.C111lIED SHAlE WID . , I:Ia UTnOOS ~iJ.. F.qgl OWommitrEap~-cr. !CY 0$0. ]-ZV (ftIIv 1K15J The Department of !:cology dOH NOT warranty the Oata andlor ;~rmation on this Well Report. j I 811III D8III m/O'!lfJs ~~ 07ntlO.5 FiL..@@~V SlIrtDlle ~ CDrrlflImcIDIIs 07/otJoS \\'ELL CONSTIUfCTlON CERTmCA110N: I oonsInK:ted 8ndlor~pt reapollSiblllty forl:OlllltNct\(lft l)fthls wen. and itlllXl1'nplillt'oCewllh 811 Wasbington "''ell ~on standBrdi. M"t(:;'ia\s used and the inform\ition rq'l(lf'ttd ebovt; are true. to my best itnvNledge and beli,f, Cltl1llkr C~ OTuoiJD NIa>>~I~~ JJt!II""~. IlriIlios~~l!.APUMP5 DriI!~1i"~~ ~ Addn!is 6~2()'J:..DOLYMPlCHWY tlriIlm'cr1lllaccU-Na. 2252 CiIy.Sblo,Zip 5BQUlM. WA ~~ (~_ ]~'.~AWA~ I I WATER WELL REPORT ;";;",, 'I OrIitmIIA l..llIIp7-.....~ ..,.-_t.3'" ftf1-4IIIR .". \.! C, J." t" I ___..~___t...dA.M (' ... -' ") ~UDl__- :{ 111 ",'fe,e. 1i1~ Cl ~()RlGINA.L1NSTALUT10N Notice of l,seR' Number I I ~WJ:r ',' t:!Dilf.. MIIIidpIl Olbar I '2llrIJi,oJ' WolOO o..'.1llIlIIk< Dfwl1i (Iflllllft lIIIrII_l IiZlllall-.1l CB.. "'. lthIiioIIiBDal. CIc1nI! CDJma C IlIlIpiIIIId CIih III &IlIIlY C .!lIlud ~ ,~ Dilm.-GfYltlll,L ,_l&chca,drillaI~,_" I DepIIt or ~ well. \1Q .II. .1 ;.,::.:,',.~,',;o~, =.=2 _.: =::1. ::tf,.._: ; ',fI~ , - ue.... ..jLlIrI A. ~: y_ No T3!l'of~Ued_. sJnOtpcd..o-" . .la.1ry_, u..dmo.ef~ fiwI, l.iO ,. ~ " v..', Nt. ~..... J.-ioa M~litilsam PVC: "i]1li , JIVe < MOIWl N<>. ~.lThJCH5IIlt~ mn ',~ 109 ._LIioI119 Jl DIam.__ 51111siu__ hm__.A.le__ il ~........ Ya He ClSil:a9f..-u-l__ MaiIldaJspltce4h1t ft. III ft. ~~IiZI\,M CNII 1'o....,..1BL-__,J, ~~1Il!IJUI tIied.IDRIa1, BEI'lrONITB 'il;dIllllyJttalacOmiit...........-n o-v. JiElt% ~~~~ ~Dliplbbl'__ ~OIlClf~1!nIlI afl' .'PmU'1.'~.w.m 'I'JPI:" ."" ',. H.P. I I I I I I ",,~~U:w.L&: ~""'~"""'-Ilw41-.,-__._"L ~tIlIic ~-11--*-t.IIDwtllp"',..r...m&6IOL MlA>JlNUllIII Ik p.i..... islII Du.l_.._ NIM!&_la-.llerllly ~IIY _ I WlLLTEns: l)znd__ ...-.....1eY1I.1I~ __CII& Jevd w......._*'11di117 th. 1Z1r~ ifYli1rtWllftl'l YIdd:_~.mb__ .,._'" ........u.._,...--1ft. jlltl4: p1Jnia. w1lb it. ~tftlli'ln. YRld; oL!IIIlI,-'ih A.~odM In. R.-..,....... (liIM"*"..JIM _,...,.1IItiI*J 6/IJ """"'Ind _utedflr* WlI Itf'IO ""*,,lwutJ 1'iat w_ L...el TiM w.....~ Tl:IlIW_ J.ml I - --:.-- I !)got_ "'1aIl__.,plllni"- wB ................Idltt_1Im. .A1,-,L--881Jml1Lv\dI_"".115 lLibr L__lP$. ~ll"", __,_ _..p.m. om. ~of__ W............lIIlWl eYe; CHI> I I I ~-+ II CURRENT Notlee afJatellt No. WII6'nO Unique &oloiY WelllD Tag No. AHIU09 Waterlllght Permit No. Propert)' Owner NImO lEU" ~ wen sum Ad4Iesa LO'f It HWY 2DNEAl ANllER!lON tAKE RP Chy POlrroWNSiI'ID ~ mFBRJON ,..:.........:..... Sl!1I4-1I-C NB1I4 See t T1m29 1.1W IMI 0...... ~- - - - - ~m- l.1IttI..Amg (Sf t. r Let DIg Lat Mila'Sec StiD ll1tQumED) Lons ))eg_ Long MinfSee i'rail. Parcel ND, g,4600011 ~uCl1Ot<l ORlUtCo.~ PaOCEDtlRE ~: IlMcDle~ooIDJ.iIInc1r;,_ oflllllWlllllllll_- __,blld ......aldw-.l ilIcch_~ - ..IoIlotGDeIldlyIbt -=blllls>tBect iD~ BE Mmm()NALSrmaTSIF~'{, MATERIAl FROM o 2 14 66 79 ill) TO 2 14 66 79 tOO 1~ TOP SOlI. BROwN tJ..A. Y Wlni GR." VEL GREY CLAY ANDORAVEl. OOYSII1ltONE GREY,CLAYWI11lU!SIONSOFGRAVa WIB (JP.EYCLAY bIl!i m/llftlS Er.oloIY iA... &juIiI ~JlmpI__ I 1lC\'fl5lj.I-20I_ 3iOS'1 The Department of Ecology does NOT ~ the Data and/or InformatltJi'\ Oft 1hil Well Report. I L1 FILE I I I I I I I I I I I I I I I I I I I WATER WELL REPORT IINli"l !;~. 0dpIIl1..-.", -1lMIr. t'"eIIp1-.-.r alJIf-"'" ~~18IIN (''z''lJf circle) . mCcJnllludlcm D ~18ion ORJGI1I.AL INSI'JfLLA.r/ON NotIce DJ Ittftnl N.mber Ji'JiICJIODD Vdt ~ Co...... T.IlWall nft OlPViOIIJCJOnn__otWfD (Ifllllntla-) 1 m~....c...iIli.",". Jbdtad'8D11l C... 8~ I O~ ' "., , DlB 1iZl1~ ........ Lr::rf ~ ClllUl~N'J" NodeeGf bltendfo. WI8671S Unique BcDlog Well u) Tag No. AHR313 Water Rigkt Pmni1 No. ~ Owner Name AlfNlIICLAOOHUN Well SInlct Acldrtll& MWY 20 ll~ ANDIiRSON LAU aD ,1.O"t 8 CllyPOllTTO\WSEND County JEFFERSON 1G:8don..!J!J/.f-1I4 ~1I4 Sell.!.- T'Ml~:R2- ~ kI.... WWJd ILl.... . utfl.ong (s, t, r LIt Dog LIt MirJSee ~ StIll 1tI!'.QUIRD)) :DDmfSI1JNfil 1JiIaImcrnf....u.A-.... .... tkiIIcd.m-ft. LonJ Dol-Long MinlSec_ DIlpIIi sf oemPeled wtIl u~ to eoNBTIIOC"'l1ON J)gtAlLl Tax ParftJ No. 9746ll1J1m QIIiDf ~~6 .. 1lIam...~i.Io~__fL JaolwWs . " u.........c . IliIm.hll.H..-.t.- 241 .. CONS1'R\JcrlONOR~ONPIf.OCZD1JU .' 'l1IiBodI!4 - ....1Ml t. .. 1. 1onJ,utIits:~ llJ!IllP.............. .rwoletilol....-,IOIlI..ldIIdad ~,~y.., 1lJN6 1lIIIID41f1lw11iilidet II '___ ~ WiG.. hiIII_ iIIlr/for eM1ll1illfll8Cl or '1'J'110 ofpcdilowk1rllllltll__.. ..- - ~"vsp. ADDlTIONAL SHJmTSIF JiECES8ARY:l snzDt)ldl ia.1Iy, .. io.1lld1lfl. of~ a- ft..... .. '" <w.T!RIIIL t=IftON T 1"0 , ~." ,,~Y.O)lo DLIWl LoIlIIicrP TOPSOT.L tl I ~.NIoo'oo'.' !YP MOWN SlLTi' lllt.ND I 10 w.,,~ JlIodIll NI>. fj,......P.1 S1LTSTONEWffHGltA \IS. 10 '3 DiIIlI. ~ mC-H likrtoiao 1Il0 a-11 I ft. J)j&,.... 1I0um iCa ILIIlI .J. BASALT 43 46 - ..~.... [J"..fZ!No..GlstDClf....... ..., (l~(U.Y 46 Il9 MnaIdI}lIm:d hD. _ ...Jl to _e. SlLTSTONB 119 107 .......JloIII:ll}Y., CNo 'IYJ"~ tJ-t. e. I!AllALT 107 HI J.folloIollIlMldR 11II. BEN'rONJn SILTSTONE III ISI Did,~ ~alIItwPI """*""..-it Cv. IiZlNo (JRE\'CLAY , ISI 1711 , "~o:f~ !)IpI!iet.. IlAS.At,'r 119 m ~id,6f~atrIlIIciff SILTJ'rONE . II! 203 ,PVtoU'I ~r'J1oII11W ~AS.u.T 205 '" 208 T!PiI:2....: ' ' ILP' " - FRA.c::rom tJLTSTOl'JE WIB 208 242 ,.,t~~~ 1.I1lIIo~;r..,.~~~~!I!Y8[ " " · '.,./", ,', .. ",.','.' - , ~teY<<. ~~. ..tiIiOwlOfl,~~ l:lM6~_ -,= A/IiliIAIi~___l1B.F..."'" 0il6 , ~"laCildrdledllr . ,_.~.........) MtL 'l'UT!lI ~it__~-*ik~....-..1BVtI .1"""'" o VII I21NQ .~.,...., -. ykll4~,wlth__..A.~aIlIr__..... yiQ uLlmin..wllti fl.~'" In \'!del; 'alJmiI1.wir!lft.~.mr 1ft , ~...... (Itl1l6l1t11111lUmov_~."..,IfIJ{II_'"'-l--..J_fJM HII I ..,*,.",,"/1-1) I TIIll6 W8I<<JaeI -na w... r..niI Time "'*' ~ - - - - - - - - ..L--.. - - - - - - , ..of_ ..- .. MIl' 1r8t_,.plhllin. wltIi. ...--.--_--'..~.. __ .__ha. AIlWl&.uu:.'IT..p!./mlIt. with _ .._23::! , tl, r". L-:...--- AtItUll8aw -- ~--J.P.IlI. l:lL't_.__ ~oI'__w..~~rtI'IIiWl Ova IZlNe GWID* (0111105 ~0Ile 07/t9/(l5 " WELL CONSTRUCTION CERTJFICA nON: I CODStI'I.1l:lle 8i\dIor accept respollllblllt5 fbr cxmlrII\llion ofthls wen, and its ~plW\oe with ell W~ 'MIll ~on standards. M$lerlaIs used. -and till: illfonnadoo reported tsbtwc m t.nJE: to my best kttowledge mil belief. .t..., D~g~~.$~....... DIII!IfI3~~...QU^J!UMPS M1~Illluw$w.- . ' ",~ ,..- 6!16HILUOL'\'MP1CH'NY Dril1et6tn-U_H" 2252 ~.Ital.Zip SEOUlM. WA. tll382 F-- ' '1="~ DB 07/19Al5 &toaIail'iIol11t ~ ~SIqioy:<. Eel' 056-I-JO (by 3105) The Department of Ecology does NOT warranty tho Dam andJor Jnformatlon on thlli WellRepol't. ;f" LJ FILf: OCT-e8-2005 03:33 PM AQUA.PUMPS.DRILLIHG I I I I I I I I I I I I I I I I I I I WATER WELL REPORT ~,III ,.. '1010 OrIgIDIIl"r'~-I:~.:I"i.-_, T,a"'WflI'~dJlllor t rt'.. l'II~li(lllIDClC_lJmNkm (.~.. in clrcl,) IiJConItNctioo o ~ission ORlGlNAtlNSJ'AUA170N NDtice D/lntMl Numbtr PiDPOU.Duu, []PII'WDr IiDIIllaD g,mdellldll ~ ~ o IuQIliDI [J tB Wj\J D 0IItllI TYPE OPWOiiltt o..-'s1lulllhwaf_ (sf",-__> 12)101........ c~""" "':8018 C!reftd 8~ C~ CaItl. m~ _.... DJM:rNSJmllil DisrPlterofMll L-..1luIw, lIIdIlollt.ltl..-ft. Dopd1at~WIlU 382 ~ eot.ISTBUcnON DXl'AlLS CebIt ,~W.w.d -'--- 0" ra- --.L-t... u Iaotlllleli: U-........., ~.._: Di8l.8Dm..!L-1.16 MI2 , , n...w . IJiIal. "* "III ~"'" CY. IC]No "I)'poo "JIIIlIftImor uciI SZEDfJlC!l1S, iD.~ lir.oncl......r~... .....1iZf \'. []ND [J K.fIllI tlIIlIIim 1 ~. NIobe PVC ~ I ~PvC _ "",,' fwbIol Nt< I DimLAlNCIL.~S1(lUee 010 '- ~S2 _ ft, (0 362 ~'__~'_ Ilcllizt Ilum __. ...._..,ll.1iD ~...,w. C V.. IiZI No> C..ar........ ..l(lIIetiIlIsplal:ld...., ,',' "',~, 'L,~",fl.to.." " .....""*lZIy. C~ T.wiI&t~ 111+ MIIIrialllMllln.... BEl!Il'fOIotITF. D111q' ..... 00DlIlia 1IlIlIlDltWU'J D v.. Ill)lo "l"yp:af....er? , .. _'. DapdI ofllnda lIIClhoddlllldntlhlu/f" " ~ Mar;~s HDD:ol ,~ "-. fl.1iI .. K.I'. 'Wttta,~'iAIJuI-RrfICG dC\'.dIcI1l1lxMllalll.lt""'IJ!v~_____fl. SWIt .......i6L.. ;, " ~~ _!of well DIlte 07LWlL ArIiahil~III_ Ik 1*........ m.'I.tlwie ~''''''D~by ".~...l WELL 1'UI1r: 'DmWll6wJlll-.a.'" !ewe ;'1__ tdowmllc *'t1 "..""-4' 0 \'11 RIND '?W>W""'" "lcid;__~_--..JIl.fDlln.wIJh ft.~lIfI:r. _ y...;;__--Jal..Iml~. wIIh .ft. ~ aft. lln. Y*'!,. UL!aoIIli.wilb____,ft...wdown... ..... Jha>....,.~ (1_ ........-f"IMP -"'Iff) "",lItd1_fr-_IJ k1p/t) "tI"I'I_D T. w_ ~Timo WaerLo<Rll T'_ ~'wIwLsnl 1-- ;;;;;:-. - - -...... - - ~MI_pl.iam. with.. !.:RMIomI Dfter _, _lIrJ AllWt In m1T p1.,irBia. wi.. _Ida 372 fI. '" !-lm. AI1alan 1191l' Il.JUIl- ~ TlIlIll_"'U'__ W....~lIIII)IIia...., CVM IZJND 1 36121 6S2:; 5113 CURUNT Notice oflateDt No. W1",,~ UDique!oolOQY w.n JOTagNo. AHK31:l WatM Rljbt Pormlt Nc. PropeJty Owner Name IERRY A. SMITH Well Street Addm. LOT 5 ~IlA.N.Ol5RSON LAnJP City JIORl TOWN&mm County .Il'!P'Pf!RSON Loo8don ~/H/-4 E V4 Seo.!.- 1\m~1l~ P.02 Lo+ 5 --o_ n... m- 1..atIJ..oog (~ 1, r Lat Des Lat MinISec Still REQUDlED) Long Des _ Long MinfSco Tax Parcel No. !101DM004 t. .. ... <:mfSTJtL1C'J'JON OR DBCOMMISSlON paoo:DIJJU!; l'oaaIita' bMt:IIMlly 1lIII1or.~. _eflDllclill&lld~"'Ib.lr:W IIIltl JIlIIIIIDat_~ .. _IIII!m)Mllllrlltll. witlllll_IID&,eomy far -" duIti= of iI1lmDtIm (Un ADOmONAI. SffiimJF NECESSAllY:l fl MATERW.. F1t~ o 2 " 14 All 4~ 52 61 7S 71 82 &4 87 1)3 ", ~$ " 98 ,,' 1t)1 IO! 109 us 2-45 276 2*1 2&& TO 2 14 4<i 42 52 61 7S 77 82 64 87 93 95 .98 I(IJ 108 1(J!;l m 24S %76 281 2lli 382 , WELLCONSllmCTION CERItFlCATlON: I consttuet<<l tmdioJ' accept W:l:pauslblllty for eoll!ll1lcOOn oftbis well,. aid ltseomp.\iance mth all Wash.ll won l>>Ul"llCtion standetd& ~ls ~ lIIid the intbanatl(lt\ teJl';l1icd above are ~ tel my best ~ md belief. ~ DP.-, . C'1DIWc N~~E.R ../... ,DrilJiD$CtJmpimy AQUA PUMPS nrlll..;'Il.....AttT....slpdur: ~ ~ 6!l6.201J) OLYMPICHW'\' tlItIIlIIlIr!laitleo U- No. 2.U2 City, &.... zip S!!QUJM, WA Wf2 t==..'. ; : ... J =..~ A- II TOP SOIL BROWN CLAYWIfH GRAVEL GREY CLAY GREy ClAY WInlMSAlT GIUlY'SILTY CLA V aREY$lL1Y'Ct.AyW/FAACT'JIUlI) a.\SA1:.T C"1ltEY CLAY Bllov,'N SffALE C"JRt,."'"V CLAY GRBYClA'Y WIlHBASALT BASALT .' OltEY$ILT\'CI.AY '.OlBVSlLTSTOWi\ B}.S.A.l.'I' ','," '. .' GItE'l,Sn.TY'CLAY .B~A.l. T ()~VStlTSToHF. BASALT BA5At.TWlI'H LllSONS OF 5n.TS'TONIi GRBYCLAY SJL~ B.~t.TWIB DttOWNSHALE '. _~_a.~ Scol-"SY l&_&pl ~ily&opko)'l". 1!('f!l*1.~(Ilet-JIOS) The D&parim&nt of Ecology dot3 NOT warranty the Data and/or lnformilUan on this Well Report LJ FILE fl. , $bltt De CI?1l1J05 CompIMlDIb fJ'l/l&'OS I I I I I I I I I I I I I I I I I I I WOOD SURVEYING INC. Arnold Wood 2155 Discovery Rd. Port Townsend, WA 98368 (360) 385-5968 Fax (360) 379-5659 MAY 17, 2006 TO WHOM IT MAY CONCERN: ON FRIDAY MAY 12 AND ON MONDAY MAY 15, 2006 MY FIELD CREW SURVEYED THE SALINE WELL LOCATED ON APN 901-084-015 LOCATED ON THE WEST SIDE OF SR 20 AND THE TWO WELLS LOCATED ON THE UPPER PORTION OF LOT 2 AND THE WESTERN EDGE OF LOT' 14 OF THE PLAT OF MOUNTAIN VIEW VISTA AS PER VOL. 8 OF PLATS PAGE 41, RECORDS OF jEFF~RSON COUNTY, WASHINGTON. OUR FINDINGS WERE AS FOLLOWS: 1. THE HORIZONTAL DISTANCE FROM THE SALINE WELL WEST OF SR 20 TO TIIE WELL ON LOT 2 OF SAID PLAT IS '868.14 FEET DISTANT ANDIS 114.33 FEET VERTICALLY Al30VEiSAIDS4INEWELL. 2. THE HORIZONTAL DISTANCE FROM THE SALINE WELL WEST OF SR 20 TO THE WELL ON LOT 14 OF SAID PLAT IS 974.49 FEET DISTANT AND IS 121.48 FEET VERTICALLY ABOVE SAID SALINE WELL. ~'RES J {11/2008 ~}; V!:~D~ ~j:DIj:Nrj: . NI=\IAnA 11r.1=N..~ NO ~1.IM. Anl70NA IIC".FN.C:F NO. 17577. WAI:)HINGTON UCENSE NO. 23911 ~o+ 1 I,.J~ ... o Ii ill W.A~RWELLREPORT :n'.lla'f" fUB 0rIpul &: 1 copy-EeolDEY. 2-' copy-8WJler,ralpy-cIrtIIer ItDLDCl . Construc:tioDlDecommissloD ("x" in circle) [!]Construction o Decommission ORIGINAL INSTALLATiON Notice II w.59 ~ oflntent Number PROPOSED USE: IZI DomesIic Q lDdusbiaI D ~,",,"1 DDew-. DIniaIll'iGll []TestWeU 0........ TWE OPWDRK: Owner's DUD1berofwell (if more thsn cme) IZI New wr:lI D RealllditiOlllld MdhtJd: 0 Du& D BORld D Driwa o Deepcmccl D c.bIc IZI Rolmy D JcttccI DIMENSIONS: Di_ofwelIL- inchcs,drilJccI~fl. Depth of camplctccI weD 281 fl. CONSTRUC'IlON DETAILS ClIsbl&tllwelcIccI ~- Diam.hm.sL--fl.lo40 IDsllllled: .IZI Liac:riDslallod!.--- DiIDl. hm~ fl.eo 282 " D Thrradcd - Dimn. fiom fl. 10 Pert'oraIloIlCU Yes IiZJNo ' Type ofpcribndor used SIZE of~ in. by in. and do. af~ .&om Screeos: IZI Yes D No D K-Pac l.oc:!IDGIl Maollf8cturor's NIlDll PVC 1)pc PVC Model No. ~4TNGHSl<ll._ 010fiom251 Jt.to261 Diam. Slot size from fl. to GnmI/IIUtW,..w: D YcsJZl No D Size afpvdl~ MatcrisIs placcd .&om ft. 10 Sarln:eSeal: IZIYes DNo To.....dqllh? 18+ Material used ill soeI BENTONITE DicI rray stnlla 00IlIain ...asabIc 1VlItcr'I Type ofwm.r? :t.iclbDdofScaJm8 sbala otr PUMP: MIlDUliIcIurcr's Name TYPe: ' CURRENT Notice ofIntent No. WE03393 Unique Ecology WeD 10 Tag No, AHR314 Water Right Pennit No. Property Owner Name MALAMUfE ASSOCIATES Well Street Address om BISCO fflI\.. J\11.An> J.U.I NT. 'VIE w ~STA City l'OltTTOWNSEND County JEFFERSON LD'" ::If Y Location NWu4-1I4 ~1I4 Sec.!- Twn~ R2... s:"'D....... WWN ill - LatILong (s, 1, r Lat Deg Lat MinlSec Still REQUIRED) Long neg _ Long Min/Sec Tax Parcel No. 974600004 - ,.J Ii 0::: I en, I~ o c Ii E ... I~ G.I .r:. I~ ,., c I; ns C 1:5 ~ IE 3: Ig en I~ ~ 'C) I~ w I~ G.I E Ii G.I c I~ a fl. a CONSTRvcnON OR DECOMMISSION PROCEDURE PDdIlIIIiGll: Describe byco1or, c:bsrlIctJlr,.. afJDllblria1 and strucIIn,..d tbo1cind IIIIlI __ oftbc moIeriaI in M:b stnIIum pc:IIllII'Itod" wiIb at Jaist IlDllcmby for each chili. of inf'urmation. ruSE ADDmONAL SHEETS IF NECESSARy) ato ft. FROM o 1 6 8 21 34 :35 57 65d 69 71,- sse. ,8&N 91 {,,1.J 106"..,. IOsc:b 135~ 137 VI 182 200 270 80 TO MAlERlAL 1 6 S 21 34 35 57 65 69 71 $5 ~8 91 106 108 135 137 182 200 270 280 282 TOP SOn. Dk.OwN CI..A Y WITIf ORA VEL BAsALT 'BRoWNtLA Y GREY CLAY AND ORA VEL BASALT GREY CLAY ~ASALT .~SiLtsTONE 0 BA51.tT . 'H; -"\? GMYS4.TsTONE 0:-1 '~CLArWiI.ESIONs OF SILTS'roNSJI" ,0 BASAtt ~ ...., ~iSI1:tSTONE ~ :BASALT .....0 GlrnYSiLTSTONE ~~. MsAL1' .,': '.' ~y SILTSTONE 1 .. FRActuRED BASALT CiREYSiL'fSToNE DROwN SHALE WIB BROWN SHALE WIBASALT fl. fl. 11. ft. [JVes IZlNo Depth or_ H.P. WATER LEVEIB: l.Ia1d-surDcc e1cvatillD 8bove _ _Icvd ft. SlBliclcvcl 178 fl. belDWtopofwell Date 07122/05 Anesim JII"SIlIUC 1bs. per squm: inelt Date A.ncsi&n -=- is CDDIJoI1od by (can, valve. etc.) .. -WELLTJrSTS:-Dlawdowa is amomt__1cvcI isIOWCRd.bc:low.sIIIio1cvel" W...pomptestlll8dc?DY", IZINo Irycs.bywbom? Y" u:1d: 1III1Jmin. with fl. clrawdDWII after hrs. Y"1cId: lIIIlImin;with fl. cIrawdDwn aft... hrs. Yield; 1IIlJmin. with fl. drawdDWII after Ius. ~", daIa (lime /DUn lI!..ra when pvmp tllm.d oJ/) (wiz,erlevel memuredfro/ll well top 10 wate, ,...1) Time WIlIorLevel rune Watc:rLevcJ llIDO W_Levcl .... tt"'!"'" ~ II ,~." .. "-'" 1111 C) n ?nnl; ,,"'... ... v Date Driest EIaiIcrlCSl_pl./min. wi1h ft. drawdown aflcr _ms. Airtost 1 25 plJmin. with stem set at 110 ft. for 1 ms. AnosiID flow R.p.m. Dam TClI3IpCllIIllRor~_ Wa..cbaJDc:alaalysislll8lle? Dyes IZINo :-~^"LOGV WELLDRlLUNG UNII Compleled Dale 07JIlJ05 SIal! Dale 01f2.0I05 WELL CONSTRUCl10N CERTIFlCA nON: I constructed and/or accept ~nsibUity for consln1ction of this well, and its compliance with all Washington well construction standards. Materials used BIllI the infonnation reported above IIIe true to my best knowledge and belief: .lI'6nuc:r 0 Ensin= OTtaincc Namc~ ~EB!)li9 /DrilliIlg Company AQUA PUMPS OriUcrIEugin_ITtainoc Signatutc ~ Address 6962 OLD OLYMPIC HWY DrilIc:r ortrainoc License No. 2252 City, SIaIc, Zip SEQUIM, W A 98382 [==NL ) =~. AQU~ DI1II:: 7- 22. .0.5 Eco1O!)' is lID Equal Opponunity Employer, The Department of Ecology does NOT warranty the Data and/or Information on this Well Report. [1 OlUGINAL ECYOSO-J.20 (Rev 3/05) I I I I ...s ~ Q , tn :E , 15 C'U E ~ ~ IV :S . c Ii c GJ I; c I~ ~ I~ en IV I~ ~ tJ) I~ w .... I~ GJ E .... la .CI) c I~ I I '":c Fill OrlQlnll and Flm Copy willi o.p.rtmenl 01 Ecology s.cond Copy - o-r'. Copy Third Copy - Orllll"l CDPY WATER WELL REPORT STATE OF WASHINGTON Slart (:Jrd No. Lv 0 't;5 0 (; 0 UNIQUE WEU J.D., It. i3 A ~ ~t (1) OWNER: Name '"FR A~ ~<. g~i,*t'{I (2) LOCAllON OF WELL: CGlrttJ'el~p; ~ ~() N (21.) STREET ADDRESS OF WELL(orN_Ulldl_) rj:p-- (3) PROPOSED USE: Domeslic IndUSlrilll 0 o lrrIgalion o DeW.lm TI.I Wen 0 (4) TYPE OF WORK' Owner'. "umber alWtln .(q morelhsn one) Abandaned 0 NswW8l1 J), Method; tlug 0 Deepened 'tJ Cable 0 Recandlllanecl 0 Ratlry ". t.tunlclpll 0 Oltler 0 Bared 0 Driven 0 JIlIlIIdD (5) DIMENSIONS: DlJIId I 'J. 3 Disnwler aI weD ~ leeI. DepIh at eompl8led well 1'23 (8) CONSTRUCTION DETAILS: I ~"ng .natall.cl: G,. .Diam. !rom ~ ;- =~ed ~ if (1." o.BIII.ltam t.. :l 1l1riIadeCl 'D" . DilUll. Irgm 1\.10 1l.1a 11,10 7~a ~l'Ieralkl": Yes rs Na 0 . Typili:ifp&tlo'fluir uMcI ~LRr TJ I€ I lJ-.. SIZE al P.8rloraliOnS P ., In. by 1/'2._ in. .'! (JJl8r10ralIO", IIlim 10 '< It. III I ~~ II. pelforat1an8 lram 1\. \0 It. pertoratlona from ft. III IL ScrHnl: "(81 0 NoJK r.t8n~ac:tIir8r" Nam& Twe' Diatn. ~SIotllz. O\am. SIal la Gnvtl pecbd:VlII DNa ~ Grevel placed 110m fram Mo6eI Na. ILlO It.la rrcm Size gl grlvel 11.10 su... ...1: Vas ~ No 0 Town" dtplh? B n ~rlllllSadinBllllgGAJ""t"Z> tJ , IF DId any strata CllnlBln unusable w.l8r? YIS 0 No 0 T,pe at ,wIler? Deplh at strall Method at &Sllmg slrala gIf (7) F>~MP : ManlJIIIc;lur..... NlUII8 TyPe: H.P. Mdr8II illChal. 1\. 1\. II. IL (8) WATER l.EVELS: .l.nd-eul1,ace elevation , ,. ,,;,,&xwl men ,.11eoe1 SIaliC IIwI HI . 0( I\. billow lop 01 WIlli AIlItliIlll P'"Slute Ills per IQlllIra inch MelIII1_r .. cordrollllCl by Pall oflBSI Saller 111II_gBl-lmln. with II. drewdawn allBr hr&. AlrlBS! ..s-. gll.lmlll. wilh Blem setal 1.d1. 0 It. lor I hnI, . MealBn flOW g.p.m. Dale Temperature 01 water _ Wes a chemical BllBly$iS msd'? Yes 0 No 0 ECl05D-I-20(2l93l"l ...... C Hf.d2/clv I Ar'f'4:J.' ~(p~,1 p~ Dlle DlIllI IClp, Vi.... 8lC.1 (9) WELL TESTS: Drawdown l& Bmounl water ItJveI is Iowlred balow alltlc I_I . WIS. pump 18S! madII? Y~i 0 Na 0 II. YBS, by wnom" 'YIeld: gal.lmin. wolh II. drswdoWfl .IIer hIS. FlBCllvery dala lllme takln 1I5 ZlIlO when pump lurned 011) (wiler level measured \rom we" \Op 10 WlIf8r leVel) 11mB Waler Levvl lime Waler Level TIme WalIIr leval WIIlfi' RlIlhl p.nnJ1 No. If" ~CJ N,f1J~~(,~1f/ bPd._r:;.OI1l0AlI)~.4w1Yf't'~6 . JJllLII4~ I/4Sec-L T~N.R..i.W..WJ.t, l&. fl. II, II. 1\. er- Work Slllled '9 - 0- WELL CONSTRUCTOR CERTlACAllON: I conslructed and/or accept responsibility lor conilruCliOn ollhiS wen, and its compliance wilh all WaShinglon well construction standards. MIllerials used lI/ld IIle informalion reponed a\loVl are true 10 my best knowl9dge and belief. NAME .:S70icAN 1)PI~l.~ tIl- ,~ ~5Qll. Flfilx,OR~ i'!VPE'6i\iIRiiiTl AddI8SS p05 161 S~ ;" ~ 9'? 'jr?.. (Signed) ,.I ~ ~ License No. J 'II J .6{A (WELL LLE4'1 Con\1'aclor's R.giatr,~ . ...1.t::!Q. ':? No. --.5P J Ie I) c.. l '3 J rt Reale ~ - .;;) t::) - (USE ADDITIONAL SHEETS IF NECESSARY) ,'9~ o I~~ o g, I~ ..J ... I~ a::: I~ en, :c Ig c o Ii ... IE cu .c .... I~ c CG I~ c I~ .... c I~ 3: I~ en cu I~ tJ) o I~ ..... Ii E .... I[ cu c I! I I ..,f~ ~+1 .. WATER WELL REPORT :1'.."1" .rlll ~a t-eopy-EcoIfJIY, :zMcopy-OWIler,3n1 copy-drlDer ,. &111.1' If ItDLOCl ' eonstructionIDeeommission ("x" in circle) [!J Construction o Decommission ORIGINAL INSTALLATION Notice CURRENT Notice of Intent No. WE03893 Unique Ecology WeD ID Tag No, AHR314 Water Right Permit No. Pr rty Own N MALAMUfE ASSOCIATES II (QS'7~F of Intent Number ope er ame Wen Street Address 42! FlISOO 41!Il. ~ JU..I m \lIEW PllOPOSED USE: III DumosIic o lDd8sIriaI o M1micipa1 City PORT TOWNSEND CoUilty JEFFERSON DDew_ o lniptiaa D TesI WcIl CI Other Locaticm N\\i/4-1l4 ~1l4 Sec~ TWD~ R..!.- EWM 0 c:ild TYPE OF WORK: Ownor's llUlDherofwe1l (if more tIwI 0118) .. . W\YN ill - IZI New well o RCllXIIIdilioDed ' McIIrDd: 8Du& D BoRlll D oma. LatILong (s. t, r Lat Deg Lat MinlSec o DoepcDccI CllbJc III R-,. D Jetted DIMENSIONS: Diamcterofwell~ inches,drillcd~ft. Still REQUIRED) Long Deg _ Long MinlSec DopIh ofcomplcted well 281 ft. CONSTllUCTION DETAILS Tax Parcel No. 974600004 CasiD& IlIwcIclcd L-- DiIm. ftom..2...--- I\. to 40 ft. 11IS1aIIed: ~ Liner insIIJ1cd L--- DiIm. ftom l!-I\. to 282 I\. CONSTRUcnON OR DECOMMISSION PROCEDURE n.n.lod - Diam. &om ft. to I\. 1Wfora1lo.... DYes IZlNo FlIDDIIIillll: Desc:ribc by color, __. siJz oflDlllaial8Dcl strucIIII'c, ..d the Jcind ad _ ofthc materi8I in lllIch IlnIIDID penoInIcd. wilb lit Jeost 0Dll ""by far C8ch chaDgc of 1)pc ofpcrfonltor UIcd inCunnalion. (USE ADDmONAL SHEETS IF NECESSARY:) SlZEof~ in.b): ia.lIIICIDO.of~ fiom 1\.10 ft. MATERIAL FROM TO ScnieIls: flI Yes DNo o K-Pac: ~OII TOP SOn. 0 1 ManufiIcturer's Name PVC Bk.OWN CLAY WITH ORA VEL 1 6 Type: PVC Model No. BASALT 6 8 0iam.4 INCH Slol size 01 0 Jinm 251 ft.to 261 ft. Oiam. Slol siJz Jinm ft.1D ft. BROWNCLA Y , ,8 21 GnnI/I1iItOr J*ked: UYesl2l No o Size of tp1IYCIIs1d Gk.EY CLAY AND GRAVEL 21 34 Materials placed fiom ft.to ft. BASALT 34 35 Sartoc:e Seal: IZJVes DNo TowbllldqlCh? 18+ I\. GkEYCLAY 35 S1 Malaiol used in seal BENTONITE l3ASALT S1 65 Did Il1I)' _ alIIIain imUSllble waltl'l Dves III No GkEYSILISTONE _0 65 c::5 (/} Type: ofwom'l DopIhof_ BASALT ;;;;~. 69 71 MclII,cidof scaIiDg sbala off GREY SILTSTONE (")-l 71 r 85 PUMP:' Manilfactum-'. Namc GREVCLAYWILESIONS OF SILTSTONE~0 851= 88 T)j>e: KP. BASALt ..... &8N 91 ~. WATER LEVELS: Land-swfiu:c e1CYl11ioo above_sea level ft. ~YSILTSTONE .~ 91 ~ 106 Salic level 178 ft. bcIowtopofwcll OllIe 07l2'JJOS I\ASAL T .....0 106,.,." 108 ArIesisn ~ Ibs. per &IjII.... inch Dote Gk.EYSILTSTONE '0'.- 108 (XI 135 ArIesisn _ is c:ontJoIlod by BASALT ~ to: r': I 135~ 137 1<8D_ v~ ctc-' o-k.EY SILTSTONE 1.. 137V1 182 WELL TESTS: Drawdown is llJIIOUI1t _ level is Jowmcd below sialic level Fk.AC11JRED BASALT 200 Was. JlUIIIIlIesI made? 0 Yes III No If yes. by whom? 182 Ymld: aa1lmio. with ft. drawdown after hrs, GREY SILTSTONE 200 1:10 Yield: aal./mio.with ft. drawdown after hrs, BROWN SHALE WIB 270 280 Yield: aaI.Imin. with fl. drawdown after Ius, :BROWN SHALB W/BASALT 80 282 &00""'" da/D (time taken olD...... when pump tumed oJ!) (waler level meolDuredfrom we/I top /0 water leveQ .... ~,.. -=' II "ie' h T"IIIIC WIIICI'Lcvcl Time Water Level Tim_ W8lerLcvcl - - - - .....--- - - - - 1111 C) 0 ?nn.. - - - - v....... _ v Datooftcst Bailer__pl./min, wilh I\. drawdowo afler _hrs. 1.lIl0GY Airtcst 1 25 pl.Imio. with stem set at 170 ft. for 1 hrs. WEll DRILLING UNII Artesi... flow R.P.m. OllIe TClIIJClIIIlIIrCofwmr_W..achcmical_)'Sismade? [JYes IlINo Start Oale 07120/05 Completed Dale 07 fl2J05 YJ:STA LeI :t1 Y WELL CONSTRUCTION CERTIFICA nON: I constructed and/or accept responsibility for constnJction of this well, and its compliance with all Washington well construction standards. Materials used and the information reported above are true to my best knowledge and belief. Jri>,,1lcr OEDginecr O,.raincc N~~./ DrilUDgCompany AQUA PUMPS DriIIerIEngin_trrainec SigDsturc , Ackhcss 6962 OLD OLYMPIC HWY Driller ortraincc Li....... No. 2252 City. SllIIe. Zip SEQUIM, W A 98382 rTlWNEE. DriIIor'. Uecascd No. Dri&r's Sipalllre ) =NCl AQUAP066LM DIIte 7-22.0.5 Ecology is 11II Equal Oppommity Employer, ECY 050-1-20 (Rev 3/05) The Deparbnent of Ecology does NOT warranty the Data and/or Information on this Well Report. [) ORIGINAL I I. ... ... o Ie. ~ - 'ii I~ :E ... 15 c o I~ ... J2 I; .c ... ... I~ c ca I~ cu I~ c ca It: ~ I- I~ cu o I~ = o I~ '0 lli E ... ... la ~ cu I~ I I SIuI CIIrd No. t.u 0 '13 () (; 0 UNIQUE WELL J.D. #I A i3 A .. '\~L WATER WELL REPORT File Origlnll.nd Flrtl Capy wlll1 Otpal'llMnlol &ology Second Capy - 0-,', COpy Third Copy - Drill... Capy (1) OWNER: HaIlll"FR At\! ~<. gC7N;Mt'tr (2) LOCAllON OF well: C4u1riJ'el~r: ~ /l3o N (2-.) 811IEET ADDRESS OFWELL(o,__8lllt8I&1 * STATE OF WASHINGTON w.w RllIIhl ...rmJt No. M:lr8II '1'1 ~~' ~J fl11'~f>fJ4i _pd.. E.ONOAlOS,4111f''':-?' . ..tJ!lL114~ 114Sec:-L T~N.JLilQWJ.l, /iF. (3) PROPOSED USE: Domeslie o ltrIg.tion o D.W'IiI' lndusl/illl 0 Teal WeD 0 (4) TYPE: OF WORK: Owne'" number of well ('I mor.\han on.) AbandllIlecI 0 New well ~. Melhod: Dug 0 Bored 0 Deepened Gable 0 DrivenD Recondllloned 0 ROI'ry P. JIlIlIld 0 (5) DIMENSIONS: Oilll1l8ler of well ~ ~a. DrtIeCl 113 Ieel. OIlpIh of complel8d well I 'J. " II. (6) CONSTRUCTION DETAILS: CUh\g Installed: G, ~1dllCl inslaIled!i;: if f 1:. " 1tQaded D" . Dlam, Irom tl'-t- [)lam. I,om '-::t DIII1l1. lrom 1\.10 11.10 11,10 7~~ . Perforallons: Vel rs No 0 . Type 01 perIo'a1Dr used .J=LRf'" D fie I Lt- SIZE 01 P.8r1oratiOna t/ ., In. by 1/'2_ In. If' 0 pertortllan& Irllm 10 "? ft. to I ~::f I\. periarll1iane !ram 1110 It. pertorallons frofIl II. ID It. Screens: Va. 0 No j8'. MllllulaclUrer's Name T,pe DIiIm- _ Sialaln DIam. Slclt .1Ze GrIVII pecked: V.. 0 Gr.vel pl.ceclltom Madel No. lt.1O 1l.1o trom Ircm No ~ Size 01 grevel II.ID su~...I: Yes ~ No 0 Towhatd9Plh? B 0 Matsrla' used in seal g GAl '"'t7) N I rz:;: DId any straI. conl8ln unusable VI.ler? v.s 0 No 0 Tl'P8 ol,w....? Depth of .lfala Method ol..aIing slrata 011 (7) PUMP: Manulllc1urer'l Nam, Type: H.P. (8) WATER LEVELS: l.""HurtaCe ,levallon , _ _ _____ I/IHI\ 1.1 Ie.., SWiC Iewl H! ".SI\. below iop 01 wall Al\elian pr.S!UIll lis per sqll8R1 inCh ArIe.lSn _. II c0ntr0lied by Dlte Ollle Icap. ........IIC.) (9) WELL TESTS: Ofawdown 15 Bmoum water ....el is bwerlel tI8Iow Sialic '-I , Was a p.lmp 18&1 mlllle? V~s 0 No 0 11 yes, by wham" 'YIeld: gal./ min. WIth 11. drawdawn ....r I1ra. Flecavery clala (lime Iaken 1I5 zero when pump lumed 1:)11) (water Ilvel m.asured Iram well top 10 werer IlMlII l1me Waler Level 11m1 Waler Level TIme WalIlr Lev.1 Date olteSl Baller 1881 _ gaJ./mln. lNiIh II. drawdown allar hrs. A1118S1 ..s- ga\.lmin. wilh Blem ..tal I ~ 0 II. far I m. Malian ftC)'N g.p.m. DaIs Temperlllu,. ol walt" _ Was a chemical a';!;,iS m.lls? Yes 0 No 0 EClO5G-I,20(2~3>..t ..... (! HkP' v 'Ar'JP4';X' 4IP,," Pfr-1. 73 tL Il. II. It. II, II. II. 0' Wo1k S1al1ed 'WeLL CONSTRUCTOR CERTlACAT10N: I cons.lruc1ed and/or accept respollSibilll)' lor construClion 01 this weB, and ~s compliance wilh all Washinglon we1l c;Qns1rucliOn s1ancSarlls, Malerials used and \he infonnalion reponed aboIIe are lrue ID my besl knowledge ami belief. NAME ~1Oi('Ml 'DPI~l.~ b>-/~ (PERSOIi. F~.OR~OM) i'M"E~NTI Address p08 16/ S~. ..;" f&.~ 1 f? lr?. (Signed) ...,/ ....J ~ License No. J Cf J J ,,!{A (WELL LlERI ' Con\r.lclOt'l ::~i~rnic 11<:.. {'31Nt'Date e-3a- (USE ADDITIONAL SHEETS IF NECESSARY) ,191:/ o