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Home My WebLink About021332021 Geotech Assessment ~ B \J~OLo-Y(o~(l 4t-1 )4"OY'lM.~...... V~l'V'N\1 <-l<.ulAkW- w~~ ~J-.'r(~ --- , BENDEI~ CONSULTING. llC Apri118, 2006 A,JJ'Jit'(1 Gr()lfll.lil1jffa SOlllliltll~ Mr. Scott Cassill 290 Smith Road Nordland, W A 98358-9530 . 630 6th Street Sou th Kirkland, WA 98033 425 828 7545 425 828 7548 fax wu1to.bendallc.com RE: AQUIFER RECHARGE REPORT, 2710 EAST MARROWSTONE ROAD PROPERTY, MARROWSTONE ISLAND, WASHINGTON Dear Scott: This letter presents the results of our critical aquifer recharge area evaluation of your property. This letter is intended to conform to the requirements of the Jefferson County Unified Development Code (UDC) paragraphs 3.6.5, Critical Aquifer Recharge Areas; and 3.6.10 Special Reports, paragraph (e) Aquifer Recharge Area Report. This analysis is required by Jefferson County due to the location of your property within a high risk Seawater Intrusion Protection Zone (SIPZ). The UDC requires an analysis ofthe well and groundwater system to evaluate the potential fur use of a well to cause adverse groundwater quality impacts. The overall intent of the code is to ensure that existing water rights are not impaired and that the use ofthe well is not detrimental to the public interest. The following conforms to the requirements of UDC paragraph 3.6.10 (e), and follows the organization of that section AQUIFER RECHARGE AREA REPORT 1. Response not required. 2. Aquifer Recharge Area Report I. Project Description The property is located on the east side of Marrow stone island, east of Mystery Bay (Figure 1). The property parcel number is 021332021. The only structure currently on the property is a mobile home; we understand that you plan to remove the mobile home and construct a two story home with approximate dimensions of62 by 65 feet. Figure 2 shows a map ofthe property and the proposed improvements. The home will be placed about 60 feet west of the top ofthe bluff The septic system and drain field will be located west of the home. The existing well is located in the northwest comer ofthe property; the proposed improvements lie outside of the 100- foot covenance for the well The site topography is slightly rolling, but generally level We estimate that the ground surface elevation ofthe site is about 60 to 65 feet: BENDER CONSULTING, LLe 0606-01 0:10606-0 I CassillIReportlCassilI Recharge Rpt.doc Letter to Mr. Scott Cassill April 18, 2006 Page 2 We understand that the well was drilled in 1968. A well log is not available. We understand that the pump was replaced about 6 years ago. At that time Mr. Cassill measured the total well depth to be 65 feet deep, and a depth to static groundwater level of about 61.5 feet. He noted that there was about 3 feet of an oxidized coating on the pump riser pipe below that level. The groundwater elevation is not known at this site, however, based on this information we assume that the groundwater table lies 3 to 4 feet above sea leve~ and the well is completed to about sea level. The yield and performance aspects ofthis well are not known, however you have stated that there has been a continuous supply from the well. You collected a water quality sample on March 15, 2006 and submitted the sample to Twiss Analytical, Inc. The laboratory report showed satisfactory results for coliform, 0.65 mg/l nitrate, and 91.1 mg/l chlorides. We understand that the site is not served by a public water system II. Hydrogeologic Evaluation A. Hydrogeologic Setting of the Aquifer Region. The site is located on Marrowstone Island, about midway along the east coast line. The island hydrogeology is sunnnarized in Water Supply Bulletin No. 59 (Ecology, 1994). Marrowstone Island is composed of glacial deposits from the Fraser Glaciation (predominately the V ashon Stade), which overlies older interglacial and glacial deposits, and bedrock. The glacial deposits are somewhat characteristic of northern Puget Sound Vashon-aged soils, where till overlies intenningled Vashon-aged glaciomarine drift and advance outwash. Till is generally considered as a unit that perches or confines groundwater. Glaciomarine drift is similar to till, in that it is a low- permeability confining or perching unit but has clay rather than silt in the matrix. Glaciomarine drift is a more recent soil classification; in our opinion, this unit may be in part referred to as "Vashon advance outwash sand and clay" in the Ecology report. Figure 3 presents a cross section from the Ecology report; the section is located just south ofthe Cassill property. This section indicates that the site is irmnediately underlain by till. The till is underlain by a thick sequence of V ashon advance outwash that extends below sea level. At depth, outwash is then underlain by bedrock. Based on the elevation of the site and the depth ofthe well; the well is completed in the advance outwash unit. The principle aquifer on Marrowstone Island is the Vashon advance outwash aquifer, which is also referred to as the sea level aq~ifer. The outwash underlies the till. This aquifer is the main source of drinking water for the majority of the island residents. Advance outwash is a common aquifer found throughout the Puget lowland. This unit was deposited in front of the advancing ice sheet and is RENDER CONSULTING, LLC 0606-01 D:I0606-01 CassillIReportlCassiU Recharge Rpt.doc Letter to Mr. Scott Cassill April 18, 2006 Page 3 composed of clean to silty sand, with periodic sih layers or lenses. Permeabilities in advance outwash can range from lxl0-3 to lxlO-1 cmIs. - The bedrock underlying Marrowstone Island is primarily comprised ofthree tertiary-age formations, the Scow Bay formation, the Quimper Sandstone, and the Marrowstone formation The Quimper Sandstone underlies the project site (Figure 3). Bedrock was not penetrated by the wells in the study area. Sea water intrusion has occurred on the island in areas where groundwater has been over-pumped. Jefferson County has recognized salt-water intrusion as a potential threat to maintaining drinking water quality and has developed ordinances with respect to salt-water intrusion. Two wells within 1,000 feet of the site are identified as high risk on the Jefferson County SIPZ map. B. Site location, topography, drainage, and surface water bodies. The Cassill property is located on Marrowstone Island, which is a sub-basin ofWIRA 17. Figure 1 shows the general location ofthe property and surrounding topography. The property is located in the east half ofthe northwest comer of Section 33, Township 30 North, Range 1 East. High bluffS 30 to 80 feet high are connnon along the shoreline. The upland topography is generally rolling. There are no surface water drainages in the vicinity ofthe site. The site elevation is roughly 60 feet. C. Soils and Geologic Units Underlying the Site. The surficial soil tyPe on the Cassill property is the Whidbey soil series. The Whidbey C series is a gravelly, sandy loam. Whidbey soils are moderately well to somewhat excessively drained soils on 0 to 15 percent slopes. The soils are products of ablation glacial till over strongly compacted and weakly cemented basal till (SCS, 1975). Test pits were excavated by others at the site for the purposes of the septic system design. The soil types observed in the pits were consistent with the Whidbey series. We understand that there was 5 to 6 feet of Whidbey soils overlying till. Soils underlying the site are well exposed along the bluff on the east side ofthe property. Based on our review of the bluff from the beach, it appears that there is about 20 feet of till underlying the site. Till consists of silty gravely sand, and typically exlnbits low permeability. The till is underlain by Vashon advance outwash. The outwash was slightly sihy to clean sand with trace gravel The writ is well cross bedded. The outwash was exposed to the level ofthe beach, and exists below sea level Where below the water table, the writ is typically a productive aquifer, though there are fine-grained portions ofthe aquifer that may limit its yield. BENDER CONSULTING, LLC 0606-0 J 0:10606-0 I CassilllReportlCassill Recharge Rpt.doc Letter to Mr. Scott Cassill April 18, 2006 Page 4 The island geology is well sunnnarized in Ecology's 1994 report. D. Groundwater Flow and Water Quality Characteristics Based on the geologic reports and the well logs included with this letter, groundwater is typically encountered between elevation 0 and 5 feet in wells constructed near the property. GrOlmdwaterrecharge predominantly occurs on the upland areas west of the property. Groundwater is unconfined in the advance outwash aquifer. The groundwater flow direction in the sea level aquifer likely mimics the land surface topography (i.e. flows from inland areas radially to the shoreline). You collected a water quality sample from your well on March 15, 2006. The chloride concentration from that sample was 91.1 mgII.. This level is below what is classified as an 'at risk' zone in UDC Section 3.6.5. Water quality data for the wells in the vicinity of the site were collected from well log data, Jefferson County PUD 2003 measurement data, and the permit infonnation on the Jefferson County web site. According to these data, the Cassill property is located just within 1,000 feet of wells that have previously measured chloride levels in excess of200 mgII.. Both wells that have high risk classifications are located to the south of the Cassill property. These wells are also near a series of wells that contain very high chloride concentrations. Figure 1 shows the locations of the properties with available water quality data (note that these only include the wells that could be accurately located). The wells in the vicinity of the site have chloride concentrations typically less than 100 mg/I, with one well at 120 mgIl. The available data suggest that the area as a whole has elevated groundwater chloride concentrations. This may be in part due to the fact that this is one of the narrowest portions of the island, and therefore has a smaller area to collect groundwater recharge. It appears that some of the wells with the higher chloride concentrations are completed either in lower permeability soils (Well 7 in cemented gravel), or are completed a greater depths below the water table. Over-pumping of either of these well types has the tendency to increase the potential for salt -water intrusion. Though the variations in the well construction details are not great compared to other wells in the area, they may be significant in an area such as this with a thinner fresh water lense. E. Location and Description of Existing Wells and Springs within 1,000 feet of the Site Logs from the surrounding wells that could be located within 1,000 feet are attached. The logs were obtained from the Department of Ecology's web site. The approximate well locations are shown in Figure 1. The logs have been assigned a location number corresponding with the figure. Wells 14 and 22 are identified as High Risk wells on the Jefferson County SIPZ Map. The wells shown in Figure 1 are all completed in Vashon advance outwash soils. Most of the logs are completed in sand and grave~ a few ofthe wells are completed in cemented or fine-grained sands which .- BENDER CONSULTING, LLe 0606-0 J D:\0606-01 CassillIReport\Cassill Recharge Rpt.doc Letter to Mr. Scott Cassill April 18, 2006 Page 5 - -, ','f have a lower permeability and a greater potential to induce salt-water intrusion when pumped at higher rates. Based on the bluff exposures opposite the Cassill property, the Cassill well is likely completed in a clean to slightly silty sand and gravel There are no documented springs within 1,000 feet of the Cassill property. F. Local and Regional Groundwater Recharge Precipitation is the only source of recharge to the sea level aquifer. A large percentage ofthe precipitation that falls on the island is lost through evapotranspiration processes or runoff In areas where the advance outwash aquifer is exposed, such as in the northern end of the island, aquifer recharge may be rapid and may account for a large percentage of recharge to the aquifer. In locations where till and glaciomarine soils are present, recharge rates will be lower. According to the Jefferson County web site, the site receives between about 17.5 to 22.5 inches of precipitation per year. As discussed in paragraph C above, the soils on your property are moderately- to well-drained and should infiltrate most precipitation events. Groundwater recharge maps provided by Jefferson County indicate that the site may receive 5 to 10 inches of recharge per year. G. Evaluation of Potential Project Impact on Groundwater Recharge It is our opinion that the Cassill home will not significantly change the groundwater recharge potential of the property. The proposed footprint ofthe home is relatively small, and no other impervious surfaces are proposed. Given the UDC's storm water infihration requirements, runoff created by development on the property will be reintroduced to the subsurface. At this site, the low permeability soils beneath the pervious surficial soils will be the limiting factor to aquifer recharge. It is our opinion that residential groundwater use ofthe well on the site will have a minimal impact on the groundwater resource and given careful use, will not significantly increase the potential for sea water intrusion We provide the following rationale for our opinion: 1) The site well is located in a pervious aquifer where groundwater will readily flow to a well without requiring excessive drawdown in the well 2) The well is completed to an elevation at or just below sea level Saltwater intrusion occurs in areas where groundwater is pulled down below sea leveL typically for extended periods of time. The well construction will not allow excessive drawdown in the aquifer. 3) The site has had aD active well since 1968 and an active drain field since 1977. It is our understanding that the well perfonnance and quality has not changed over that period. The ,- RENDER CONSULTING, LLC 0606-0 J D:\0606-OI CassillIRcport\Cassill Recharge Rptdoc '} ~J Letter to Mr. Scott Cassill April 18, 2006 Page 6 site has therefore experienced groWldwater withdrawals for an extended period oftime, and an equilibrium likely exists between the aquifer and the saltwater interface. Since the home size will be greater than the existing mobile home, it is reasonable to assume that there will be an increase in water use. Given the proper water-saving utilities required by the CoWlty, and only spot irrigation, normal domestic use should not significantly move the location ofthe saltwater interface. 4) Given the maximum 400 gallons per day yield by the COWlty for wells on the island, the recharge on the site will be greater than the pumping withdrawal. A 400 gallon per day use would equal 146, 000 gallons per year. As discussed above, the estimated island recharge rate is between 5 to 10 inches per year. Given a property size of 450 by 110 feet, the annual recharge for the property is between 154,000 and 308,000 gallons per year. As such, the recharge potential for the property is greater than the maximum water use for the site. Based on the completion depth of the Cassill well and the proposed water use, it is our opinion that the risk of adversely affecting a neighboring well is also minimal. It is our opinion that if your property is developed with the UOC's water conservation reconnnendations, and the well is operated in accordance with the UDC's special requirements for Marrowstone Island, the risk of seawater intrusion is low. I. Contaminant Transport Analysis Since this site is used for residential purposes, a contaminant transport analysis may not be applicable. The land use activity is not considered a high impact land use as defined in UDC 3.6.5{ 4).c. In addition, because the water-bearing zone lies beneath about a 20 foot or greater thickness oflow permeability till soils, the potential for a contaminant spill to reach the water-bearing zone is likely small. Contaminants would likely be retarded in the low-permeability soils or travel as shallow subsurface flow toward the sOWld before entering the groundwater system. II. Spill Response Training Not applicable for a residential site with no known use of chemicals. III. Best Management Practices. UDC 3.6.5 d (2) ii requires infiltration of all storm water for new development on Marrowstone Island. We Wlderstand that storm water on your property will be collected and infiltrated on site. We recormnend that you agree and adhere to both the volWltary and involWltary BMP's as prescnbed in the UDC for Marrowstone Island (UDC 3.6.5 d (9) iv D). BENDER CONSULTING, LLC 0606-01 D:\0606-01 CassillIReportlCassill Recharge Rpt.doc ! '5 Letter to Mr. Scott Cassill April 18, 2006 Page 7 IV. Monitoring Program We reconnnend that you adhere to monitoring program as prescribed in the UDC for Marrowstone Island. 3. Qualifications REGISTRATIONS Registered Professional Engineering Geologist: Washington (874) Registered Professional Hydrogeologist: Washington (874) Registered Professional Geologist: Washington (874) Registered Professional Geologist: Oregon (G1642) Certified Groundwater Professional: NGWA (518) CORPORATE SUMMARY Bender Consulting, LLC is a consultancy in groundwater science and engineering - specializing in water rights support, dispute resolution related to hydrogeology, and construction dewatering design services. We support the legal, environmental, engineering, and construction industries. A unique hydrogeologic consulting firm in the Northwest that specializes in these fields; we offer the proven ability to develop innovative yet sensible groundwater solutions that satisfY project performance, design criteria, and schedule. Our goal is to reduce risk for our clients engaged in design and construction, and to provide a sound, technical, and defendable understanding ofthe groundwater regime to our legal and engineering clientele. Scott Bender is the Principal ofthe firm with 22 years of applied experience in groundwater control, water supply, and water rights. His work is innovative and award winning. He conceptualized one ofthe first mitigated water rights since the 1996 batch denial by Ecology; this set a precedent for the current state of the practice in water right mitigation. He has won ASCE Engineering Excellence Awards for his groundwater control system designs for projects at the U.S. Embassy site in Bogota, Columbia and at the Boston Central Artery in Boston, Massachusetts. RENDER CONSUL TlNG, LLC 0606-01 D:I0606'{)1 CassiUIReportlCassill Recharge Rpt.doc Letter to Mr. Scott Cassill April 18, 2006 Page 8 Thank you again for the opportwrity to be of service, please call us at (425) 828-7545 if you have any qu~tIDm. - Scott F. Bender L.H.G., C.G.W.P. Enclosur~: Figure 1. Site Location Map and Water Quality Data Figure 2. Detailed Site Plan, Cassill Property Figure 3. Area Hydrogeology Well Logs (7) References: Jefferson County Unified Development Code: Paragraphs 3.6.5 and 3.6.10. Washington Department of Ecology, 1994. Geology, Water Resources, and Seawater Intrusion Assessment of Marrows tone Island, Jefferson County, Washington BENDER CONSULTING, LLC 0606-0 J D:I0606-01 CassilllReportlCassill Recharge Rpl.doc ~ "'""" ~. """" en c:: ~ = > ~ = '-lIjj. 0 ~,,_. ,-..-. ...,.....~-., =~\~ ! I , j f , " REN[)ER ('()r--..;\tjl rIN(~. I t,e .. . i ~,-.! ' '" ,. " ,', .' .." ,i " " "",,,,,-.\ J _~ ~-.lo _ _ ~/_~ 4! ' .,.~, . .:'....~' _ 1___ ",0,,', ' ~...," "" ~ ~ /'. "-, ", '\ ~\ ' ,~ . 'J;\ t , ' I ~ i,; ;, ill!, ,.- L \; '\. Jr"'/~ ,j\)~; Z. ~.., ~ J;l :;11" -, 1 l"'" I . \ i \ 1 it~'\. i',.'~ (' ,11"" , . .. '. r ii ,I: i. !\ "~j 1ft \., iini .:' lio \I'... It( l\' ,. ~:.,z.." / . \ I ! \ l.'. ~--60, ... 'Ii;." ( ,.~\' /l\\r.; -" ! j ,,-;, '. \ 2 9 -.,.'..... .. \ '. . \'. '11. .....~...I' '\. \. -"" ... ~ \'. "'.", I ~ '-. ~,..,.,'>.:;;~f\\..... () A -\.. ,>~;:~ .,\ l I ~ '. \',y!. \\ . \ \\\~\"I. J \ \,~} ~!, i i~:~ It' a . ' l' , I, \ .." -*tC . i : I, ..I ~!. ......... 'i \ I ." , , , \ \ \ j i t Cassill Property Aquifer Recharge Report Nordland, Washington Project Number 0606-0 I Site Location Map and Chloride Data Figure 1 .. ., ~ ~ '" I ~ ~ "" ~ .. () ~ ~ r ; I, M) ) : - '0 ; I ~ ~+I- ._. - " ~ ~--'~._~ "__. t- - . _____ _-.. \. - - ~ . ~ - . - -- - /----- - - '-'~ -- - ~- - - - - t .M t - I , I _ .-.L __ '~-tl---~- ,,:1 J .~ i. I t - "; -~ tl. ~ '" : I '~J I ~ -~#. 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I , I ,~ 1 ~ 'pu lU!Od S 41!1l1J~ t>! co (;,II.s.>:io ~""""'T''''~'''''-''''''''''''':'''''''''''''''''''' ,~ 8 i 0 $ 8 fa ... .- f . TI E e 1-'0 Q) .0 .lIl: o O"e 1-"0 Q) .0 (Jaal U!) NOll V ^313 >. bl) o - o CI) bl) o l-i '"0 >. ::r: aj CI) l-i <r: 1:: o 0..= ;>.C1)O 1::~~ C1) C1)._ 0.. Of) ~ o I-< ~ I-< tU ~ ,:l....c::;;> _ 0 ~ - C1)"o 'c;j ~ ; ~ I-<:a U~... ._ 0 ::sZ 0" ~ cr:. \... 3 l-W .~ J O~ Z; ~ u..J z c -,... ~- C::C~~ " ~.-.-:-- -- .-- '-r- ~~t F . r~ . FUll Original ;mil F1~t Copy with Department of Ecology Sclcond Copy - Owner's CoP,. Thti'd Copy - Drine\";s CoP:." STATE OF WASBINGTON- Permit No. .... .___._____.._.._.__.___ ~ (1) OWNER: Name..t2-b::t1.?tA..----~4y..3.-.--.-----.-.--..-- Address..2-J.?.a._2.4-SZ:-~~~...... (2) LOCATION OF WELL: County.....:t.t!:._E~ ________.._..____~_..- ~W.'-Z'd-\~ Sec..3..3._ r..30..N.. R~W.M. ~.-...;... ~ .~ ') J. .~ Bearlnc and d1stancll trom section or subdivision corner 3 (3) PROPOSED USE: .. . Domatic ~ IndusU1aJ 0 Irr~attoll 0 Test Wen 0 1llflIn1&:1paJ 0 other Cl , ('1) TYPE OF WORK: Ownel"s number of well : (if mDre Ulan one).. .. ..._.........__._..._.__ ::; New _11 -8l. Method: Out Cl Bored 0 . Deepenec1 0 Cable 11- Drtvaa 0 ) Reconditioned Cl Rotluy 0 .Jetted Cl ; (5) nmIENSIONS: Diameter of wen .__-'.._.__.. Inches. ::; DrUled___.~7_.____!t. Depth of completed weu._~__...ft. 1 . (6) CONSTRUCTION DETAILS: ,So 5'.@~d ) Casing iDsta11ed: .....4>;:;:::_.. Dtam. b'oD1 L~~ (to to _.s::.L ft. : Tluear1ec1 0 .-.5.--" Dtam~ tram .~~_ !t. to ~-,... A. Welded ~ __.._" Dtam. frmn ____ ft. to __ iL , Perforations: ~ l 4 3 ) J :; Yes 0 NoJ<t Type of. pertorator used___.._________ SIZE of lle:1ontions ______.. In. by _____._.._.._ In. __._._ per!orattons !ram ___ ft. to ___.. ft. _____ perforations fron\ .__. ft. to ___'_ ft. -.-:.._ pu1orations fr'llID ___ IL to _ ft. '" .. Screens: Yes ~ Ko CJ ""_ I.. . _ " Manutactun:r a Name~_+T~:5:.q_ . ~_.2- W.~--- lIodal No_. DImn.q2._ Slot size !l..a_~ tram ~;l::' ft. to ..5"".-2- ft. Dlam. __._. Slot su. ~__ from __ ft.to ___ ft. Gravel packed: Yu Cl No}iJ- Size of gravel: _____..: Gravel placed trom _._.__ It. to _________ 1t: Surface seal: Yes~ :fo Cl To what depth? -I~_ ft. . ~terW used ni ~eaL__._________ :lId allY matll contaJn unusable water? Yes 0 No 0 Tnle of WIIter7_________ Depth of strab Me1hod of sealing strata o~.....--'--__ (7) PUMP: Manufacturer's Name.-.._._____.__ T:n>e: _'_.... . .lLP ....:...-.__._ (8) WATER. LEVELS: (9) WELL' TESTS: Drawdo",", Is amount wllter level is lowered below static level No 0 U yes, by whom?..__.:............___.. ft. drawdown alter MS. . W..s a pump test made? Yes 0 ) YJeld: gal./min. with ~- -IFo-Zl ~'I'f' AppllcaUon No. ......__.._......._....__. (10) WELL LOG: "ormation: De~cTlbe bv color. choraclu. Nil! 01 malarial a1Id JtruGun. alld ~hOlD Ihie1CJleu of aqui/cn an4 the Jc1'1l1 alld l>Gture of the malerial in each Jt1'otum Jl<<7Miroted. tDith at least one ~Uv for eaeh C:ha7lQ. of I_don. XATZmAL 1'-1 TO 7O;P SOL i:' ' C I '3 R~()t~.IIO t7...At€A1T"'''',..t ~AN~ .3 ! ~-G-1e.~I":t (/-I'AAd) . i 17 I -. - ..! .. W~k .tarte'" 3 -2~'" .1e.2c.'l, ComplelecL~ .7...:-:::_.._19,:;!c WELL DRILLER'S STATEMENT: This well wall drilled under my jurisdiction and this report is true to the best at my knowledge and bell~f. l l. R~ov.ry d.l~ (tJme tak.n aa zero when pump turDed 01l') (water level J measured from well top to water level) ; Time Willer Ll1lel I Time WaIn- Lr1lel I TIme WaleT Lnlel : ::::::~==::: :::==::=:::~:::::~ :~=~:::=:::: ::~~:::==~=:=:: ~:=::::::== =====:::=:::: Date of rt=t .---..-..............--..~_.---- ll..l. Baller test.J. __.__gal.Jmin. wit.h___o.._._-ft. drawdown att.er_~"'<:"'...hn. Artesian lIo _..__..__~.p.m. Date.___.___.__.____ TC!mperature of.water__.... Was ac:hemJclll analy3!s made? Yes 0 N~ J(L~ J,,1-e.T (USE ADDlTIONAL SBDTa II' N!:OSSARY) et"'''' t'UU\..t-"" _ NAMEm;?rP(~___.[j)Rf.?l~~._...4A_~....I.LlJ/..l............. (Person. arm. or corponatlod;7 (Type or print) ~Ul~-,l.VA-' Address...-..~~.WA.-.......-_-...--_..........-.-.....-...-.... [Signed]......._.._._____.____....................(~ttM_Cte:.._~~ (Wall Driller) . License Noa..~~~._................. Date...(:l~...1:::___....... 19~- B~~ .w s- o a.; cu J:: o 2: <n cu o 'C ~ en (8) .2 o (,) '..u .... o oW c: GJ E oW J.. (U ~ cu a cu .c ~ FlleOrlglllllland FlrstCopv wllh Depertment of EClllogy .;econd copy - Owner's copy ThIrd Copy - DrIller's Copy ./ S~rtCardNo. e)cc; -)~09 UNIQue WELL I.D. ill4CI1 J l S" (1) OWNER: Name STATE OF WASHINGTON \Vater Right Permit No. (2) LOCAllON Of WELL: Counly (2a) S'mEET ADDRESS OF WELL '(Of nelleSl adItess) Domestic o Irtlgatlon o DeWlIfar InduSlJ10ll 0 _ _ ~ ~unlc.l~ 0 Test WeU O. .:.' other 0 "... . - - <U (3) PROPOSED USE: ~ <n ,- .c .. c o c o ~ CU E J.. o ... c - GJ .c oW J.. o - 'C C CU CU -. cu a GJ .c oW ~ oW C cu s- s- cu 3: (4) TYPE OF WORK: Owner's number of well (II male than one) Absndaned 0 Nsw well dY"" Method: Dug V Bared 0 Deepened 0 Cable Driven 0 RecondiliDned 0 Rotary 0 Jelled 0 (5) DIMENSIONS: Dil\ll1llt8r 0' WIlli indies. Dnlled b F feel. DspCh of compI8l8d well It. (8) CONSTRUCTION DET.AILS: casing Insta~ b . DIam.from 0 It. to b 0 =ralled 0 - <;' . Dl&m. rrom_fLLlt. to 6 ,.Y Threaded 0 . DIam. from It. to No [B-'"" PlIrforatlons: Yes 0 Type 01 perf\lraIor used SIZE of perfOrBIlDns perforatlanl from pe!foratlons from perforBlicns lram Screens: Yes No 0 } Manu~l's~ -~ -!tJl!S(V1 Typo ~(\' . Dtam. 6- Slot sizB / )J /rom {. 0 Dlam. SIol slzB /rom Gravel packed: Yes D' No Size 01 gr_1 Gravel placed from It. 10 "..1 ~ /lID -.. L- It.lo SUrflCB seal: Yes MallHial used in sBal Did any sITata contain unusable water? Type of walar? Meltllld at sealing sIrBIa off (7) PUMP: MlIIIUfac:turer's Name Type: I-lP. WATER LEVEL~: l.anr.1-surlace elevation . . ("- q .., abcMl mean sea level SlIIIic IlIVel ..) I ~, below top 01 well Mesian.p=s\lnl lbe. per squire inch Adesian water is COIlIlIllled by Date Dale (cap, "a.... elC.) (9) WELL TESTS: . Drawdown Is amount~ yells Ia_ed bebN stalic 1aw1 WBsapumpteslmade? 'fesO No~ llyes,b\lwIl0lTl7 , YlllId: galJinln. with h. drawdown a~er RecovIllY data (~me laken OLS zsro when pump turned oll(wa/sr IewIJ measured from_a lop 10 water IeveQ Tams Water level Tame Water L_I lime Watsr IAwI Dal8 ~ lesl Bailer lest gal.Jmin, with All\est gal.imin. IllIilh stem set at Artesian !low g.p.m. Date Tsmperalurs of walsr _ Was a chemical analysis mqde? o tL drawdown aftOf tt.for L:. Yes 0 No~ ECV Q50.l-20 (9100) .., (10) WELL LOG or ABANDONMENT PROCEDURE DESCRIPTION Fcnnallnn: DS!lCribe by color. cmraClllr. aIze of ma18rlaJ and s1ruc1ulB, and show Ihlcknesa c1l1Qufers IInd tie Idnd ancl nalure of the material in etlch st"'llnII penlllra\P.d. wit1 ~I """" aM sntry rar .""h ~~~~~. , It. It. ft. In. Il II. Il fl. ft. ft. It. Weill< Started 19. COrII1lf8ted 19W WELL CONSTRUCTOR CERTIFICATION: 1115. NAME Address (Signed) Conlractor's Reolsl~1Io~ . I,..., , r ~ 7 No. rne.. ;'(.///'-'>10/010_ Dale' 11 (USE ADDITIONAL SHEETS IF NECESSARY) CD"" ,19 10 hrs. hr9. Ecology is an Equal Opportunity and Affirmative Action employer. For spa- clalaccommcdation needs, contact me Water Resources Program at (206) 407-6600. The TOO number is (206) 407-6006. ~ . Ii 6ilO Original and Finl Copy vrilh Department 01 Ecology Second Copy-o..nar's Copy Third CO~-DrMlar', Copy start Card He. C>~ Sa.l $-b l..', REPORT , ..... 10.. o Q. ~ :x: (1) STATE OF WASHINGTON ,'\:, OWNER: Nallle J11,'J(a.. ~ AI tL~y LOCATlON OF WELL: County :I;E. FFF~ (pl,/ :2.!?t 0 (2) (2a) STREET ADDDRESS OF WELL (or naara,1 IIddrnsl - "a:i ., :::. "J) (3) PROPOSED USE: 2' D~e~tic o Irrigation o DeWaler Induslriel . 0 Test Well 0 Mtmiclpal 0 Other 0 (4) TVPE OF WORK' Ownar',nuDIOllrolwllll , (il mora Ihan ona) AbandonlJd = New well ~ Melhod: Deepened 0" Reconditioned 0 Bored 0 Driven 0 Jelted 0 - - ... Dug ...... Cable Jt. Rolary'O- c o c: o '; ~ E 10.. o 40- - :: (5) DIMENS10NS: Dlameler 01 well ~ inches. Drilled 3'> leel. Depth 01 completed well .,g ~ It. (6) CONSTRUCTION DETAILS: CaSng Inslalled: b Clam. from "'t' .2.- Wellflld Or ~ Diam. from 2 t:?-' i.uler 11Islallell'C Ttnacled 0 . Dillm. Irom Perl orations: Va, LJ No Typ a of parforalor usad /t.to rt.lo---:t!-ft. ft. to ~~ It. <U ~ :. 10.. o ~ c ~ ~ ... ~ ::) C1I .: ... SIZE 01 partoralicns in. by partoralloRS Irom perforations Irom 1l.10 ".'0 n.lo Screens: Va No Manufac:urar,Name S MrTi'f- Type ~ ~& Oiam ~ Slot liuO/S- from Moda' No :?-?- ".lo.3~ fl. I" ~ ... = ~ - ~ ::- ;:a. Oiem Grave' packed: Vaa Itof!' Sica of gravel tL 10 Graftl plaead Iro", If(' ~ Surlace seal: y.,~ Malariat "Slid in seal Did any ~rat. cOlllain unusabla waler? Yes 0 NoD To wnat c1apth? NaD n.pth 01.__ :> 2: J) ~ j ~ >" 0) o o (.) ,lJ T Ylla 0/ ....a..r1 lotalllad af sealing slrat a all (7) PUMP: Manulaclurer', Hama (8) TYlle: H.P WATER LEVELS: ~:e~''::~:~-ra~n It Slaticlavel ~I 1I.balowtopalwen Oate I-'2..Y-~2.-- ,\tIasien areasure Ib". p.r aquare inch Oala ...nes,an ",allr ,,, eontroned by (Cap. ...... "cJ' i- .j (9) WELL TESTS: Orawdown I, amaunl watar levOI islowared below stallc leval Wu a pump 'e.t mada? Ve.O No)8l 1/ yes, by who",? Viald: galJmln. With fl. dr..,down eller hra. -- - ~ - - ... ... ~ Q. C1I :) <U - - FlacoYlry oal. (lime takan as zero when pumplurnad 011) (water level me."uraa lram well lOp :0 "'a'8r 'a.el) i1Int. Wtler LWII Tilll. W.t.r LlVel n..... W...r Level 0.1. 01 losl Bailarle.l ~ gaUml.. wilh .. ~ fl. drawdawn .fter I Alnesl 081.1 mi.. with ,Iem '01 al It. for Alleslen !Io'" g.p.m. Dale Temparalure olw.'.r _ Was a che""cal analys.. made? YesU ~ ECv OSQ.I.:lO (10!81) .1J2~. ooGlr- 3 Water Right Permit No. AdrJre,,~lJ ~~"'~~~~ }JfIJ"~15I ~ !::' '~"L).!:4)_ll. Se" ~ ~. RLLw.'M. '" e ~.AI~IV(; I<&. (10) WELL LOG or ABANDONMENT PROCEDURE DESCRIPTION Formation: Dascrlbe by corar. Character. slu ot mlteri" and strudure. and sllaw thickness of lqui/.ra uc:llhe kind allcl nature 01 the ,.Itllflal ill eltCh atr&turn penatrated. wilh at 1000,t one "ry lor ellCh ch_lle o.lnlorm.aliaA. 1oI"T!RIAL FROII TO It. In. ft. Il. It. ft. ft. !to :t.. Wor. started ,'9~ WELL CONSTRUCTOR CERTIFICATION: I construcled and/or accept resllonsibiily for construction of this well. and its camp Rance with all Washing Ion well construction standards. Materials used and the in.armstlon reported above ore true 10 my best knowledgeeRd baief. . NAME ~{ qnJ .~R,L4-~ (PERSON. FIRM. OR COflPORA11ON1 .. (111, ~ Ai ~ lTYPE OR PRINT) Address LIcense No ttA- (!lu"leP e hrs. hIS. (Slg.!lj{. Conlractor'g Regi~liOn No. n7C - (k:./57Af11'- Date . 19.!L2- /-).. ? - (USE ADDITIONA~ SHEETS IF NECESSARP'-'"'\ l~ ~V n';Orl...~.... "....COpy _n. ~~--- - --------.._.. -- - -- --- - ----- Pep:lt'tment oC Ecolocy wATER W'F.'.T. REP6RT Applicatlon No. _....._...........__...... Second Cnpy - Ownv's Cow 'n'Jrd Co~y - PrlJ1er's Copy STATE OF WASBINGTON Permit No. .... "". ............_.............. (1) OWNER: Name_1Ull...Be!ldicksen...._........_......_.__._.._______.._. Adclress...226a...Eaat.-P.lattlJllL.s.tcna....Nordlaru:l....JJJa......98.3~:S.._.._. (2) LOCATION OF WELL: COUrlIY.....Jeff.eJ:S.ocl..___.._______.._____._- ._N...E_\~ .s.JIL.,~ See.-.3.3...... T..3(L.N~ R.LE._.W.M. Bea~lng and distance from section or !<Ubdivlsion corner ... .... o :2. .]) 1'.: - (3) PROPOSED USE: ii ., ~ n Domestic ~ IndUstrial 0 Irrtgal10n 0 Test WeU 0 M1ID1~Jlal [J Other 0 - ::: (4) TYPE OF WORK: ?l.i~:;; ~~~~~~.~:I~.._..._....___.__.._._ New well ~ MeU\ol1: Due 0 Bored 0 Deepened [J Cablo JB Driven 0 RecoudSUoned 0 R0ta:7 0 JetQd 0 - o c (5) DIMENSIONS: o Drilled-S9..'Jl~........._ft. W ~ - - o I- Diameter of well ...-.-__fi..__. 1nc:hcs. Depth ot completed wclL60.!.~~ - - (6) CONSTRUCTION DETAILS: Casing mstalled: __6.......... .Dlam. from _.U._.. ~. to Sl.!a~_ ft. Thn!!JIded 0 ...._~.._..." Dlam. tram .42ill~J it. to e~~ tt. Welded 0 ..--..-." Dlarn. !tom ____ tt. to __ it. (U - ::l .... o a = :'U tU ... tU :) (1) ,.. w Perforations: Yes 0 No ~ Type of perforator used.-.._.___..__._.._.___.____..____ SIZE at pe:1ontlons '--'_'_,__, in. by ________.___ In. -"'--'-" perforations from -__.____.. tt. to ____._. tt. -......-..-. perforatlons from -____. n. to ____ ft. ---.....-.. peUllI'AtlolU fnlm _____._ ft. to ___..... ft. Screens: Yeli)!t No 0 ManUfaetunr's Name.__~Son 'l'ne_____St.aiDlass Model No_.____ Dlam. --~_ Slot size ...!.~~L tram ~,~..'.~..'.'... ft. to ~.:r.a~ ft. DLam. '-.--- Stot size '''___. tnml ..___ ft. to ___ 1t. ~ ;.I C ~ .... .... c"a ;:;,0 :> Gravel packed: Yes 0 No.!t Size of gravel: ____ Gr..vel placed lrDm ----...._._...... ft. 'to _._..-:....._._.._ tt. Surface seal: Yes ~ No 0 To what depth? _..1.11__ It. Matenal used in seal...-.Cemeot-L8entoaite_._._____ Dtd my strata oontain unusable water? YlI!lI 0 No 18 ~ at water7__.__..__ Depth of strata_..____ Method of sealing strata olf__...._._._._._____ J 2 'n ~ (7) PUMP:. Ma~utacturl!r's Nllm....____.___________ ~ ' . 'T;-p~:' ,., .,-.., . .' ".. '-. .-.. . . H.P ..:.. ~(8) WA1'Elt LEVELS' Land-surf2ce el~t1on' ~s- . C) . 'I . abo.... mean sea ll!Vu.... -;;;1'--1'- o Sbtlc level -S.1.....:2..___ft. below top of well Date_L/.J.!t~.._ 3 Art<!Slan pressure ---.--~.-....1bs_ pn- square inch Date.____.__ .~ Arteslan water is coDtroUed by.___._____....__.____.._ .u tCap. valve. etc.> o (9) WELL TESTS: Drawdown Is amount water level Is lowered below statlc lev..l ;: Was a pump test made? Yes 0 No 0 U yes. by whom?..__._......_...._._.... ii YIeld: ,al./min. with !to drawdown afler , hrs. ... - .... ... .. (U QJleeovery d:lla (time taken as ZCTO when pump twned olf) (wllter level Q) measured f::oorn well top to water leVel} :::::l Tim~ Water LweI l Tim.. Water Level Time Wat.... Letlel ~:~:::::::=: :~:=:=:=:~~:::::r=::::::::::: :::::::=:===:::::. .:::::::::==: ::::~::====:~=:= ,- ..n..;~.;~..~;..-.n...~~=.'2liilJ..b.~..=~=~=......--- -............. ........................ Baller ttst....::6......_g31./mln. wllh__.c2.._.__.n. drawdown at1er_..A__.....hrs. Artesian llow______....__g.P.m. DIIII:......_...___________ Temperature o( waler_.... Wa.s II c:ltemical analysis made? Yes 0 No Qi' (10) WELL LOG: FDft1latlon: Dac'l"ibe b1l color, diameter, ~c of mateTlGt and stnu:tu1'e. and shoUI tllielcnes. of aqullerJ: Chad the lcind ancl N2tu,... 01 the matm(lf In each stnUwn penet1lltlfd. unth at Ieut 011. -crv for each cl&<mge 01 JOMllQtioll. )(ATDLU. FRON c:emF!I)tRd 1 r-=- ) \. <.II ~:: .::;:: s::..::. c::- -.- -.- WOI'k startell..---1/.JL . Ii_BEL COm!>l.tHL._..__.._...2t22....... 19.B6_ WELL DRn.LER'S STATEMENT: This well was drilled UDder'my jurisdiction and this report is true to the best of my knowledge and belief. NAME._...~~g..ic.i!O.. J;lX.llUD!J.....Inc.__..... .................. ...... ...... .......... _.......... (PeDon. firm. or corpor..tionl (Type Ot' print) AddresS...P.Q~..JE.1.~_.!?~i~..~.~...~~~~.?...._... _........._.._...................... (Sjgned)..()o.l.i.ta..~......u~..~:Jj ~::~~eN::~~.~..~:~~:.~...~~~~..:.::::~...f3..............~.$..6 -zU fGY ~"20 (USE ADDITIONAL SHEETS IF mcESSARYI ~. ....; \,. o 0.. ~ v ..... ,- <U :::> ~ './) - :::: - o c o .i:l <is - i:: '- .:) ... - - - ~ - - ... 1.0 o - g .... t'\S rG ... t'\S ::l IV .- ::; ~ ... - :'\S ... ... t'\S :- ~ :> ~ ./) u ~ ::1 ~ :n o o ~ .u - ~ ,.J - - J) :. is Q. ~ ::l ~ - - ~- , W~ ~'Z-I / Ale Original and FIrat Copy ....th Depanmenl of Eeclcgy ~~~~~~~PV 1f~/~3 . (1) OWNER: Nome ..€i~"., Q/ft!'7Gt2c"r.< LL REPORT SlInCltnlNo. k!~709 \lNQUI;WEllI.D.,M4 .510 STATE OF WASHINGTON WeI.r Right Pam" No. 1dnss~'"D g;~&~~.I~~#'. ~ (2) LOCATION OF welL: CotrlIy (7if;9:~~72~<.rlJ . J&L.1~ "4Sec $5 i.~ R / E' wu. (20) S~EET ADDRESS OF WELL lo< IlOIIBSt "'*""1 ~..4)~ -ll,;:,'-T::> d':~,{!a~~_ AlerbLd;l/,t;J ,UlAFH. 9~~ , , (3) PROPOSED USE: ~ Domestic II"dJsIriaI 0 MloIltopaJ 0 Irrtgllllcn Tell Well 0 Olller 0 o OeWater (4) TYPE OF WORK: Owner's number or we' (II_U'en......' Abeno:med 0 New WIll ~ lIIethad: DuQ 0 !!orad 0 Oeepetted 0 Cable 0 DctvanO Atalndl1\clned 0 Jo/;e RoIaIy ~ Jd8d 0 (5) DIMENSIONS: a~r..' well 7d" Inches. Dnlled 7.5 lee\. Depth 01 colqlleled WIlli 73 It. (6) CONSTRUCTION DETAILS: CBsIIlg InsllllIed: ~" Clam. rnxn + / ILia b2 It.. W~ ~ ~' . Clam. !ram 57' It.'" ~ It. Limrlns1a1 &S- Threldtd ..6'" . Clsm. !ram fI... It. Plrforatlons: Yes 0 No ~ Type 01 "",*,rocor used SlZE of perlorallona perfolallOns Iroln perforwbcns from porlctatlons fn:m Sc'Hn5: Ves fiZl ~y 0 Manu'actuier's N:Ime tf/~~ TI'JIll l?lR3caok. I V;.:cV/!2eT ,r"IIlr"'" ,.., 10 Dfam.~S'otsiz9 ,,/,~ Cram Olam. SlollllZ9 It'llm $4'7' ~~ ModtI We. &2. It. 10 IPS- 11.10 GI1l'VeJ pllCked: Vas 0 31",,01 ;:laced fram No ~ Size 01 g.-I ft.lo Surface seal: Yo. ~ No O~ To whal <l8plh"/.~ (' \\alera! ussd in $181 W-'.7Of}I rr;r Did any s1IaIa c:omaln un~sal?Ie "a1Ol'7 VB. ~ No ~ Typo> of wa!8l1 ~ Oepth of strata & S-" ~..,. Mehld of seeling slnlta oil ~cc) - '/Jt.G:dl - 7 -=> (7) PUMP: Uall\lladllrers Nlme ~ H.P. (0) WATER LEVELS: Laftd....riIloeelw8llOn "'bM_,. /,,_, 1 abow_"'lIlav.I!ZF~. &&.> I\. S:aI!c.....1 /'p:r.... it. be....lap oI_a D8tIl If> -//-'17 M....n pres..." lie. per equate .ndl Date .III.,,,,,, ...alM " contl1l'1ecl ~ 'Cap. vaNe, otc.} ({l) WELL TESTS: Orawdown;, amoul\t Wltar IlMlI is Iowtted tN%w SIalic IeueI Was a ~amp 18S! mads? Yes 0 NO~ II yes. by wl'om? YIeld: !lBl.:mln. with It ~ after m. Ac",....., data (11/n8 tel<en as zero...non pump turnecl 011) (weIer Ie\/\II ~urlld hom__ lOP to wat81 ......ell 'T1mo Waler Lewl Ttmo Weier LallOl ""'" Water L""'" Da" 01 t...1 Bailsr lost ~ ~al.lmin. WIth' / n. cbwdown after AUt..1 - gal/mil\. w.th slom sel at - l\. lot Ar\esian 110" g.p.m Oa\ll T.mperOlIUtO cf waler _ Was e ctJemlcal analysIs made? YBa 0 C:,o pp/JT ('ilioq~ / hr&. ----- hrs. NoS ECY 050+20 (!II9J) . ./ (10) well. LOG or ABANDONMENT PROCEDURE DESCRtPTlON "-": Descrfbt bV COb<. ell_,. lire........... _ .-....1Rd ."-IIIIcIm.... aI-"!!llS Uld ... Idnd and _ of ... ~lln IIIdl _ penoIrated. llIlIh .. Ieasl 0118 ..my 101 ud'l d\angII 01 ......ilIII. 1oIA'1ElUAL ~.ml 7i'J'S:f)t'2. ~-tV~o S4N.0~&iji; ~ 8I'LJLLf"tJ~#~G~ StLJ~ (!I.,( ~ 1J8-~ n-~ ea;, u(d ~ WM I. 2-.. H./,If,I .mGP..o;;,o r,::'A;j;; 'lo'" ~ ~cz.. .7i17A I'JlOM o :2 JL/ 10 ;Z It.! ;ZP 2.J'./ 28 n~ . "7 ---Z:"7 73 In. It. It. 'l It. !\. 3;l~__ --""Vt:;:f 1I0l'\ ^ " U 0 I~~R DEP.'\HT~.vl :J,.. '>1;LI.. UHllllNG Ul'JfT fL :to , . WotkStlo1ed h-"7' . 1!1. Cllmplt..., . .. 1922 7,;- /, WELL CONSTRUCTOR CERTIFICATION: I ccnslruc:t8d and! or IIOCepl rasponslbllty far construcllon of lIIIs well. and I~ ocmollancll wllh aU Washington WlIM conslnlt:llon alllnd8tds. I.lalarials used and tile i~IOfl11l11lcn reported lIOOVe are bue 10 trr1 beat knawledgll DIKI bellel. NAMEC~/~ aa,-/V6 ~ A . IPEJlI6OH. f--" "" CORI'OlIAT'OHl fl"tPE OR PAINO . ........Rc:: ~ ~/ co:;:~~,$"~ 9.9.5"82- (SIgned) ~~ ueanceNo. /Cl?:3 '''B.L QfIIu.~ Conlr8dor'l: Rag151Iil11otl . . '" No. ..Y7V(c..pc-1..s7~ Dale (~-// (USE ADDITIONAL SHEETS IF NECESSARY) .19:17 Ecology is an Equal Opportunity and Affirmative Acllon employer. For spe- cial eccommodalion needs. contact the Water Resources Program at (206) 407.66()O. The TDO number Is (206) 407-6006. ~\ File Ol\aIn.1 and FQI Copy -.\Ih . Dclpftnment of ECOlOgy SecoRd Copy-Owner'. Copy Thlrll Copy-DrtIar's Copy Sllllt Card No. CBS"' /9B REPORT STATE OF WASHINGTON is ~ ~ at.r Right Permit No. Addrese ' / z z. 7 ~/. . 5#,,~ sdL T 3'c) .... ~w.u. ~,./ AI. 4,c ".t;f,.~ "vdtlV'LJ,v A WA- 9 :P~.s-B (1) OWNER: Hame (2) LOCAnON OF WEU: Coun", :r eFfi,~ (2e) STREET ADDDRESS OF WELL (01' n.-at .dhaa)$~Jl9N6 ...: "- o c. CD ~ Gi ~ en .c ..... c o c o :w ta E "- o ... c CD .c ..... .. o - "C C ta ta ..... ta C CD .c ..... >, ..... C ta "- "- CV ~ I- o Z en CD o "C >, 0) o o (J w .... o ..... c CD E ..... ... ta C. CD C CD .c I- (3) PROPOSED USE: X"~8stlc tr lrngetlon o OeWater Indlstrlal 0 TestWaU 0 tdunictpel 0 Other 0 (4) TYPE OF WORK' Owner's numberot well . 01 mora tllan one) Abandoned 0 New well B Method: Dug .Q.... Deepened 0 Cable ~ Reconditioned 0 Rotary 0 (5) DIMENSIONS: OIemeterofwea .. t, inclles. t:!'....,. -9"/~rlt. Dr1IllIc:l ~ '-' leet. Deplh of completed well ., _ u Bored 0 Driven 0 Jetted 0 (6) CONSTRUCTION DETAILS: ~ 5" ' O"m.lrom ,. ~ " .;- z /I to '-9 ~ It. 7Z0~":10 7f'" "". ".\0 It. Ill. by in. n.to It. tt.to It. 11.10 II. C88Jng lnatelled: W~ l!( t.lftarlnatalledB 1lveadlld . Dlem.lrom . olam. fflHll NoISr Perfor8l1onc Ve. TYPeofped~toraled SIZE 01 per1ol.Uonl per1orallonl Irom pertorlUons /rom Screens: Vu No ....nutac:lunr'sN.me Hd<r!:.~,.J Type II r#,'"Lt€.- ro(!l/4>S (' ~r;4- J1OdelNo #C/ Dlam :( Slol si~. ,Idl'3 'rOll' ~7 ~ It.lo 72 ~ I II. Dlam Gravel packed: Yes Gravel plac:ad troll' lrom 11.1" Site of graval /I. to Surface 18.1: Vag No 0 To wh.I daptll'1 / r It. IoIalerlll ueacllue.' A~I'l'".J ;r~ Old Iny alrall COlltaln UIIIllla~e wellf1 y" 0 No 0 Typeolwat8l'1 n.ptll ohnt- Melllod of ee.llng elret. off (7) PUMP: Manvf8clurer'a Nama T~' H.P (8) WATER LEVELS: ~~:;,..:~~::,= 7t:' If. S1.IIcIevtl 1:,7 ll.bllOWlcpOfwell O.t. ///~VZ. Maalllll prauurl Ill$. per equt.r8lnell Dale Art..lan. wat... II cC1ltroUed by (c.p.. __ tle.)) (9) WELL TESTS: or.wdO\lltl ie am~~ wlll.r 10000laloweree! below :llallo 1""./ W.. a pump 1.., made? Vea 0 No e:!" "yea. by whom? YIeld: Oll.lml.. with n. drllWdOwll atter tn. Rec01tetYdll11 (IImolaken as tero when pump tamed off) (welor le"ol musared fnlm well top to ..al.r level) T'1tM Wa1.rt...n' nm. Wal.rLevel r~. Wotorlevel O.te 01 lost a.n.. tosl 2- gel.lmln. wllh C) it. drawdow. after / ma. Alrte.t II'/./mln. with 310m s.lal n. lor hm. Meslan now g.p.m. oala T ImperatUB 01 woler ~f"was a ctlemlcal .nely.1s meete? vos8r' NoD ECVo.so...2(I ,10/8n '13>>- 0o,~1I C:~l'k /.52J.-/66 (10) WELL LOG or ABANDONMENT PROCEDURE DESCRJPTlON FOIlMIlon: Oeecrtlle by color, Character. aID of ",.terlaI and 'JlIIclun. .nd 8'- fhlcknea. of .qllIf.... and Ibe kllld encl"alura of 1M mUarf.. II aedl etrltUlll penetratacl. wItII at ....t 0MI1Inl1Y tor..eIl change III 1/lfonnatlocL MA1IIlIAL FRCMI 10 It. ft. .. WOIll .'arted 19. .' WELL CONSTRUCTOR CERnFJCAnON: I constructed alld/or acclIpt responsibility for conetructlon of Ihls well. and lis complIance with all W.shlnglon well conatrucllon st.ndards. MaJerials used and the informalion raported &boY. are true to my beat knowledge III1d b&nnf. // ~ W~ NAME >'7?/~ /J~~;~ ./ (PERSON, FIRM. OR CORPORAllOIi) !TYPE OR PRHr) Addreu ~d~ ,,61...~~pt';"" AA- 9e?.:!82 {Sjgned)..$~. LlceMeNo /?c6 (WU.t. DRlUER) COt1trac10r'1l ~~ill~e..()e /f?'1ste /;h- / (USE ADDITIONAL SHEETS IF NECESSARY) 07& .1~ ~~ \ ...; \. ;:) ~ ~ x; >> " ,;a J) .- .~ - o c: o ::; .~ - - 3 "- - - - .u = 5 -- 2 ,~ ~ .... ~ :) J) :::; ~ - - .~ .~ ~ ::;. ') '::>' J) u :> j >\ :>> :) .- :) :) .J .- :> oJ - u ~ 'a ,:l. u :) .!! " ....-.......-._~'_. "._-"'""-.",..~,:-:--- '--- Wb""l--L. *' ~ '-') ------ .- Please print, sign ana rettJl'l't1l5"tne-r5epartment of Ecology .. Water Well Report ....'..... ,.... Or\clDal-Eco'-c. l...opy-ow.... :z-<I.opy-clriller [Ie.,'t'i', 'i ConstructionIDecommissioD 181 Construction o Decommission ISSLJ.48 Current Notice oflntent No. \A) \" 3 ~ ~ ~ Umque Ecology Well ID Tag No. ~ ORIGINAL INSTALLATION NOlice of Intent Number Water Right Pennit ~o~.. ~ Property Owner Name Well Street Address a ~~ /ld. ~~;::':J:S/;;l1d PROPOSED USE: ~ Domesnc 8 InduSlJiol o Muni.ipal Cily 1\lQrolJ.s",,/ County . :J"eIO~1ll o DeWaler lnillalion Teu Well o Olhcr Tl'pt; O~' WORK: Owner's numbcrofwcll (ifmore lhalI ane) locationtUJli4-114~1I4 Sec33Twn3'RI- EW ~ WWM - I ~ Newwdl o Rcco...Ji.ioncd MetJuxl: 0 Dull iRe;; o Dnvcn Lat/Long (S, t, r Lat Deg Lat Mil1lSec Deepened Oc.bl. OJerle\l DI:\tENSIONS: Diameter ohlell....l.&i- ~Jrillod L." It stilI REQUIRED) Long Deg _ Long MinlSec Uepch of complCled well 1\. Tax Parcel No.~~ '< ()tJ btJ~ CO:-;STRtJCTION DETAILS , ~2 . Casine ~ Welded -1a..-., Diam. from ~ It 10 ft, J nstaJled: Liner installed _" Oill/ll.fl'Ol1l_tlto ft. CO.'lSTRUCTION OR DECOMMISSION PROCEDURE Threaded .. Oi..... from n.1O fl. FOI1I1lIIion: Ocs<;ribe by .;oiar, charao:tcr. sin of lIIalerial and stl1IClllre. and tb<i killd and PcrforatioDS: 0 Yes ~o naIUn: oflhc =tenal in each Slr.llUm penetrated. With atleasl on. CII!ly for cac:b c!lane. of Tvpc: of ,xrforalOr usctI infOl11latlon indicate ,11 \VOler encountered. (USE ADDITIONAL SHEETS IF NECESSARY I SIZE of perfs _in. by _ in. iU1<l nu. ufpc:m_from _ It to_It MATERIAL FROM TO Seren.: .8l Yes 0 No 0 K-Pac Location (" \ 1').." R r,^ ~ CL.",1"l J /) !JI" MaoufaClUrer's Name :> z--h ,}. ~(\ \ I - f , I T~pc: ~+Ft^ ~ "S!t-NO' ~ 5 '40." 1\. .c; ~VVj\ J I 2..2 Oiam, S Slot size I from 1\, to ...... I - Oiam, Slot size from 1\. to fl . I I GraYdlFilkr p.cked: 0 Yes 11 No o Size of gJ3Y.Vsond r~ o..\I\J ' (~n~.Up , .~? ~:n I Miltenab pl.eN from fl to It . , I , .. ' , Surrace SuI: :;fJ Y cs %NO ~ what ~cpU"! \~+ fl. I 5 1'l '" 1 or <.'1 fA.\l, \ bl to'::> \..) (..c... ( i Malenal usN in seal e" Ov-\t +e J!gNo ' Did any stnra cantun unusable wale(! 0 Y.s Type ofwolCl! Depth of_.. MellloJ of scalin~ slrata off \\eJ'-J \.4~ '" ~ PUMP: Manufacturer's Name l. Type: H.P, .l.r\ '~l ~r~A.1' _' I WATER LEVES ~d-sulf'c. .levatlon .boYe mean sea level~] . SialiC :ev.1 ') q ft. below top of well Dale 0 '"f I Artesian ?rcssurc tbs. per square inch OalO K~\<..,;1EHVIF'n i AACSliUl wal.. is conr:oiled by (cao, valve. erC.1 ~tfJ 1 47004 , I WELL TESTS: Draw<lown IS amounl w.ter l.v.I is lowered below slalic 1...1 Was:J. Jump tcslnuuc'! 0 Yes l!f ~o If Y". by whom? Ut:::',~ I.I~~.!:'I,! ,'Jr ~CULOG'i Yield: ~IJmin. willi ft. ,Jr.w<lo......1ler hIS. Yield: ealJmin. with fl <lrnw<lo......1ler hrs. ....._:...'11....; Iwt:- UI'4J. Yi.kI: ,,,,IJmin, with tl tJrdw<lown oller hr.;. .. I ~CU\'Cry lima (11m. lak~n ilS Zero when pump turnct/ ulf) (>wiler /"""/ 'PHUl>1InIiJrom_/1 .~ ,- lOp IU wuJ,r level) ....,.,.'~ C " ,,- -~ I~ W Iter Level Time Water Lc\iel Time Water Level 0") '~_' (") '~ - - - 1- - - - ," " . - , -n - -' - - ; DOIcC' of lcsl .1 ._, B.i1er :CSI+ llalJmin, \l(ith 0 fl, dta..doWR aner ~Ivs. ~ ,.. -- Aln.>'_ ~aJjmln. wllh slem ><1 al It for ~ ~'. ~ p, m. Dale 0 '-/ .....:: ~. . --' AnC'::t14ln :low Tern(lCT.1IU~ n(water _ Was ;)ChemlCal :JnalYSJs macJe'J 0 Yes tH'No J I ~.,..... " . I J Start Date '"" /,J 1 I D4 - .~ Completed Dale .LAIr}.." WELL COr;STRUCTION CERTIFICATION: I constructed and/or accepl responsibi/!), for !onslTUction of this well. and its compli;nce w[th all Washington well construction stan DrillcriEngincer.7rnincc Name (Print) Orillc:r/Engineer;Trniocc Signature: Driller or OiJ.incc L:CCf'l$C: :--.10. IfTRAI!,;EE, Driller's UCC'Ilstd ~o. DnUtr', Sitn...n Materials used and the information reported above are lru I r Ecology IS an CquJ.1 Opportunity Cmployer. , JAr Zb