HomeMy WebLinkAboutWEC2017-00070 - WEC Water Sample Results - 6/18/2018 .40 WATER WELL REPORT CURRENT
Original&1"copy-Ecology,2e1 copy-owner,3rd copy-driller Notice of Intent No. W 359569 "t//y /
OECARTME"r Or
ECOLOGY Construction/Decommission("x"in circle) Unique Ecology Well ID Tag No. BJT928k
SW, washion
Construction Water Right Permit No. na •~•••�
❑ Decommission ORIGINAL INSTALLATION
Notice of Intent Number Property Owner Name Brandy Smith •`"�
PROPOSED USE: I. Domestic 0 Industrial 0 Municipal Well Street Address 560 E Cronquist Rd.
0 Deviator 0 Irrigation 0 Test Well 0 Other
City Grapeview County Mason
TYPE OF WORK: Owner's number of well(if more than one) 1 Su./
lit New well 0 Reconditioned Method:0 Dug 0 Bored 0 Driven LocationNWl4-I/44El/4 Sec 32 Twn 22n R lw EWM ❑
❑ Deepened • Cable ❑ Rotary ❑ Jetted (s,t,r Still REQUIRED) Or
WWM 111
DIMENSIONS: Diameter of well 6 inches,drilled 99 ft. Lat/Long
Depth of completed well fs ft. Lat Deg Lat Min/Sec
CONSTRUCTION DETAILS Long Deg Long Min/Sec
Casing IN Welded 6 " Diam.from +1 ft.to 95 ft.
Installed: ❑ Liner installed " Diem.from ft.to ft. Tax parcel No.(Required) 12232-10-92110
0 Threaded " Diem.From fl.to ft.
Perforations: ❑ Yes • No CONSTRUCTION OR DECOMMISSION PROCEDURE
Type of perforator used Formation:Describe by color,character,size of material and structure,
and the kind and nature of the material in each stratum penetrated,with at
SIZE of perfs in.by_in.and no.of perfs_from ft.to_ft. least one entry for each change of information. (USE ADDITIONAL
Screens: ❑ Yes ❑ No • K-Pee Location 92 SHEETS IF NECESSARY.)
Manufacturer s Name alloy MATERIAL, FROM TO
Type stainless wire wrap Model No. brown packed sand&gravel 0 4
Diam. 5 Slo1 size 15 from sn ft.to 99 ft. br till silt bound 4 58
Diam. Slot size from ft.to ft. tanish brown med sand some gravels watei 58 99
Gravel/Filter packed: 0 Yes II No Size of gravel/sand
Materials placed from ft.to ft.
Surface Seal: Yes 0 No To what depth? 21 ft.
Material used in seal cegE
Did any strata contain unusable water? 0 Yes lie No
Type of water? Depth of strata
Method of sealing strata off
PUMP: Manufacturer's Name Shaefer
Type: submersible Lt.p. 1.5 hp 20 gpm
WATER LEVELS: Land-surface elevation above mean sea level ft.
Static level 30.5 ft.below top of well Date 4/25/18
Artesian pressure lbs.per square inch Date
Artesian water is controlled b __ ca.,valve,etc.
WELL TESTS: Drawdown is amount water level is lowered below static level
Was a pump test made? 0 Yes IN No If yes,by whom?
Yield: gal./min.with ft.drawdown after hrs.
Yield: gal.imin.with ft.drawdown after hrs.
Yield: galiinin.with ft.drawdown alter arcs.
Recovery data(time taken as zero when pump turned on)(water level measured from
well top to water level)
Time Water Level Time Water Level Time Water Level
Date of test
Bailer test 20 gal./min.with 51 ft.drawdown after 4 hrs.
Airiest gal./min.with stem set at ft.for hrs.
Artesian flow g.p.m. Date 2/22/18
Temperature of water Was a chemical analysis made? 0 Yes MI No Start Date4/19/18 Completed Date 4/22/18
WELL CONSTRUCTION CERTIFICATION: I constructed and/or accept responsibility for construction ot'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
®Driller❑Engineer ❑Trainee Name Dwane Knapp Drilling Company Knapp Drilling Inc.
Driller/Engineer/Trainee Signature Address 50 East Lesaca Dr.
Driller or trainee License No.1706 City,State,Zip Shelton Wa,.98584
IF TRAINEE:Driller's License No: Contractor's
Driller's Signature: ee� � Registration No. KNAPPDI952BI Date 4/26/18
F.CY050-1-20(Rev 02-201 o request ADA accotian including materials in a format for the visually impaired,call Ecology Water Resources Pram
at 3 60 40 7-68 72. Persons with impaired hearing may call Washington Relay Service at 711. Persons with speech disability may call 7TY at 877-833-6341.
CENTRIC 1786 SE Mile Hill Drive
Orchard,WA 98366
C
.
LA B O RATO R I E S srcx www.centricanalytical.com
a (360)443-7845
COLIFORM BACTERIA ANALYSIS FORMCX y�V
Date Sample Collected Time Sample County I
Collected llli1l 1 2
I 2 ae i �� >� � 018
Month Day Year I V :I 0 PM
Type of Water System(check only one box) BY
❑Group A ❑Group B Other .
Group A and Group B Systems-Provide from Water Facilities Inventory(WFI):
ID#
System Name: C__;L�ly
Contact Person: y, p t\�.
il Day Phone: 3bb Li oL ( $11 Cell Phone:
Email: Eve.Phone:
Send results to:(Print full name,address and zip code or e-mail)
SAMPLE INFORMATION
Sample collected by(name):
Specific location where sample collected: Special instructions or comments:
C(00 E CforITAlK\" RA.
Type of Sample(check only one box)
1.❑Routine Distribution Sample 2.Repeat Sample(after unsat routine)
Chlorinated:Yes❑ No❑ 0 Distribution System
Chlorine Residual:Total Free Unsatisfactory routine lab number:
3.Source Ground Water Rule Sample - --
S I I Unsatisfactory routine collect date:
i 1
❑Triggered Chlorinated:Yes 0 No 0
❑Assessment Chlorine Residual:Total Free
4. Enumeration Source Water Sample I I I
❑E.coli ❑Fecal-Surface.Owl,Wigs:Filtered Yes❑ No❑
5. Sample Collected for Information Onty: T-A J
r‘B
USE ONLY DRINKING WATER RESULTS R USE ONLY
❑Unsatisfactory Total Coliform Present and atisfactory
❑E.coli present ❑E.coli absent
Replacement Sample Required:
In Sample too old(>30 hours) 0 TNTC ❑
Bacterial Density Results:Total Coliform 1100m1. E.coil I100m1.
Fecal Coliform 1100m1. HPC /1 ml.
Lab ID Number Date and Time Received:
1aaaP.—o , APR 2 6 2018 iLt.. o
Method Code: Date and Time Incubated:
SM 9223 B APR 2 6 2018 t
Dale Analyzed: Date Re.e >e
APR 27 2018 1 'R 27 2018
DOH lab-Sampleit Lab Use Only:
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