HomeMy WebLinkAboutWRIA - PLN Water Resource Inventory - 7/22/2024 2213523 MASON CO WA
07/22/2024 02-33 PM NOTCE
THOMAS, NICKOLAS #199699 Rec Fee: $304.50 Pages: 2
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Grantor(s): (1) (2)
Grantee(s): (1) PUBLIC
Legal Description (1) l-�c�✓.�P
(Abbreviated form:i.e. lot, block,plat or section, township, range)
Assessor's Tax Parcel: (1)
TITLE NOTIFICATION OF WATER RESOURCE INVENTORY AREA (WRIA)
I (We), the undersigned grantor(s), hereby place this notice on record that the described real
estate situated in Mason County, State of Washington is subject to water use restrictions and
conditions set by Washington State Senate Bill 6091 and Mason County Code 6.68. These
restrictions and conditions are based on location of property and/or Water Resource
Inventory Area or WRIA.
WRIA: 4
Maximum Annual Average Gallons Per Day: or5o gallons
Dated on this �da of , 20
y
Signature of Grantor(s):
(1) , (2)
State of Washington )
County of Mason )
Page 1 of 2
I, the undersigned, a Not Public in a d f r the above n ed County and State, do hereby
ce i th t o this ay of 20
pers ally appeare before me, who is known to be
signer of the above instrument, and acknowledged that e (she) (theyksigned it.
GIVEN under my hand and official seal the day a ar last atpve e .
O... R SF�e ''% ry blic in or t e Uate of Washington,
•��c-S��N F-Y• ��
o� NOTARyp� residing at
23038426 = My commission expires:
Nam: PUBLIC _
'70/1712�?�•'GAOL
e lop
Page 2 of 2
WATER WELL REPORT L [PA' T&I--N' Notice oflntentNo. WE55543
ECOLOGY Unique Ecology Well ID Tag No. BPN052
•rypeofWork- State of 4i'a0-ington
❑O Construction Site Well Name(ifmore than one well):
❑ D curmnission b Original installation NOI No. Water Right PenniVCertificale No.
Proposed Use: 1.Domestic Industrial Municipal Property Ow-ncrN:one NICHOLAS AND COURTNEY THOMAS
❑Dew•atering —Irrigarimn _Test Well _Other
1Vc11 Street Addrems 51 E HOMESTEAD DRIVE
Comlruclion Ttpe: Method:
❑New vre11 _Alteration =Driven C Mitt] Cable'foul City ALLYN County MASON
I I Decpcuing I Other Due la Air- Mud-Rotary "fax Parcel No. 122172450033
Dimensions: Diamcicr of boring 6 in..a, 267 ft. Was a variance approved for this well? ::1 Yes O No
Dcplh ofetvmplcted well 267 (l.
Construction Details: wall If yes,what was the variance foe:?
Casing Liner Diameter from To "lltickmcas Steel PVC;welded lltrrad
p I D 6 in. +1.5 261 .25 in. IE I ❑ B I :3 Location(see instructions on pace 2): w. W\\N or❑EWM
L) I J in. _ in. 1_I I _1 J I J NE y4-Y4 ofthe SW ''/v;Section 17 Township 22N Range 1
❑ I 0 itL In- ❑ I ❑ ❑ I ❑
❑ ❑ in. in. ❑ D ❑ D latitude(Example:47,12345)
Longitude(Example:-120.12345)
Perforations: ❑Yes Do No Type of perforator used
No.ofperforalions size orperfomtions—in.by in. Driller's LoglCouslruction or Decommission Procedure
Perforated from ft.in_A.below ground surface Formation:Describe by color.character.size of material and structure,and the kind and
nature ofthe material in each layer peneiraled,with at least one entry for each clunse of
Screens: T Yes J No 101 K-Paeker c=> Depth 260 li. information. Use additional shwas if necessary.
Manufaclurcr's Name JOHNSON
}PC STAINLESS Material From To
I'• hlvdel No.
Diameter 5 in. Slot size 16 in.from 262 ft.to 267 ft. BROWN CLAY 0 3
Diameter_ in. Slot sir in.I"rom 11.to 11. BROWN CLAY GRAVEL 3 20
BROWN CLAY GRAVEL 20 60
SandtFiller pack:=Yes 74 No Size urpack material in. GRAVEL SAND 60 160
Materials placed I"rom ft.to—ft. GRAVEL SAND 160 260
Surface Scal: K Yes ❑No To what depth:' 19 It. GRAVEL SAND WB 260 267
Material used in seal 3/8 BENTONITE CHIP
Did any strata contain unusable water.' ❑Yes O So
Type o f water? Depth of strata
Method oricaling strata off
Pump: Manufacturers Name Type:
I I.P. Pump intake depth:—ft. Designed flow rule: epm
Water Levels: Land-surface elevation above mean sea level ft.
Slick-up of top of wel I casing +1.5 ft.above ground surface
Static water level 217 li.below top of well casirte Date 04110/24
Anesian pressure lbs.per square inch Date
Artesian water is controlled by (cap.vale.etc.)
Well Tests:
Was a pumping test perlbrined". D No ❑Yes c=* by whom'
Yield gtnn with_ft.dmwdown after_hn.
Yield_,gpm with_ft.dmwduwn after_Jim
Yield—spin with_ft.draw•down after—his.
Recovery data(tithe-zero when pump is tumcd art'-wMcr Icvcl measured from coed
top to waicr level)
That: Water Level Time Water LeycI Time Water Level
Date of pumping test —
Ruder test—gpm with_R.drtwdown aficr_hn.
Air lest 8 gpm with stem set at 267 A.for 3 hts. Date 4/10/24
Ancsian❑uw bent —
'fcmpemturc of water -F Was a chemical analysis nude? C Yes IN No
Slar1 p;t)c 04/08/2024 Completed Dale 04/10/2024
\?•ELL CONSTRUCTION CERTIFICATION: I cunstructLd and'or accept responsibility for construction 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. y
❑O Driller❑T inee❑PE-Print Name ROBERT LAYMON Drilling Company ADVANCED DRILLING LLC
Signature w� Address 11530 SCHOOL LAND RD SW
License No. 2588 100' City,Slate.Zip ROCHESTER WA 98579
IF TRANr+.:Sponwr's License No. Contractor's
Sponsor's Signature Registration No.ADVANDL804DL Date 04/1 512 0 24
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