HomeMy WebLinkAboutWRIA and Well Report - PLN Water Resource Inventory - 7/26/2024 2213731 MASON CO WA
07/26/2024 11:10 RM NOTCE
SURREZ, M p199878 Rec Fee: $304 50 Pages: 2
�I I��IIlI,������IIIIII IN 111111111111111111111 III 11111111111111 IN
Return To
4 SW t7
(owq? Iq-2 5� i
Grantor(s): (1) Mtin'4fk! 5,1�2�..� , (2)
Grantee(s): (1) PUBLIC
Legal Description (1) COT 3 Or, �� # �`�5 -5� rO
(Abbreviated form:i.e. lot, block,plat or section, township, range)
Assessor's Tax Parcel: (1)_V_L - -
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:
-02-
Maximum Annual Average Gallons Per Day: 34 _gallons
Dated on this o day of ��`r' , 20�.
Signature of rantor(s):
(1) ' (2)
State of Washington )
County of Mason )
Page 1 of 2
I, the undersigned, a No Public in d for the above naYned County and State, do hereby
certify t on this day of , 20 L
pe onally appeare before me, who is known to be
signer of the above instrument, and acknowledged that he ( e) (they) sig it.
GIVEN under my hand and official seal the day and e r las bove wr tte .
o ryPublic in and fort e State f Washington,
gER SF residing at Q
SSI0N
o NOTARyQPF; My commission expires: 0
U .
23038426
(S) PUBLIC ;
9 7 �izo21. '�(;
Page 2 of 2
PLANNING
WATER WELL REPORT DEPARTMENT Of Notice of Intent No. WE54564
ECOLOGY
i Unique Ecology well ID Tag No. BPF054
Type of woric: state of Mshingion
N Coasm,ctioa Site Well Natne(if.more than one wetlj
i O I3ecouttaission r_� Origirut irslallatioo NOl No. Water Right PermiVCenificate No.
1
3 Proposed Use: M Domestic 0 tMtugriat ❑mank;pat Propeny OuTier Name Matlhe4v Suarez
❑Dewatering ❑Irrigation ❑Test\1`za ❑Odwr
Well Street Address 8174 W Matlock Brady Rd
Construction Ty pr: Method:
j 10 New well G Alteration D Driven O kited O Cable Tool City E3rria County Mason
❑Deepening O Other O Dog 0 Air- ❑Mud-Rotary Tay Pared No. 61918-42-90003
1 Dimensions: Diamcterorboring 6 in,to 94 fL
Was a variance a w
pproved for this ell? O Yes El No
Depth ofcompleted well 94 IL
l Construction Delaus: Walt If Yes.what uss the variance for?
1 Casing Liner Diameter From To lhiclux-- Steel PVC\Vetded Thread
C3 1 ❑ ti in 0 94 .025 in r3 9 D 0 I ❑D 1 D ❑ D ❑ ❑ Location(see instructions on page 2): (A\NAM or D EWNI
` ia. is ; l
— t El I D in- in � D ❑ ❑
NW %-%ofthe SE 'Y.;Section 18 Towship 19N Range 6W
._._. r �
O 1 ❑ in. in CI 1 D ❑ 1 ❑ Latitude(Example.47.12345) 47.13182 N
— Longitude(Examplo:420.12345) -12147607
Perforations: Oyes MNo Typeofperforaterused
1 No.orperforations_ Six 017perf6mliuns_in by—in. Drifter's Log/Construction or Decommission Procedure
Perforated Sum tl to R below ground surface wn Dcscribc by color,character,size of tmterial and structure,and the kind and
E rutura of lha material in each layer penetrmcd.With at least one entry for each change of
= Screens: ❑Yes r7 No G IC-Packet 1--* Depth—A information else additinn it sheers if accessary.
g �tanufactcrei s Name Ytodel Material From To
is Fine to mecum sandy
1 Diameter_ Slot size in frout 11.to fi- gravel,Silt bound,d 0 18
1 Diamelcr— Slot size—in.from _IL to—9 Fine to medium sandy qravel,loose 18 46
`• Brown medium sarvidy gravel.moist 46 57
o SandMilter pack:❑Yes 21 No Size ofpack marctial_in.
eo F Materials pbced hover_1L to R Brown medium Sand ravel,>,iel,loose 57 67
Brown medium sand gravel,loose,wafer 67 94
Surract Snl: O Yes ❑\o To wfiat depth? 18 R
= ataterialttsedinszai BentoniiecttiOs
Dud any strata conain unusable srattr? ❑Yes O No
Type aEwatzr? Depth alsu=&
° 1 Melbodofsealingsuataoff
a
Vy Pomp: �faarfaitWTr'SNanp T1pt- --
} 1 H.P._ Pump intake depth:-lL Designed flow vale: gpm
i
` Water levels: Land-surface elevation above mean sea level 241
[ Stick-up of top ofwa casing 1_7 ft-above ground surface
Static water level 50 fi-1edocr top ofwellcasing Datc 11/20123
c
Ancsianpressm—lbs-per squxo in:b Date
Artesian water is controlled by (cap,vatve,etc.)
b f Well Tests:
Was a pumping icA perkawed? 91 No ❑Yes by whom? -
3
w { Yield—gpm with_ft drawdown after h,s
o } Yield—Spin with_R.drawdown alter Ins,
I Yield—epm,with ft.draw dow n after—hrs.
E ! Recovery data(lirne=zero wbtn pump is turned off-water level meastued from-Aelt
Q top ra\\clef lerel) _-
j`�S j Time Water Levrl Time Water Levet Time \Cater Level
WA Stre :it
eir
Uat—co fpumping tilt
Bader test pro wirh_ft drowdown after_hrs
Air test 30 Spin with stem set at So 1L for 1 h>s Date 11/20/23
Artesian flow_fpm t I ,
Temperaturt ofwaler 50 'F \Pas a chemical anallsi;trade° ❑Yti Fl t o Start Late 11/20123 Completed Da:e 11120/23
WELL CON.'M 1CTION CER 1TF1CATION, I comrtcted and/or accept responsdtilay for construction of this mel 1,and its compliance acith all Washington tsell
construction standards-KWedols used and Ux information rrparted above are true to my best kno-wicdgr and belief
_a]Driller D Traince D PE-Print e;7erPhytltian lhitlitlgCompany Arcadia Drilling Inc.
_Signature % _ Address PO Box 1790
License No.2053 r City,State,"Lily Shelton,WA 98584
IF TRAINEE:Sponsor's License No Coruractor's
S nsor's Signature Registration No.ARCADD10981<1 D.-tte 11/20/23
ECY 050-1-20(Rev 09118) if ywr Aced ibis dauntew in an oilernale fimnerr,please call die It aver Resources Program at 360-407-6812
Persons Frith hearing loss call c0171I for Washington Relay Serrrce. Persons will(a sivech drsrrbilrry can caMB77-333-6341.