HomeMy WebLinkAboutWEC2025-00027 - WEC Inspections - 2/27/2025 k1a_c0.-P,( A ep
MASON COUNTY 415N6THELTON: ,S427-96. ,EXT 400
SHELTON:360-027-4467,EXT 400
BELFAIR:360-275-4467,E%T 400
Public Health & Human Services ELMA:360482-5269,EXT 400
FAX 360427-7787
THIS FORM IS TO BE USED ONLY AS TRANSFER OF DATA INTO SG. WEC RESULTS REPORT SHOULD BE USED AS
PERMIT REPORT
WELL PERMIT: CONSTRUCTION OF NEW WELL WEC2025-00027
APPLICANT Robinson, Savannah Phone: 3606696858
Address: 1213 S Yew St Centralia, WA 98531
OWNER HOLLIS ROBERT A Phone:
Address: 4551 E PALOBREA LN CAVE CREEK, AZ 85331
RD 51T ST;iEPO f2F
DOE Start Card: 58950 A R e.IW l nrr E�Ds At L M� fie
Well Tag (if avail.):
Well Site within 1000 of saltwa[er9 No ff.E140. PA44vt b�
DOE Variance? v/A t.144"
JVJN *eW S� -AACA-PIA RO
Site Address: `N' '
Primary Parcel Number: 220207590011
Contractor/Driller: Moerke and Sons Pump and Drilling
Date Received: 02/2712025
Date Requested: 03/17/2025 F e A 3 ( t rt I L S
Date Inspected: --
Inspected By:
Inspection Status: IN PROGRESS
Inspection Results:
Is there a 2"annular space on all sides of the casing? -hl'YES [ ] O [ ] Not Observ.
Is there evidence of cascading water) [ ] YES [ ] NO 111Jot Observ.
Was the driller on site? U YES [ j NNO— I ]] Not Observ.
Is the well flowing or is there evidence of other leakage? [ ] YES AkO k-11.t Observ.
Is there evidence that the seal is at least 18 feet long? y]-'ES [ ] NO [ ] Not Observ.
Has the seal slumped? [ ] YES I ] NO _jj446t'Observ.
Is there evidence of a surface seal? [ ] YES [ ] NO [ Not Observ.
Is the well capped and vented? [ j YES [J.NO [ ] Not Observ.
Is there evidence of improper well siting or sources of I ] YES �r }NO [ ] Not Observ.
contamination?
Comments/Summary: 7
I ] PASS [ ] FAIL [ ] Not Insp.
3�IPI�Z GIS Lat: I ( R S$
GIS Lon: L 1 . `j !T tf 35 S1i
THIS FORM IS TO BE USED ONLY AS TRANSFER OF DATA INTO SG. WEC RESULTS REPORT SHOULD BE USED AS
PERMIT REPORT