HomeMy WebLinkAboutWEC2025-00007 - WEC Inspections - 1/17/2025 KArKLLC-
: MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584
SHELTON:360-427-9670,EXT 400
BELFAIR:360-275-4467,EXT 400
s Public Health & Human Services ELMA:360-482-5269,EXT 400
FAX:360-427-7787
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 WEC2025-00007
APPLICANT ARCADIA DRILLING INC Phone: 360-426-3395
Address: PO BOX 1790 SHELTON, WA 98584
OWNER FAGERGREN ET AL ERIC LINN Phone:
Address: PATRICIA LYNN FAGERGREN SHELTON, WA 98584
DOE Start Card: WE58736
Well Tag (if avail.): ¢tml L-Cr-t£ � /5LI)0 .F (ELF
Well Site within 100ft of saltwater? No (17 ,y_S -pAt-A N1/4-46t N
DOE Variance?
Site Address: 400 SE Fagergren Rd
Primary Parcel Number: 319143100214
Contractor/Driller: Arcadia Drilling
Date Received: 01/17/2025 2
1/4
Date Requested: 01/22/2025 fp(Z k/Z3(�--5 1 ~ — `
Date Inspected: Lfl ry A S,r6'Y--' l'Y
Inspected By: yz."3Inspection Status: IN PROGRESS
Inspection Results:
Is there a 2"annular space on all sides of the casing? [ ] YES [ ] NO ['Not Observ.
Is there evidence of cascading water? [ ] YES [r NO [ ] Not Observ.
Was the driller on site?
[ ] YES be NO [ ] Not Observ.
Is the well flowing or is there evidence of other leakage? [ ] YES () NO [ ] Not Observ.
Is there evidence that the seal is at least 18 feet long? [ ] YES [ ] NO [X Not Observ.
Has the seal slumped? [ ] YES [y N Not Observ.
Is there evidence of a surface seal? [ ] YES - [X'NO ' [ ] Not Observ.
Is the well capped and vented? y YES ] NO [ ] Not Observ.
Is there evidence of improper well siting or sources of
contamination? [ ] YES [/ NO [ ] Not Observ.
Comments/Summary:
WC' not /pI/ /r.) 1t/no( kte f [ ] PASS [ ] FAIL [ ] Not Insp.
Leff d % Ivaco' thii e r) GIS Lat: ift, 32 ?'e
cd) / V/z 17 GIS Lon: _173. 6 z 9 Z6
THIS FORM IS TO BE USED ONLY AS TRANSFER OF DATA INTO SG. WEC RESULTS REPORT SHOULD BE USED AS
PERMIT REPORT