HomeMy WebLinkAboutWEC2024-00122 - WEC Inspections - 10/28/2024 fv�h Seµ 4K RD 'kl caaR Mlk Ke�iin
MASON COUNTY 415NfiSHELTON: , 0427-970,EXT 400
SBEL AIR 360-427-9667,EXT 400
BELFAIR:360-275-0467,EXT 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 WEC2024-00122
APPLICANT TRIANA, JOSE Phone: 3607483805
Address: 1162 NW STATE AVENUE CHEHALIS, WA 98532
OWNER MEIKLE JONATHAN B &SARAH R Phone:
Address: 50 E CATFISH LAKE RD SHELTON,WA 98594
DOE Start Card: WE58235 ( ,
Well Tag (if avail.): Q>(�. L.GLI
Well Site within 100 t of saltwater? Yes
DOE Variance?
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Site Address: -moo-roicrFi'a'rrb'cr'ecRv p c�-r v s H i n re
Primary Parcel Number:
Contractor/Driller: MOERKE AND SONS AND DRILLING
Date Received: 10/28/2024 I' I2'-I
Date Requested:
Date Inspected:
Inspected By:
Inspection Status: IN PROGRESS
Inspection Results:
Is there a 2"annular space on all sides of the casing? YES [ ] NO Observ.
Is there evidence of cascading water? [ I YES JeC, [ ] Not Observ.
Was the driller on site? [ ] YES >NO [ ] Not Observ.
Is the well flowing or is there evidence of other leakage? [ ] YES 1.1.NO [ ] Not Observ.
Is there evidence that the seal is at least 18 feet long? [ ] YES [ ] NO ,DV Not Observ.
Has the seal stumped? [ ] YES XNO [ ] Not Observ.
Is there evidence of a surface seal? 11/`Y YES [ ] NO [ I Not Observ.
Is the well capped and vented? /XES [ ] NO [ ] Not Observ.
Is there evidence of improper well siting or sources of [ ] YES XNO [ ] Not Observ.
contamination?
W Ahv -
Comments/Summary:
P I ] FAIL ( ] Not Insp.
Gys Ea
GIS Lon: _ 23. 04D Z
THIS FORM IS TO BE USED ONLY AS TRANSFER OF DATA INTO SG. WEC RESULTS REPORT SHOULD BE USED AS
PERMIT REPORT R