HomeMy WebLinkAboutWEC Well Report / Log - 1/15/2026 WATER WELL REPORT ... DEPARTMENT OF Notice of Intent No. W E 3& ' / 0
ECOLOGY Unique Ecology Well ID Tag No.
Type of Work: State of Washington
Construction Site Well Name(if more than one well):
0 Decommission b Original installation NOI No. Water Right Permit/Certificate No.
Proposed Use: ❑Domestic ❑Industrial ❑Municipal Property Owner Name Ice rr 1.e) 11
❑Dewatering ❑Irrigation O Test Well O Other 3-/0 75 / et LA )/4'L c n
Well Street Address -/ /1 lip'
Construction Type: Method: 1/y (4�JrD�
New well O Alteration O Driven O Jetted O Cable Tool City County i_lti
0 Deepening O Other O Dug O Air- O Mud-Rotary Tax Parcel No.121? C.7 51 a/ 412 •
Dimensions: Diameter of boring 49 in.,to 3" 8.
Was a variance approved for this well? 0 Yes ®+No
Depth of completed well .,3 X 8.
If yes,what was the variance for?
Construction Details: Wall
Casing Liner Diameter From To Thickness Steel PVC Welded Thread
Vi---I 0 _ in. 4-. "33 42Zin. & I ❑ Ell 0 Location' 1 (see instructions on page 2): 0 or 0 EWM
O I O in. _ in. 0 I 0 0 I O 64,00 'A-'%of the i /;Section
0 I 0 in. in. 0 I 0 0 I O
S �n Township�� Range
CIO in _ in ❑ I ❑ DIE Latitude(Example:47.12345) L1—I• 3 t`j 2- U
Longitude(Example:-120.12345) - I t2,•8"."7.'i 5 o' -
Perforations: O Yes No Type of perforator used
No.of perforations Size of perforations-in.by in. Driller's Log/Construction or Decommission Procedure
Formation:Describe by color,character,size of material and structure,and the kind and
Perforated from ft.to ft.below ground surface
nature of the material in each layer penetrated,with at least one entry for each change of
Screens: p-Yes O No l 4S-K-Packer b Depthl 23 ft. information. Use additional sheets if necessary.
Manufac er's,N e , 1 h S0rl_ Material From To
Type CIA it f G Model No. '
Diameter 1-_ .`.Z 3Yft. t O eSV I 1 3
� in. Slot size in.from �� ft.to
Diameter in. Slot size in.from ft.to ft. ()tam-/ �n /IV cjS j 3 2_1
Sand/Filter pack:❑Yes 'No Size of pack material in.
��� P I.'���� �S
Materials placed from ft.to ft. 5LL�l s� ('y�L(JCr` ��'�d� C '�'
Surface Seal:�Yes� rn�❑No To what de ? D � �n ��c4 1 ci 1 "7 f e
Material used in seal W�f �� NI(�i. �� /f 2 ' O
� 'SC'" ,J —`Did any strata contain unusable water? O Yes No etVAD/ " 4.1 t
it l'h/ti- rZ..2_3
c.
Type of water? Depth o strata / Q /�,�� ��/(� G
Method of sealing strata off i_) t (OO n -�L1ZDC &k id /t`•V 2..t. 12
Pump: Man facturer's Name(7.nt.AJ d� Type:J"L,,b)'ners i$1.•
H.P.I4,5— Pump intake depth ft. Designed flow rate4 P gpm
k- Levels:flop fwel Land-surface i elevation$ • . e mea o ad level ft. -Stick-up oftop ofwell casing ,S ft.above ground surfacenI [1' ' �
Static water level c�� ft.below to of well casing Date ≤'3 r7 -2-0142- D
Artesian pressure lbs.per square inch Date
Artesian water is controlled by (cap,valve,etc.) ,
JAN 152026
Well Tests:
Was a2umping test performed? O No EP'fes b by whom?Kr-hy s-i.L'ik y
Yield gpm with,,ft.drawdown after 1 hrs. V —
Yield 7.Q_gpm with .:-S- ft.drawdown after hrs. By --
Yield ij)__gpm with 4'1 ft.drawdown after hrs.
Recovery data(time=zero when pump is turned off-water level measured from well top to water level) —
Time WatimLevel Time Water Level Time Water Level —
<r.ol0 QQ • —
x Os' WO —
Date of pumping test& t^'ZJ
Bailer test gpm with..ft.drawdown after g hrs.
Air test gpm with stem set at ft.for hrs. Dates-3°-C7/21)
Artesian flow gpm
Temperature of water °F Was a chemical analysis made? ❑Yes ❑No Start Date 3- ''S - L.,Dia•Completed Date ^ I q-2-np
WELL CONSTRUCTION CERTIFICATION: I constructed 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.
g3-Driller 0 Trainee 0 PE—Print Name Ke-T ry (A)ov 116 7' Drilling Company ,
Si e9U Or,peaC ( bW net )- Address
License No. City,State,Zip
IF TRAINEE:Sponsor's License No. Contractor's
Sponsor's Signature Registration No. Date
ECY 050-1-20(Rev 08/19)If you need this document in an alternate format.please call the Water Resources Program at 360-407-6872.
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