Well Information 001aap uuryuX
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Well Log Images Map
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. ITt' L_ p ~- Well Log Locations
® _:1^ I. ^ ~ ~. ° ® water SupaN
C/y} ° °
E' I ~ ~ _'-~ LT---. ° Rewurce Pratedan
ml ;j - j~ i ~ V \~~ •~ ^ Dewmmssvnad
j' ,' j., l li. 9~ .View',. ~° ^ MutlWle weX Types
y Y rn- ° .q ~/ Major Roads
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53Ra•- _ g' ~ 11, i t a j
_ _ .. _ .. _ .. _ Stree6
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N Sections
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,°0 9y. ~ : I Citles
4n ~., 'o ea ~ Counties
I 6
~ ~ ~' NCO ~ ~`Oe Waler Botlies
° ft. lM1RU'~ St0 ^: ~1~r ^•arF.e ~~ r~ I f~k.~1E~ ^.
4x, 2 ~•y _ _= i ~ Reservax
-_ _.Barry` beY---_ 0C°~ {BI~O~~ / Ste` ~ =-.Raihvay _ ~ Gbuer
_ ~ a 4
~ ,
`e Aar ~' ee L°~.d , f
~ ^ 5 ~~u~ pgDF' VJ,. ~ ^ ~ 1. ~ Rack
\ _ ~__. - X16...0 s~ ` ~ Island
\ ~n ,~efl'S'o \\ Ay, ~ water
° ^ town ^ ,~`~-£•An e • e: °"~s /~ Sveams I
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ar _ : ~-; -_ toaRa_ 1
R^nmm~ - e i
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al - •~. __ 105Th a~f Spy I
~Oy.~-... (~ ~ 5 t Pratre 1
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Gaoye •IS" -_ Fa Hill- ~ Ci ben 1 Ir , , 1 ~
^ ,.i ° : __-t0y9Th __.. ° Iii ` I
i
ry1 Drtetntl •na nm Cow wlu Apuuruon NO. ....... _...
D.ymn.n{pe slolav WATER WELL REPORT
savY~ o~: cocOOpyr ifA1R OR FA/~IOSON ram{[ Ne...
(1) OWNEB: N.b~__3nhn..t:'atz ._ ----._.. _'.___'. wam~..Ht-~' Sox 3252-A-Yelm..--Na. ~f153Z... __-__..
(2) LDCATION OF WELL: crew _... __TAIiA@tDil _..... _ SE. 's NE_,.. +. e. 24_.. m 7Y. r R?E.....v.a.
arrW •na Ola•pee nnm renm or ~uOmvbbn wrner ....._.._. .
(3) PROPOSED USE: Debewp m map.nl.l ^ aod<Ip.l ^
freymn O Tre w<u ^ omW ^
(4) TYPE OF WORH: ~°,;;;"m„'m°",n °t Y'e0_......L...__._....._.
nemree ^ c.hu ^ Dnvm ^
RwmNUmtl ^ Bebrl a I<[W ^
(6) DIMENSIONS: Dumeta a wa _...........6..... mw..
DrlDea-. 1 ].0.....__. x. D•pm oe robplaea .eu..... 1011__._...x.
(6) CONSTRUCTION DETAII3:
CasinH installed:...6...._° Dub. nom _.0......... n. b 100_.. n.
Twaw ^ .__..__•' ,»m ate. ____....... n. b ..._..__ x.
Yertoratlom: Y. ^ na m
Typo a paronw u[.a-__.._ -_..__._....___....._..________.
atza W p•tleY•tlru __..__...____. m. e9 .._..__.__.__.._ b.
....._._..__.._. pamr•npu em .._._..._.._. n. b ____._._..._ n.
..__........_.. p.repr.dpm em ___ ...___.. n. m .__ -_____.. n.
...... penornem xam ..... __.._..... n. m ._...__-._ n.
Screens: yr ^ No
H•emmmer• x.be._.__.___..__._____.__.____....___.__._.
TYC•___ _ _ .. .........___ _. YOa•l N0_ ._____ ...
DYm. ___........ 9b1 Yu .._____ n® ......_._., n. m .._....._.. n.
oWn. _........._ Slot •ve ..._____. [mm ___... _.. tt b ..._..._.._ n.
Gnval yadted: ve. ^ xoZ7 sv x a.w: _._.___......_...
ce..a pl.eee wm _. _...___.__._.._._ n. b _..._......_.-____ n.
Sur4ee seal: yr ~ xo O Te wh.{ eepm+ _7II_._____ n.
Latea•I u•ed In rLL ....._)3EIILOSI~?R.._..._..__ ................ __.__
Dld •ny arvY <anWn uvurWe mUri Yr ^ No-F]
qYp O} wvMrl. _._..... ......_..__..__ D[pm O[ RnY .............__.....
(7) PUMP: wnw.nmr~N.me........_SHCUZZi._HTnfl.~~_..JJ._.__.
~
type:......7S~IH........ _.___..
....___..__... _._._._._._......._ HP..tI
(B) WATER LEVELS: Gna-wr.r<<u<.mo
veo.e m.a. w IrN., __x
6 Da 7 ~?2
0 _._. ..___.
sum le.a .__...
n. haor by oe weu
aetnlN pirNr< _...._........._...__ Jb. p<r g1Yre Inc4 D•te...._....__.........._
AMtl•n w<te. b rctlOllM E9......._.._ _............._
(C•p. vIw. aed
9 WELL TESTS:
( ) Dr'wa°w° ° <'nnum was levx ~
lowvea plow nave bwl
Wa • pump lnr meaei Yn ~^ No ~I D Yr, hY wbomf..... _..._.....__. _.
YI<la: W /mm MN n. aravaavn .ft<r hn.
Rero«< aced [rvm ..D 1ep rlo w•n< 1<v<Il amp Iwnea oRl IwNa YvY
T{m< Wat<r Lewl Thne Wolr Lawl Tlnw Weta Goal
• ••D p Of {rl ..__.
sate. un._.10.._.._w.iml•. wlm ...20. _tt a wmwo .na .1. An.
r.mp.retme o[ veta_...__.. wr • enrm<.t .c+b•I• m•aee v. ^ xoA
LOG:
This weH wea drlllcd under my 1ut1edl<Hon and thta report ie
4ve b the beet o[ my knowladae and ballet.
tiAME_Rg)?agdBOn_We11 .Ih-1_llin&_CO. ,
trnAn. wno. or e~ioanuovl I~tYpe m prmtl
Aaapem_......_P <Q.e.. Box_44408,. Tac far„Wae 9&V44....... ....
(gi~ .._. ... .. _......_........ ._.
( W Dn1Yr1
LeeDw No....22a_.4.2-6500........._ Date_$-zb.....""__..::., tn`.: `.l7
1[1RL ADDrfIOxAL BHlZI! V NCtaRARYI _ a
[CV r<bt-ie
WELL DRILLERS STATE1liF.NT:
Please print, sign and return to the Department of Ecology
Water Well Report cnrTent ~ L/~ ~' '-~ ~
onglw-HmWp. Intopr-m.n,r, x.e wpy_awl.r Notice of Intent No.
g dp lp~g ~r Omgpe Ecology Well ID Tag No
CanatructiodDeeommiasion
^ on Water Rlght Permit Ho.
xommission ORIGINAL lNSTALLAT10NNonre property Owner Name _
ofln(en! Number u
We115trret Address I~021
PROPo6ED USE ]Damwly ^ Imlasmol ^ Mumnpvl
^cewala ^Imaam ^Tmwdl ^omet
City ,,xp,~l~.~`~ County r~~~~~j~
T
'
/
S
P~
ivpe of woRR. owxr'a numbs orwNl prmare man aml
^ New wsll ] ftecmJmodJ Mdhw/ ] Dug ~ amd ^ Dnven
^ oRperw ^ablt ^ aou.y ^ Ituw ec
L
Corona
4-1/4IEwl/4
w11L
wM ~~
Lat/Long (s, t, r Lat Deg (a[ Mnl/Sec
mmervsorvs mamneorw,pmtne.,Jnllwn
Ocpm orw~Mw well fl ShII REQUIRED) Long Deg Long MRl/Sec
~x
CONSTRUCTION DE(AIIS
^wtww -Dram oamflm n
c.n,r Taz Parcel No ~ g~~ ~ y ~ 3 O e/~ C7
g
InsWkJ. ^Lmvwullwv,aa (mmnrofi
^ThrterWl Dum lromft,o fl CONSTRUCTION ORDECOMMISSION PROCEDURE
Perrorawm: ]YO Na
Type ofpeRwawuW Fomwrm Carobs bv.ola, clwraner, ave ofinercnalaW aWCmre.aw WeL ml.rW
reorMC mv,nd mucM1 atraamprnevnw, wnM1nlean vrc mq(m uT dwge of
nnfomuuoa Jrcde vll wain encvun¢rw IUSE gDDTONAL SHEETS If NECE55gRY1
fiIZEOfpe,fa _rn Ey_rn vtlao o(peRa_finm fl b_fl MPTERIAL FROM TO
$aneni: ^Yes QNO QK-Pat Irc+ucn
Manuratturs, Name
Type Mwel Na
R
11
fi
um
b
Dum Sld au
Drw 6ld ers__rmm nm fl
Gr,veUFlMp,t4W'1]Yn ^Na ^6ru o(gnveVaaw
Malmalr pLmlrmm flro fl
6m4a HnL.Q Ye QNO TowMt JepA" _fl
Ma¢nal utJ rn swl
Dvl any swGCOm.un umublewvel' ^Yn ^No
Type O(twlM CeplA OfymY
MemW ofa~Lng WuaaR
PUMP. Manuredmn's Name
Type N P
WwTER LQVEIS: Lmbnvf,n elevaaonaMuemun wlnel fl
SW,c levtl fl Mlaw by Orwell part
Annran lneuurt Iba pwpwre ru'M1 Ddt __
Arloun wYa ntvrwllw by_
( valve
l
WELLTPET& DrawJmm a utowl wamrlewl a lowerw below sWl¢ Iwe
^N
1l
b
wMm"
l
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a
yi;
Wnaprmp ¢u mu
e
n
Y
fl JrnwJOwnaM Arz
W I/mrn w0
T
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e
TrtW ul/mm wrm n rbawJOwn uOa brs __ T(1 1n,I`I
"
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YmIJ sal /mrn wnb aJrvwJowa aNV Ara 1xLFtJt~tl
-IlR3`~
Rnarcry Jv4r(/ure mkenwnm wM1mpunrp mmw offf (xmerlrvermemurN/ xvll
rvrver lex(l
A•
y
Trine WMn Level Tine W,Im Level Tine Warc level
Dde orlN
a JnwJown aflvbn
tlsrlp mlgal/mrn mm li ill l L
__
grrtnl yl/mm wnh Hen an at R 6t Fn
pnm.n flaw spin Dalt
_.
nuurt ofwaae WasncAem¢ul enalyan rwJe" QYe QNo
Tem
i Skit Dak Compkle O Dale
WELL CONSTRUCTION CERTIFICA9'ION: 1 constructed and/or adept responslblhry for constmcnon of this well, and ns compliance with all
Washington well cpnsmscnon Skn and Malarrals used and the mfomtaaon repvncd above are t e m my best kn wl a and bdmf ,r
pnnenersmar(mrrr~ rv,ra(Padl pnnrng crenpany (-~
Dnliv'FnB'nxN(rvrnee 9grm AJJrw
Onllerorrmm¢Lrtrnw NO Crry. Amq Zq ~
IITRAINHE, LmMCmi
DnNn4litrua Ne RegrNan pae~
n,Ad'[Sr{ntlure ~ologY^%'E9ml PPOwmry EmPloYe ECY USLLI-N IRty ]A))
F11B1 OrSg. i PI[et Copy - pept o1 BCOlogy MATBR YHLL RBPORT Steil Cartl No. p 0]]91
6ecerN Copy - Moei] TRlzd Cagy - Or111¢ D1 MesWngton
9Lete Bnleae Xell oD }
I Xat
ec Rlght permtt n
Q) OXHBR: None <0.6RTIV8 9gRS Mdree Po p% 1306 EeLM XA 9899] page 1 of
12) LOG14IX1 OP N9LL: Cemty iBV881ON ~ B8 1/6 N8 I/i Sec 36 T 1] N R I 6
12s) GIAE83' ADDRE99 OF XELI. (ai nesreat sMreeel 809 YLLM 'Ve Zef.X YA
(3) PROP086D ll66: A6AXWtl}RXT
(i) Tyla of work: ABANCONEB
McLhW: 110TARY
(5j OSt~}6ION6: Dluoatei of wall 6 inehs.
D[illed 0 feet DeptR c[ cmnpleted xell 0 [t.
(6j <Ox 91RVCTIOA DClAIL9:
CaeLVg tvetldi Oiam. Erm ft. tm ft.
Neltled _ OSam. from ft. to ft.
Liner _ DSc.. from ft. to [[.
Threaded
Pe[EOaticnse Yee _ Po %
xypm v£ perforator aced
81.e oP peilOlstlOne ln. by lo.
perforetfom £x® ft. !e In.
perforaticne frw ft. to in.
pei£oretlam frm f[. to lO.
Bczeena: T _ po %
Nenufenture••e Name
Type Xotlel xa
Dian eloL are frm Si. t0 [t.
oam 63et uae frm lt. tc St.
Gravel pcked: Yea _ No % cis cf gzevel
travel placed Fran ft. to £t.
9uif.cs ual: Yae xc % TO that tlepth] £t.
xat.rial we.a i seal
D;a any .bola anntam nnn.abl. rater r.. _ m :
ryp aE xfter} ppth of etrate
XetTatl of eeollnq a za< oLf
(]) POXPi Mamlmtuiez'e N.me
Type tl.P. 0
IB) NATCR LEVE}i: 8uzfece plw eDOVe ma a level
a Et.
cf roll wte
Static level ft. Oaw top
Artaeim preaeab lhe. paz eq. in. Da4
Attaetan preeeuce 1e cantcolled by
(9) NBLL T&fiT6f Pump tee[ made] By rhae]
Yield 0 9a1./min. XSCR £t. drawdan sfGr
field 0 gel./min. ri[h ft. dreMwn sfter
zleld 0 gel./min. rith ft. tltaWwn after
Recovery de[e:
Time R[r. Lvl. Tame Nt[. Lvl. T1me N
(l01 NA.l IUO mi OHLtlMMIBBIONIXp PRCC80VRL DG6GIPTIOX
x.btia I Prm I Ta
i
ABRXBOR 99PI. OBBP N61L fMX ORApE
XELL XAB IN A VRVLT BPT BHLON ORApB
A BifIB XA8 NBLD&I1 ON 'LV BIIBTIflO
CblNp. VAVI¢ NAY ERCRPZLLCO 8Y I I
NBMNBR. ALL ABRNDOXBD B4 GBLLINO
NOLH NI Ttl BBNNXSTL 40.0UT AXO PVItING
CMIN4 OBT.
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Xoik BCUYetl 03/39/96 <®pletetl p L39/96
Rcel X6LL MXB3RVCICIR C[RTIPIGTION:
Riel I r mtiuated av0/or a rapt ropumibility £ur canetructien
I CRfe wll. sntl lte compliance with all Nul:ington xell cnnnt
tc La1.I zvctlon eLntlards. NeNiiaL •M antl the infarnatim report
O Bae1d 00 fBlm 8CL 050-140 (S/9](•K-1JJ9- by Speed Pyetmae CU
I alava ¢e trve tO my beet knoNletl9e and OeL1ef.
Nome R[C&1NMON XSI.}. ORILLIXG
MdIDee P.O. Box iU2] Tecane X.A'~,9~8/IiC
Ri (8lgnedj ~'L'/]f 'r-~ Llc. No 1HV
R[e (Nell Bri eq
<mit[ectoi'e Reglstzatlon Xo. 0.ICXAN•]310B a a Ol/OS/
Oate of teat
Bailer teat 0 gel/ma Xith ft. tlzeudvm atbr
Airte.t 0 9a1/min vitl: etea set et Fc £ez
Azteeisn flvv 0 9a1/min Dab
Tempaiat V:e of Ate[ Xav cpemical enelysie made] N