5-Nearby Well Logs.pdf

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File Or,g,nal llnd Fire! Copy with Depar1ment of Ecology WATER· WELL REPORT

O 71./ .J. s- 7 Star1 Card No. _____________ _

Second Copy-Owner'a Copy Third Copy-Driller's Copy STATE OF WASHINGTON

{1) OWNER: Nama_--1l ... S.u.l__:J=-......,,,C:.c:,,,( ____ g.,L..;_.q+Ja-..........:.1=~ ...... rt"-'------- Water Rlglll Permit No. _____________ _

18'.722 ~c;;;~ ;;;I Aef

(2) LOCATION OF WELL: County_~--~=-"-=---=--7""""'"----=:=r---.-- 3 '6 "-,1(0...L.~ T.-R-,. .. R ___ w.M.

(2a) STREET ADDDAESS OF WELL (or nHrHI addreH>--L-....!11!~_..!.....$.. ____ ~:;ur:Lo~o.i..t.:::!~--=--=-L..--.JC.......1....;=-~--------

(3) PROPOSED USE: B""Domealic Industrial D Municipal D (10) WELL LOG or ABANDONMENT PROCEDURE DESCRIPTION □ Irrigation Cl DeWater Teat Wall □ Other □ Formellon: Describe by color, charecter, aize ol m■terlel and alruclure, and ahow thlckneea ol aqulfara ■nd the kind and nature ol th■ material In HCh atr■lum penetrated,

(4) TYPE OF WORK. Owner' 1 number Of wall with el leHI one ■nlry lor ••ch change ol lnformallon.

• (II more then one} .-

Abandoned [J New well ~ethod:

. MA!]IAL fROM TO

Dug □ Bored □ ------- ------ --- -- ,-57 - Deepened □ Cabla V Driven □ r"'\.; d.J J '(.,., .. 0 Reconditioned 0 ., Rotary Jetted □

I

(5) DIMENSIONS: Diameter of well t;, inches.

(.,.,A./ t:fA ... / 15< 5(:0

- \ I i

Drilled teat. Depth of completed wall ft.

,.. I ' sL.lc I ~'f:--~7!.frY- K'O I "i?'S

(6) CONSTRUCTION DEblLS:

t)l , I+< 'i Y -""'( v-'r'< 0 ft. to srs-r,E,-+ Caelng lnet•r · Diem. lrom ff. 6-114,,,..f, •--

Welded . . Diam.from ff.lo ff .

Liner inatelled Threaded □ . Diam from ff.to ff.

Per1'oratlone: YH D No[iJ/ ---~- ----- -----~- ----- Type of pertorator u .. d

SIZE ol perloreliona In. by In.

per1oratlon■ from ff.lo ff.

partora!lona from ff.lo It.

par1orallona trOJII It. lo It.

Screens: YealJ No[J./

Manulaclurar'a Name

Type Model No.

Diam. Slol alze lrom ff.to ff. -----~---• Diam. Slotalza ..,,om It. to It.

Grevel packed: YeaU No CYs"ize ol gravel

Gravel placed from ft.lo ff.

Yea~NoD T~al de'% ft' Surface •••I: ff.

-e',s, 0'"'1 • ✓ -c:.. Material uaed in aeal

Did any alr■I• contain unua■ble water? v .. O No~ --

Type ol wat■r? Depth ot ■tr■IA ···-- - +-----llilelhOd 01 ·••ling alr■la oH ·-f-------------

Manulacturt. Nema ,; / 14 - If::. I f C ~---(7) PUMP: n..-, Typa: <1, ..,"'ly,rc,; I~{.,, H.P. J U~\.t .:,

(8) WATER LEVELS: Land-1ur1■ce ■lev&llon ,...,. t--..-. r,r r- • . -above me■n a■a lav■ I - n. ........ 1- u, Lu·;Lu~:r

Static level 3 >' ff. below top of wall Date :2: [f,.,,- ~o Artaaian preaaura lbe. per ■quue Inch D•te --~~---

Ar1a■ len weler I■ controlled by {~p. ,11,e, .ic.l!

/-I~ ~- lb • 19 Cj; Work ■l■rtlld , 19. Comolated

(9) WELL TESTS: Drawdown I■ •m~ar level II lowered below at■tlo level

Wu ■ pump teat me.de? v■1D No II ya■ , by whom? WELL CONSTRUCTOR CERTIFICATION:

Yield· gel. I min with ff. drawdown ■Her hra.

I con■tructed and/or accept reaponaiblllty lor construction of thia well, " " " .. and 1111 compliance with all Washington wall conalruction atandarda .

" " " .. Materlals uaed and Iha information reported above era true to my beat ------knowt•ind belle!. Recovery data (Um• taken H zero when pump turned all) (w■t■r level meaaurad foe lrom well top to watar level)

NAME ""-0 t,R.4()11..1)2~ 'l l,~J.f. Time Water L•v■ I Tim• Waterlevail 111111 W■l•L-

(PERSON, Fl~. OR CO'lbAATlON) (TYPE OR PRINT)

74 fJ,- ..lo-{ ,1G Ae/. Addrea■

Date of teat .P~L License No . L-:36" (Signed) 2 Bailer teat gal. /min. w"h ft. i"'down alter l'lr■. (WELL DRILLER]

3c, d, Contr11ctor'a

~I Alr1e■ t g■ l.lmln. wlll'I elem ••t II f ff. lor hr•- Regi~tlon ~ £Jc 137 (c 32:?. 19 70 Ar1Hlan flow g.p.m. Date « No_"f,,C, O< Dale

Temperature al waler __ W■■ a chemlcel anelyele made? Yea [i' No 0 USE ADDITIONAL SHEETS IF NECESSARY ECY060-l-20 (10187) ·1329·

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31/1:' Frle Onl(in~I ~n,I F•r~t C,,p.,· with DcµJrtmenl of 1-:Poiol(;,· Second Copy - Own~r·s Copy \\''ATER WELL REPORT A1>µJn:;,tio11 Nu

Third Copy - Drtller·s Copy 8 TE OF WA ____ -·-- --·- --· _ TA 8BINGTON Permit No

(1) OWNER: Name.P.E.:~:MER M. McMAH.0.!i' ................................... Add~JJ2.?.<?-~ ~4. H.~ ..... Arl.ins.~.on..1. .... W..a•. 9.~?.?:3-.

(2) LOCATION OF WELL: County..... . ............ ................... §J.l:~~.~~~.:11.!J: ................. - NE .. \~ .. NE:.,,, Sec .... ,?O T.31 .. N .. R .. 6-.E! W.M.

{3) PROPOSED USE: Domestic llX Industrial D Municipal D (10) WELL LOG: --'---'-------------------------- Irrigation D Test Well D Other O

(4) TYPE OF WORK: l'wrier·s number of well 11[ more lhan one).... .. .7..9..?.9

New well I Method: Dug □

Deepened D Cable D Reconditioned D Rotar:llXX

Bored D Driven D Jetted O

6 Diameter of well

..Jnchl!I.

Depth of completed well... .. . .. .2 ......... ft.

(6) CONSTRUCTION DETA~:

Casing installed:~ 5./Smam. from ...... t.l. tt. to .... .5..1.. .. ft .

Threaded D Welded JJ

......... " Diam. from ............ It. to ............... ft.

................ " Diam. from . . . . .. .. It. to .. . ........... ft.

Perforations: Yee □ No II Type of perforator used

SIZE of perforations ........................... in. by ......... . ................ In.

........ perforations from .. . . ........... fl. to ....................... ft.

........ perloraUona from .. .. . ............. ft. to ....................... ft.

............ . ....... perforations from ... .. . ........... ft. to ........................ ft.

Screens: Yes □ No m Manufacturer·• Name

Type...... . ........... ••············· ···························· Model No Olam. . .......... Slot el-z:e .......... . .. from ......... ft. to ............... ft.

Diam ..... . Slot s lze .. . ........ from . . . ..... .. .. .. ft. to ............... ft.

Gravel packed: ve9 □ No i!J Size of gravel:

Gr~vel placed from ................ . ........... ft. to .. . ....................... fl .

Surf:a~e:i:~!~e:etn~al. N~ ... ~P~n:t~~.f..r.~~~ :···: ·:::::.:?::~::: .. ~:

Did any strata contain unusable water? Yes D No Im Type of water?.. . ........................ Depth of strata

Method of sealing strata off

(7) PUMP: Manufacturer·s Name .. ......... ....... ... .. •

Type: ................................................................................ HP

(8) WATER LEVELS• Land-surface elevation 290 1 9

, above mean sea level. ... ·,··ot"l··l"7~· Static level ....... .. . .. . . ........ ft. below top of well Date .......... ..!.!. .. J Artesian pressure .. ..... .. ........ .. lb1. per square Inch Date

Artesian water Is controlled by (Cap, valve, etc.)

(9) WELL TESTS: Drawdown Is amount water level II lowered below static level

Was a pump test made? Yes D No ml If yes. hy whom?

Yield: ___ !lal..:./.:::m.::r:....n:.... . .::w.::lt:.:.:hc__ ___ .:..:rtc... . ..:;;dc..rac..w_d_oc....w_n_a_ftc.:.e:...r ____ h_r_a.

Recovery data (time taken as zero when pump turned off) (water level me,.sured from well top to water level)

Tune Water Level Time Water Level Time Watirr Level

Date of test aiJlnller test ........ 8gal./min. with .. -31 ..... ft. drawdown atter ............. t .. hn.

;;;;~ar:t~~: of ·~~~~;: ::s.2::····~il$··~··~::~~~11ID:;~·;~;~ ·~~;~;··;;;;;··□···;;

FormatJon: Describe b1,1 color, character •u-e of material and structure and allow thtcknHI of aquifers and the kind and nature of tlie material In 'each lt1'atum penetnited, wfth at le111t one entl"II Jo1' 11ach chanae of fonnatton

MATERIAL PROM TO

Soil brown 0 ,-~3 -------- -- --- - -- -- -•L ·-

IXIJXV'lttI•X¥1£Mf

Clay _brown san<!x_ __ ~-·---- -r---3- --- 24

Clay stone gra;y ---- . - :-_2-~ =-~.~35..

Clav arav sandv 1c; .Jif Sandstone Q'ra_v coi::irse L.1 -i;s r----

-- 1------ -

,-----·-~1=- -

----· -- - ------II.'---:-;-- •• ·-, --- - - --- - - -----

eef 2, --- - - .- ~/q

----~- ---9£;-,, - ---ur C(. ~LOGY

1013779 10-nncr. Work 1tarted ............... .................... , 111........... Completed ..................................... 19

WELL DRILLER'S STATEMENT:

This well was drilled under my jurisdiction and this report is true to the best of my knowledge and belief .

JANNSEN WELL DRILLING NAME

(Per110n. ftrm. or corporation) (Type or print)

430 West Ave. Arlington, Wa. 98223

:::;::•~••:w;;;;;,;.i:::::::::::·::············· (Well Driller)

1060 10/10/79 License No ............................................. Date ............................... , 19

(USE ADDITIONAL mmrrs II' NECESSARY) fCY 050-1·20

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J1jo,--17,e, File Original and t'lrst C"1>.1· ,,, 1tl1 Dep,,rtment or F:~olo~y Second Copy - Ownn·s Cnp~ Third Cllpy Dr1lln's Copy

WATER WELL REPORT

STATE OF WASBINOTON

Applic;iUon No.

Permit No ..

(1) OWNER: Name .. □□ r.i ..... l:iut1:;e.r ................................... Addrt!III J!;;l.?.;;:.0 ... 1 . .0.Ei.1;.h ..... N.J; ... A.rl i.nGto.n.,. WA .9.6.Z~.3

(2) LOCATION OF WELL: County. Sm:iho.mish ················ Jc- .. ~ • .. .r.-"::-\, ~c. /.7 T..J'.IN, R .. ~ .. W,M.

E\e.11"111g and distance rrom sectl<J_~r .subdivision. corner. ____ _

(J) PROPOSED USE: Dom<'5tic- 'J{. Indw;trial 0 frrigatlon D Test Well D

Municipal D

Other 0

( 4) TYPE OF WORK• Pw11er"s number of well

New w~ll l!f rn;f th~:::':J: D~g O ... ··Bo~~d··· □ Deepened D Cable D Driven O Rl'condltloned O Rotary'J( Jetted O

(5) DIMENS,ONc: Diameter of well .IP /I !Jlche■.

Drllled. . .'i . . ft Depth o[ c-omplete-d well... . - .. ~ .... ft,

(6) CONSTRUCTION eETAil.S:

Casing imtalled: .. . . . . ... Diem. rrom O tt. to ... I..~ .... ft

Threaded D .... ·· Diam. from . . ... ft. to ............ ft.

-~•"lded ,£ .. . . ..... " Diam. from .. _·_···_· _n_._to_._· _···_· ._ .. _._·_ft_.

Perf:::!i:~;~rf~::~ use:.°. □ ~~'!··L . .f.. J.'.._~ ... :- SIZE or perforations ........ - ... .:1,. ·;;,. ' by . . .... 1/Lw••··· in, . . perforations from . .K . .... ft. to ... /¥. 'ftt,. .. ft.

. perforations from rt. to . .. . ............ ft.

.. .... perforations from .. ft. to ...... ..... ft.

Scree-ns: Yes □ No){ Manuracturer·s Neme. .... ..... . .......................... ,. •·······

Type ........... . . Model No

Diam .

Diam ..

... Slot s,u• ... . from ft. to ... .. . ....... ft.

Slot sile .. .. from .. . . ... ft. to ........... tt.

Gravel packed: Yes □ Gr.,vt>I placerl from

No i)r Size o! gravel, . ft. to

Dlct any strata contain unusable water? Yes D

.... fl.

NoJ( Type of water?.. . ................ Depth or alrata Method of sealing strata off . ... .. ... . ... . ............. ,

(7) PUMP: Manufacturer·s Name

Typt,: . .... H.P

(8) WATER L~ELS· Land-surfac" elevation

• above mean sea level .. , , -J-/ ."E, .. 1·A-

Static lr-ve\ ... .. . ... ft. below top of well Date r-::- ..... -::a .. L.

Artesian pressure .... .lbs per square Inch Date

Arte~ian water Is controlled by ...

(9) WELL TESTS: Drawdown Is amount water level Is lowered below static level

No )l" If yes, hy whom? ..

ft. ctrawdown after hra.

Was a pump tr-st made? Yes D Y,elct __ . ii:~.!_'1!.!_n_:...""lh. ·--·--~-- ~--~-----

Hr-covery data (time taken as zero when pump turned olTI (water l■vel measured from well top to water level I

T,me Water .~~~el. I .~.•~·~····· .~.nt.cr Level. I ... ~i~~:··:: ::~:~:~~-~:·~~~~:'.::

. -. . . . . . . . I . . .

Ua re of test/_ . . ... . ... , .,., Bailer te~t .. ~ 11al./mln. wtt.h. -F 0. .. . n. ctrawdown after .... ..... ..... hn.

Arte-sian tlow. ... . ........ r.p.m. Date

Temper.ituJ"e of w;,tcr Was a chemical analysis made? Yea O No J(

(10) WELL LOG:

Formation: De1crtb1 b1,1 color, character rize of matenal and 3truc1Ure, and thow thlckneH of aquiJers and the kind and nature of th,;, material In each •tratum penetrated, wfth at len.,t one entrv for each ch.an"• oJ formntl~~:

MATERIAL

Dirty Sand &Gravel -□·eirk s·ra-c1<_s_a.nc:fst □ne·- --

FROM TO

0 11 11 50

~-----5..and.s_t.c_ne .. _ -~ __ ,____...____..........,.____ . .Park B 1 eek Sandstone _ __§_rei Soft S~_d~_!:;~ne -~----

--water _ _J,..~.st 60 l~g -r·tf~~ 15"S- .

ated li04r

' - -------t

' .- - t

~J ___ _ I

I

4-6-87 Worlie ■tarted .................................... , 111 ....... ... . Co~~le\ed .... '.4 ~.? .. :.~.? ... , ., 19~

WELL DRILLER'S STATEMENT:

This well was drilled under my jurisdiction and this report is true to the best of my knowledle and belief .

NAME ... O.AHLMAN .. FUMP ... & .... W.E.l..1.. .... 0.RIJ .. L.!.NG •· lNC:.,.

<Peraon, llrm, or corporation) (Type or print)

License No,06.23 .......................... Date. 4.-.8.~.87 ....... , 19 i t•SE ADDlTIONAL SHEETS II' NECESSARY)

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-31 / ~ ·- daA- File Original and ~•1rst Copy with Department of Ecology Second Copy - Ownrr·s Copy Third Copy - Driller•~ Copy

WATER WELL REPORT

STATE OP WABBJNGTON

Appllcatlon No.

Pennit No

(1) OWNER: Name . £..J..

(2) LOCATION OF WELL:

~e_ .. ring _a_11_d dlsla~,;:e_lrom section or subdlv1~ion corner __

(3) PROPOSED USE: Dome~Uc ~du.stria! O Mu.nlcipal □ lrrigatlon D Test Well D Other D

(4) TYPE OF WORK: Uw11er"s number of well '.:l- New well llf m~:;:«:i:" D~ ···· ·~o~~d·· ·□ Deepened D Cable D Driven D Reconditioned D Rotary D J'etted □

Diameter of well .. . S. .'2 ........ inches.

Depth of completed well... . . .3 Y. .......... tt.

(6) CONSTRUCTION DETAILS:

Casing installed: .~b .. " Diam. from .,.f! ... tt. to .. '/.?... tt .

Threaded OC\,ltJ. 3-o ... " Dtaro. from ~.J ... ft. to ... !;r."...1. ft.

Welded 0 ....... . .... " Diam. from . . .. .. . .. ft. to . . ........... n.

Perforations: Yea ~ No □ (" Type of perforator uaed ......... &. r ~ . .f..1 l~r·············· SIZl!: of per1oraUona ........... ib..... ........ in, .by ..... 7-........ c--·· in.

.. . . . . . ... perforation■ from ..... "I :l..--:z_. tt. to .... fl. .J. ....... ft.

...... perforationa from ....... . ........... ft. to ....................... ft.

.. perforation■ from .......... . ....... ft. to ....................... ft.

Diam. Slot size . .. .. . ..... from . . . ........ ft. to ............... It.

Surface seal: Yes ~No □ To whet ~epth? ..... ./.f,':.. ....... n.

Material used In seal.. ~hc..Y'e,.,f-.~ Did any strata contain UnllBable water? Yes D No Type of water?............. . ............. Depth of strata

Method of sealine strata off

(7) PUMP: Manufacturer·s Name ...

Type: ····················· .................................... H.P

(8) WATER LEVELS: ~~1;;-•~r::~e.!~e1;!~~~ .... :7'0.~···a.7 Static level J ~·· ...... ft.below \op of well Date J.D. .... {.~ Artesian pressure lb■. per square Inch Date .. .

Artesian water 18 controlled by (C■p. v■lve. etc.)

(9) WELL TESTS: Drawdown ls amount water level I■ lowered below 9latlc level

Was a pump test made? Yes D No &-r,-":,-es. by whom? .

Yield:_. _ -·· gal./min. with -----'f-'-t._d_r_a_w_d...co_w_n_a_ft--'-e-'-r _____ h_r■.

Recovery datii (time taken as zero when pump turned o!fl (water level measured from well lop to water levell

Time .... ~at~.~ .. ~~~e.' .. 1 .T.t~·~····· .~.at~~ .. ~~~.el ...... ~~=~···-· .. :~.~~.~ .. ~:~.~ ..

Date of test

Baller test / 0 A.rte■l::m flow

. ·1··· ·········· ................ ···• ......... •·······················

.......... 1 ... ••··"·········· ··········--------····-• gal./m!n. with. '? .tt. drawdown .n.er ..... / ... '. ....... hn.

.. ... . ...... r.p.m. Date

Temperature of water .. Was a ehemtcal analysis made? Yes □ No

(10) WELL LOG:

Formation: Dettribe bl/ color, c/1.aro.et■t'~ me of material and ,tn&emt'■, and 1/ww t/1.tcll:neH of o.q1dftt'1 and ttw ktno. and no.tut'lt oJ t/1.c mo.terlal '" ecaclt nn1'1&m ~tro.ted, toft/1. ac lccaat on• entn, /O'f' 11ac1t clto.ng• of fon11Gtlcm.

MATERIAL FROM TO

-----• L" 5. ~.J '.-ri .::;,----·- z:i.-., Work lltartld. ..... ;!..t. ........ ~ ....... , 111... ... ~ Completed ... ./.(;.J. ........ , .......... lll .. 0 .. {

WELL DRILLER'S STATEMEN~

This well wa■ drilled under my jurisdiction and this report is true to the best of my knowledle and belief .

NAME.A.v..k ...... hlc...ll. ..... D.17 . .)..I.~~- (P-n. ftrm, or corporation) (Type or print)

Addre11 ... /D.~k . .J .. ::) ....... ko .. -:/..>::: ...... d/.w..{~.f.:l

[Sli1led]~ .. ~i·····"································· cense No .. J~tJ... .. J ................. Da~ ...... /..~ .. ~ .. , 19~7 [USE ADDITIONAL 9111:rrs II' NECUSARYI

ECY 050 I •20

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FIie Original and First Copy with Department of Ecology Second Copy - owner's Copy WATER WELL REPORT A1,>1,>IJL·dl1on l'Ju

Third Copy - Dnllcr's Copy STATB 01' WASBINGTON Permit No ---

(1) OWNER: Name ........ d. (r..'./1,, .,.,,., ... 5 .(v.v'•' ... ~~~ .............................. Addreu ...... ./1,~.j,·;,_,: .. T&~: .......... .// Ir

(2) LOCATION OF WELL: County ... ) /v,/ .. 11 .. ~ .. ~ ... ::.,. .... ~! ...................... " .Sh.t..~ • . ,Sc:~ .... ~~ Secl.6• .. T. Jf..N., R.6.:t.i...w.M.

~~ring And distance from section or ~~~i_y_ision c~ ~ ·-

(3) PROPOSED USE: Domestic 'if Industrial D Irrigation O Test Well D

Municipal □

Other D

(4) TYPE OF WORK: Owner's number of well 1 If more than one)

New well til' Method: Dug t1· Bored D Deepened O Cable O Driven 0 Reconditioned D Rotary D Jetted D

(5) DIMENSIONS: Diameter of well ..... ]Ji!.... .. .. lnchea.

Drilled .. ')..'> "" .... rt. Depth of completed well... . .................... .fl .

(6) CONSTRUCTION DETAILS: 41""_,.7_ ~

Casing installed:

Threaded D Welded 0

. " Diam. from .. ...... ft. to ............. ft .

.... " Diam. from ....... ft. to .............. ft.

...... " Diam. from .......... ft. to ............ n.

Perforations: Yes □ No ·fit Type of perforator used

SIZE of perforations .. ..... ............... . in. by ........ . ...... in.

perforations from . . ... . . ...... ft. to ..................... ft.

........ perforations from ... .. .. .. ....... ft. to ....................... ft.

..... perforations from .... .. ....... .. .. ft. to . .......... .......... ft.

Screens: Yes □ No [j' Manufacturer's Name Type... ..... ...... . ....... ....... .. ..................... Model No D1arn. .... . .... Slot size ........... from H. to ............. ft .

Diam .. Slot size .. ...... ... from ........... ft. to ............... ft.

Gravel packed: Yes .Ill No □ Gr~vel placed from .......... / .b:· ..

Size of gravel: .. J,.(..J- .... ft. to ....... ?. . .5.. . .......... ft.

Surface seal: Yes~ No O. Ty-hat depth? ................... ft.

Material used in seal . .J;. •'· ; ~ f.,:,, " · T" Did any strata contain unusable waler? Yes O No I)!"

Type of water?.. ..... ... Depth or strata

Method of sealing strata off

(8) WATER ~VELS· Land-tiurface elevation ;· C LJ.

• above mean sea level. . . . .. .... .,J.... .. .... ,.

Static level ... . b .. ...... .. .. ft. below top of well Date. :7.~./ ... : .. Ji Artesian pressure .. ....... .... ... .. .Iba. per square Inch Dau

Artesian water Is controlled by (Cap, valve, etc.)

(9) WELL TESTS: Drawdown Is amount water level l■ lowered below static level

Was a pump test made? Yes D No r,J If yes, hy whom?

Y_i_eld_:_. ___ gal /min. with ____ f_t._d_r_a_w_d_o_w_n_a_ft_e_r _____ h_rs.

Recovery data (lime taken as zero when pump turned off) (water level measured from well top to water levell

.. ~•~e ..... --~a.~~.~ .. ~:~e.~. ! ~.~~.~ ...... ~.~~~r .. ~~.~-~.!.. .. .~'.~~···· ... :~.~~.~ .. :~.~·-

.: .. :: ::: : : .: ··:: ::: : ::: :::: J .. ::: ::: : : . : : : · ·::: ·. :::::: ·:: ::: · ::::::::: :: ::: . : : : ::: :::::::::::::·: ::::

Date of test .. .. . . .. ..... .... . .. . .,I...

Baller test ... ./., gal./mln. wtth.... Q .. ft. drawdown after ..... d ........ hrs.

Art.NI.an ftow... ..... ..... ........ ..... ...... ...g.p.m. Dale ................................. - Temperature of water.... ....... Was a chemic'1.I analysis made? Yes D No 0

(10) WELL LOG:

Formation: Describe bj,! coloT, character~ size of material and structuTe, and •hola thl.t'k11eu Of aqu1Jer-11 and tile kina and =tur• of the material in •ach ~m penetTated, wtth at least 011e e11t711 JOT each chan11e of formation.

MATERIAL FROM TO

'> -·--·--------,------- -- --------t--~---

-----•·-------------------j----j:----

~--~~~.~~-.~--_----:_~=-·-~--------_J~=-=:

Work •t.art.ed ..... ,S..~J::'..-:< .. ):.( le .. J.'J. .. Completed ........ 1'.~/7 ... L .... 19cJf...

WELL DRILLER'S STATEMENT:

This well was drilled under my jurisdiction and this report is true to the best of my knowledge and belief.

NAME ..... 4-J./(i'_t/~> ........ &/((_ ...... !1.oQ!.c..o ..

(Penon, ftrm, or corporattonf 7"" (Type or print)

Address .. :2.J.L-.~.(: .... :fJ.&.J ...... 13:Y.!. ....... ~ti. ...... k.-..-..¥.::.'.: .~.t..<:<.-;

[Signed) ....... /·-::/. ... <. ..... .<:,;a....-..:=:

(Well Driller)

License NO.f!?.'i. .. ) ....... . . ... Date ..

(USE ADDfflONAL SHEICTS II' Nr.CESSARY)

ECV 0!I0-1 ·20

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I-

31/~/1-=1- Fil• Original and Flr■ I Copy with Dep•r1ment ot Ecology WATER WELL REPORT' Slert C•rd No. 0 /St 7 9 Second Copy-Owner:• Copy Third C-Opy-Driller'a Copy STATE OF WASHINGTON

W■l•t Right Permit No, ____________ _

( 1) OWNER: N■m■ .....,,,-..8...,,'--... b;"-"-',f:.,_,=--S:..__ __________ _

(2) l.OCATION Of WELL• County ·--- - - - ., (2a) STREET AODDRESS OF WELL (or n-■r-■ t addrn•> JC, s-o ~ - F'J. ') ,1v-( /41l /:Jn/, ·,, . I':.;., .

J

(3) PROPOSED USE: ~ Dome~tic lnduatrlel D Municipal D (10) WELL LOG or ABANDONMENT PROCEDURE DESCRIPTION D Irrigation [J 0eWater Taal Well D Olher 0 Form■liOf!: DeMlrlbe by color, charac1er, ■lte or mat■rial ■ nd atructur■, and ■how tnlcknHI ol aquifer• and the kind al>d nnlur■ ol th• l'll ■ Jerlal in ■■ch 11ral11m p■n■tralad,

(4) TYPE OF WORK. Owner'• number 04 well with ■t 1-■al on■ entry lor each chenoe ot information.

• (If mo,a than one)

IIATERIAL FROM TO

Abandoned LJ New well ~ Method: Dug ~ Bored □ - T-- "' ... -~--~~ ;r ,-- - ···--·- ---- Deepened Cabla [] Driven D 0 I' Reconditioned 0 Rotary D Jetted D 5·,;.,.)d "" c i l'4 v. I' 7'

(5) DIMENSIONS: Diam et or ot well inche&. '$ ,,,., " ",·..,,1.., .. 1' " , 10' ~J.,,,.,,, {l_y, l\'

' 'J " Orillad leet. Deplh of completed well ft.

(,.....,,,..,(/ ID

~' A't:lf~. ~ -(6) CONSTRUCTION DETAILS: l(f\.i( v-~- :1,~1 bft~y §1-1q~ _TUJ __ __ J_t ~o~_ -CHlng lnetalled: · Diam. from II. Co It.

n >--··----- " ---·~······ - · -- -·-- - -- --- ··-W■lded . Diam. from ft. 10-----"· liner lnatalled B Threaded Di•m.lrom It. to It, Perforation•: v .. O No!xl -··- ---- -----· -· ---- ·---·--,_. ____ -----· Type ot perforator uud

SIZE of perfor■tiona In. by In.

p■rlor■tlona from ft. lo It .

perlor1t1on1 from It.lo It.

pertoratlona from It.to It.

veaLJ Nol.lJ ' Scr••n•: A

Manulaoturer' ■ Name _ _ _jJ 1.<..i' ."(.(t<.)/ .V ~ i,h_ J.l& k,' ll~ llnCJ t,-9tJ Type Modal No . ·~ +o tiOo u io<., t- n lk-< l'ia 11t P I')~, r:, JI I 'elk Diam. Slot ,tre from 11. to It. _ f-_ J.~- tM~t:t-4~ i__-f . et. .sJ:1 u .. d: t;;,~u/ uiJl,_ Diam. Slotalz■ from It.lo ti. b.:o U(,., Gravel packed: veal){! NoLJ Size ol gravel "f ~.p') I C>C'l'--C'J\J'r--... , Gravel placed lrom It.lo It..., y81 JXl Na O To what depth? 9 A 111' "I I.

S11rl■c• Hel: It. MUU '- • l:J::1U M■terlel ua■d in ■nl {!~"t.( , ·, ~ Did any ■Irate contain unuuble water? v .. O No~ ,_ ·- - - ·- ·- --·-- Dft>r: OF ICOCTlG'/' ~ · -·-- -- - · r------ Type of waler? nepth ol 1tr■t• -·- - --- --- -- ·-•"--•

Method 0111alino et111a oll ---·· - ·- - - ------ ---- - ----- --·-- ·- - - - -- ·------- -·-·· (7) PUMP: Manulaclu,111'1 Name

Type: H.P

(8) WATER LEVELS: L1nd-eur11ce elevation I~> t1bove mHn aH lev■l "· St ■ lic level l Q N. below top or well DIie

Arteal■n preaaure lb ■. par ■quare Inch Date - -- ·-- ·----·- - r----- --- A.rteeien wet■r 11 controlled by lilop, valve. ate.!!

Work alerted 11 ~ -:J.b - "f(J k .. b HI~ '$, Completed

(9) WELL TESTS: o,,wd'i, le •mount w■tar level ii lowered below ■1y1c level Waa • pump tnt made? Vea No D H VH, by whom? 1/DlfJA WELL CONSTRUCTOR CERTIFICATION:

Yield: --Stl.-. gal, /min. wllh ... .l ft. dr,wdown ■her ~ hr■.

I conatructed and/or accept ,eaponelbillty tor conetrucllon of Ihle well, --·--··- -·-- --- . -·· -· ·- ·--------··--·- - --~----.. U II ti and lta compliance with all W■11hington well conatructlon atanderds. .. .. " .. Matetlale used and the Information repor!ed above ere true to my beat - ·--·-- knowledge and ballet. Recovery d■ta (Hm• tak■n a■ rero when pump turnad off) (water level m111ur•d lrom well top to waler level)

WOIOT L...-11 AOk' I ~J W-t II Dl ... ~/M<;. Ttfno We1erL1vtl r ... W■l•rLt'ill TIIM

NAME

lP~RSOf!, FIRM, 0A COf!PORAT..,,., " J (TYPE OR PRINn

JI 01.5 "'q ~ I\ ,ti-I, II. I; . fl p ), 'Ni'a·-, Addreae

Oat ■ of teat &""'1. (M_~~-. 6. t? (Signed) LicenaeNo.

Bliler IHI gal.I min. wllh N. dr■wdown attar hr■. !WELL DRILLER)

Contractor' 11 AirtHI gal. I min. with •••m HI at N. ror hr•.

Regiatralf°" i l A.:1..-- Ii"-' C. a.J. ?' Date , 19/(., Artear•~ now g,p.rn. Oat, No.JU) J,(/1.J ~ ) , l Tamp<1r■ture or water __ Wu• chemical an■lyale made? VH E(l No□ USE ADDITIONAL SHEETS IF NECESSARY)

Department of Ecology

SEP 2 7 2022

Well Tagging Forrn .· .

DEPA RTMENT OF

ECOLOGY

8 p K 3{) 7ater Resources Program

Unique Ecology Well ID Tag Nur:nber: _· _· _____ _ State of Washington

Use this form only if a well report is found.

Attach original well report to this form. If a well report is not available, contact the Well Construction and

Licensing Office at: wclo@ecy.wa.gov or 360-407-6650 to request a Well Report for an Existing Well form.

Well Ownershi First name Last name oA - - ~ . C)L-l~kf\ 5

Ci Statw+-

Well Address

Count3 n £'.> )--, L> nl I s1J Section Township Range

11 3 ('.')(p N ' EWM or D WWM (check one) Latitude Degrees ·Tax Parcel Number

Longitude Degrees

810 fo /7f)D4'cJloPC)

/f?re, v Pa rc.e.1 J?efere11ce~;

(__.I 7E 16&1./ol '8CJLJ0O

Report in NAO 83 or WGS 84

Elevation at land surface

Well Characteristics Location of Well Identification Tag L J d h cl-ltd / ~

,--- --- 1- - - ---r---- - -i--- - --, : D l C : B : A :

I I I I I

: E : F : G : H :

I I I I I I I I I I

1 M l L l K l J ·1 I I I I I ,-- --- -~-- ---- 1-------1- -- --- -t : N 1 P l Q : R i I I I I I ·---- --~- -----~---------- ---

Indicate the location of ihe well within the Section by drawing a dot representing that location.

Section Number _rJ_

_feet D meters (check one)

Comments:----- - - -------------------------

Certification: The information reported above is true to the best of my knowledge and belief.

D Consulting Firm D Driller O Engineer 'Ji'Property Owner

Name Drilling Company

Driller License Number Address of person completing this form

Engineer License Number City, State, ZIP

Signature Date Signed

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F,le Original •nd First Copy with Department or Ecology WATER WELL REPORT Start Card No. -

Second Copy-Owner·• Copy Third Copy -Driller'• Copy STATE OF WASHINGTON W•t■r Right Permit No. _3 __ l_•-~-=---€ __ ._,....:V/=-_M __ _

(1) OWNER: Nsme __ L~a .. r"-'r.....,_y~F...,r......,.e~e'-'s.._e,.___ _________ ~

AddrH■ 19020-131st Jve NE Jrlingtac wa

(2) LOCATION OF WELL: county ___ ·3~n ..... a ....... h ... a ... m ... t ....... s,..h...__ ___________ _w__,,.__3Li,:, sec 16 T.-}L_N., R--6....W.M.

(28) STREET ADDDRESS OF WELL (or nHreat 1ddrea1)___.s ...... am __ .,.e_,a_sL-a .... b"-'o~Yc...:e,,__ _______________________ _

(3) PROPOSED USE: XI Dome1tic Industrial [] Munlcipel 0 (10) WELL LOG or ABANDONMENT PROCEDURE DESCRIPTION n Irrigation

[l Dewater Test Well [J Other □ F0<matlon: Deacriba by color, cheract■r, aire of material and atruoture, and ahow lhickneaa of ■qulfera ■nd the kind and nature of the materl■ I in each atr■tum panelrated,

(4) TYPE OF WORK· Owner'enumberofwell with at leaet one entry tor each change of lntom,atlon

• (ii more than one)

MATERIAL FAOII TO

Abandoned LJ New well gJ Method: Dug ~ Bored □ --------· -- -- -- -- ,----

Deepened □ Cable Driven □ So11.sAndv () 4 Reconditioned □ Rotary □ Jetted □ IR'"'-rdoan 4 18

(5) DIMENSIONS: Diameter ot well ri inchea. m A_V~bJ ue 18 ~Cj

Dtilled 53 feet. Depth of completed well 53 It. lr.rRve1. AA.nd. sll tv.wet ~i:; c:;~

(6) CONSTRUCTION DETAILS: i----------- -- --- ----------- - ---

6 ,.1 ~a r-------·--· ··- - - --- ---- --- +.-------u------ -- - r---------- --

C•■lng lnat•lled: . Diam. tram It.to It.

IX! r--------~------ ------ ----• --

Welded Diam. lrom It. to It.

Liner installed Ll Threaded [""_I Diam. from II.lo It .

Perfor•tlon•: YeaLJ NolxJ --- - - ·- -·- _, ___ -~-- r------- Type al partorator ueed

SIZE ol perforation■ in. by In.

pertorationa from It. lo It.

p11rtoration1 from It.lo It.

perlor■tione from fl.lo It.

Screen•: Yea~ NoLJ

Ma nulacturer' 1 Name WESCO --- -- -----··----e-----1------r--------- - -

Type ii1 rew:a1rnd Mod11NoSta1nl 19$

Diam. 6 Slot size .030 from 48 It. to 53 11.

r-- -- - --~--- - - - . - -- ~ -- - --

D,■m Slot eiz■ from It.to II.

Gravel packed: veaU No llCJ Size al gravel

Gravel placed lrom It.to It. r~a--•--• .

' - ,._ C.. I ~' t:. u

Surface •e•I: Yea5a No□ To what depth? 11. ..... _ Material uaed in aeal Puddling C] SJ _ r_~o- Z _IL ~~l_ veeO No[jj r-------- --- - - -- ---Did eny at rate contain unueable water?

·--- -- --- -- "!:f rr. o ~ J c1 r----- - -----Type ol w■tar? r>apth al atrat• tL GY___

Method ot aealmg etrata off •---- -- ---- - -- -- -- - - -- - - . - ------ - - ~ --- ~---(7) PUMP: Manutacturer'■ Name

Type:. H.P.

(8) WATER LEVELS: L■nd•■urtace elevation 115 It. above mean aea level

Static level 8 It. below lop al wall Dat•2 S-9a Arte■ian pre1■ure Iba. per equere inch Data --· -

Arteai■n w■ter ;, controlled by !C■p. •••••· o1c.jj

1-22-q2 ?-11-0? Work ■tarted 19. Completed ,19

(9) WE LL TESTS: Dr■wdown I■ amount w■ter level la lowered below Italic level

Wu a pump teat made? Yea D No Iii II yea, by whom? WELL CONSTRUCTOR CERTIFICATION:

Yield: _____ gal.I min. with It. drawdown alter hr1.

I constructed and/ or accept reaponaibility for construction DI thia well. --·-·- --------- --~--~----- --- " " " and ila compliance with all Wa•hington well construction atandards. .. .. " " Material■ uaed and the information reported above ere true to my best

R•cov•ry data (lime taken ■ 11 zero when pump turned oN) (water level meeaured knowledge and baliet.

from well top to water level) Tim• Water L•v•• Tlme Wet•r L•v•I TilN Water L..,ol

NAME .Ace Dr1111ng & Pumf ser:v:1ce [PERSON, FIRM, OR CORPORAll()fj (TYPE OR PRINT>

Addreaa 14503-23rd .lye NE J,rl 1ngtan iiJ Date ol leat

(Signed)~~~"'-'.!. LicenseNo.0697 B■ilarleat 10 gal. /min. with 34 It. drawdown after 1 hre, (WELL ORILLERI

Contractor's Airt■-1 gal. 1 min. wtth atem ••• at 11. lor hra, =~titlk:>s 1 3QllZ 2-13-92 Date ,19 __ Arteaian flow g.p.m. D■te

Temperature al waler _5Q__ We.a a chemical analyai■ made? Y ■a D NoliJ (USE ADDITIONAL SHEETS IF NECESSARY)

ECY0&0•t-20 C•0187J ·1329·

File Original end First Copy with Department of Ecology

Second Copy-Owner's Copy Third Copy-Drlller'a Copy

WATER WELL REPORT Start Card No at: j~[)

STATE OF WASHINGTON 11/ lo/ I 7r Wat,r Right Permit No. ______________ _

._ (1) OWNER: Nema-4LI.L~~-!.L~~i.-...J1:io,_ _________ ~ 0 AddrH•---------------------~---

:rr- (2) LOCATION OF WELL: County•__:=.L.J""-"'<'--L.J'-"0'-'¥)1'--'---'-_,.1'...__\...:..,__ _______ ~-~y.SE_11,, sec / 7 r.3L__N_, I_ If: w.M.

c::: (2a) STREET ADDDRESS OF WELL (or nHrHI eddreH) LBR33 ,..O,,Al,S6N ,e.J_ Ila I.

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(3) PROPOSED USE: OJ Domestic Industrial □ Municipal 0 0 Irrigation D DaWatar Taal Wall □ Other □

(4) TYPE OF WORK: Owner' a number of well (II more than one)

.M Abandoned 0 New well Method: Dug ~ Bored □ Deepened □ Cable Driven □ Reconditioned □ Rotary □ Jetted □

(5) DIMENSIONS: Diameter ol well inches.

Drilled feet. Depth of completed well It.

CONSTRUCTION DE,ILS: ~-::tz. UAt (6)

Casing lnatalled: :3 · Diam. rrom II.to ?cl 11.

Welded □ Diem.from (1 11.lo l'J, II, Liner lnat■ Hed □ Threaded □ . Diem, lrom II.lo H, Pertor■tlon•~ VH D Nol)(]

Type of perforetor uaed

SIZE of perforation• In.by In, perforations from It.lo H, p,rfor■tlon■ from It.lo H.

perforation, from It. to H.

SCr••n•: v .. LJ NoljCI

M■nul■ctur■r' ■ Nam■

Type Mod■INo.

Diam Slotalze from tt. to H, Diam. Slol alze from It.to H.

Gravel packed: v■ab(l NolJ Slzaofgravel

Gravel placed from q

It.lo -1'1... II.

Surface Hal: v .. I:&, No D To ~t depth?

Cf' It, Material u■ad In ■HI Co n C • -< -e, Did any 1trat■ contain unuHble water? v .. O NolJ

Type ol water? Depth ol alrat•

Method of ■•■ ling atr■ta oll

(7) PUMP: M■nuf■cturer'a Name

Type: H.P.

(8) WATER LEVELS~ L■nd•lurf■ce ■ievallon :Joo above me■n ■aa level It.

Static level fl. below top ol well Data

Arta■len preHure Iba, per aq111ra Inch Data

Art■al■n water 11 controlled by !~p. ••I••· •tc.ll

(8) WELL TESTS: Dr1wdD I ■ ■m~~j"' w■tar level la lowered below ■t■tlc level We■ • pump IHI meda? Vea No If YH, by whom?

Yield: g■l./mln. with It. dr■wdown ■Har hr■.

R■covary data (llma taken ae zero when pump turned off) (water level meuurad from well top to water lev,I) Tlma W■t•r Level Tim• W•terLevel Tl.,. W•t•rLevel

D■teofte■t

B■llerl■at 16 gal.I min. with t/ H. dr■wdown alter hr■.

AlrtHI gal, I min. with ■tam aet ■t 11. ror hr■.

Art■al■n flow g.p.m. Dete

Temper■lure of w■t■r __ Wa■ a chemical analy■la m■de? Ye• D No~

ECY 0!i0-1-20 (10187) ·1329·

(10) WELL LOG or ABANDONMENT PROCEDURE DESCRIPTION

Formation: Deecrlbe by color, character, size of m■lerlel ■nd ■tructure, end ehow thlckneH of equlf■r■ ■nd th• kind and nature of the materiel In each 1tretum penetrated, with ■t lee,t one entry for each chang• of lnlormallon.

MATERIAL FIIOM TO

7-c'~ ~-:I -sitr 0 / p,,,. ,R,.~~ ar/Hf'/ / 9 a r--,.,, ,,, J - J..,,.f, "b IC 0 ~ 7_ .

"t:.\.C.1 Y ~u

U\, I IQ a,,£ Utr'I. ur tl,ULUul

Wort ■larted 7- /? • 19. Comolet■d ~- <-")'"' L ,HI.£_·

WELL CONSTRUCTOR CERTIFICATION:

I constructed and/ or accept responsibility lor construction of this well, and lta compliance with all Washington well construction standards.

Materials used and Iha inlormation reported above are true to my beat knowledge end belief.

D,·,,/~ NAME AQk/,4/S,_ t../G'J.. L

(PERSON, FIRM, OR CORPORATION) (TYPE OR PRINTI

Addre88 /letS·- 9911'.1~ >J. {. /l1/

(Signed) /Pd u/~ License No, &:> 6 j 7

(WELL DRILLER)

Contractor's

Regi~o~ No , J /,')Iv l)J '). Jt-Loate ,18 __

USE ADDITIONAL SHEETS IF NECESSARY 0

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OF WASHINGTON

3/-I.E· l7R start Card No. W067946

Unjq_ue Well I.D.I ACP4S7 Water R1gllt Per■it No.

cu MER: VlHCE B. SHOOOERGER ADDRESS; 2915 148th ST. s. W,, LYNHWOCJD 98037 $ SE 1/4 SE 1/4 Sec 17 T 31 N, R 06 WM en ug_L.11JUll!ltL.11.la!A~~JU!.!,tlL...J.!ll.J!ll1ru~c...&i:YIJ:l;i.!il..i.....!..'2'..1'.1~'-lYI....A.YA,_n....,J~~Rld.l~K ill!l!L._ _____________ _

.c ... PROroSED USE: X Dom~sti~ Industrial Municipal C

• Irngation -------=W.,,,_.,at""e,,__ ___ _,.AT..!,!!ES,!..!.T.....!W!.!!EL!=!L,!____~Ot,i.!e!e<.!,r'-'-. !...!' •..!.,•--+ For■ation: Describe by color, character, size of ■aterial and show thickness of aquifiers and the kind of nature of the material in each stratu1 penetrated, with at least one entry for each change of infor1ation.

c (4) TYPE OF WORK: owner' No of Well if more than one: 1 0 Abandoned New We 11.. • .. X METHOD Dug.. . Bored.

~ Deepened..... Caf>le. Driven E R o ditio d Ro x ...

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(5)

(6)

DIMENSIONS: Dia1eter of well 6 inches.

Drill tho COi let

CON~TRUCTION DETAILS:

Diam Fro■ +1.5 Casi~ Installed: 6

Weld Dia■ Fro1 Liner Inst X 4 Dia, From o Threaded

Perforations: NO Types of perforator used

Inches, by Size of perfor~tions Perforations from ft to Perforations from ft to fo t' s fro1 t

Screens: YES Manufacturer's Na1e:WESTERN WELL SCREEN Type: PVC Hodel No .

Diam 4 Slot sjze 15 Fro■ 45 D1a1 4 s ts ze BLAIIK Fro■ 5

Ft To 18.5 Ft To Ft To 90

Inches

Ft To 55 t To 90

Gravel packed: YES size of gravel: 8-12 Gave lac fro1: 100 Ft To: 35 Ft

Ft Ft Ft t.

Ft Ft

Surface seal: YES Material used in seal BENTONITE

To What Depth?: 35 Ft

Did anv strata contain unusable water?: KO Type of water: Depth of strata:

H tho o se lin strata off:

Ft

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(9) WELL TEST~:

Drawdown 1s a1ount water level is lowered below static level Was a pu■p test 1ade?: YES If yes, by who1?: HIMEBAUGH DRILL Yield: 1.1 Gal/1in. with 90 Ft drawaown after 24 Hrs.

Yjeld: Gal/■ in. wjth Ft drawdown after Hrs.

Yield: Gal/11n. with Ft drawdown after Hrs •

RECOVERY DATA

Ti1e Water Level Time Water Level Time Water Level ...

Date of test / / ~iler Test 1 gal/min wjth 90 ft. drawdown after 1 Hrs A1rtest gal/11n with ste1 set at ft for Hrs Artesian flow G.P.H. Date { / Temperature of Water Was a che■ ica analysis made?: YES

AT IA

TOP SOIL 00 02

TILL 02 11

TILL BLUE 11 34

SAND 1COARSE INCHES BLUE 34 35

TILL BLUE 35 45

GRAVEL 4S 55

CLAY 55 62

ROCK 62 100

WELL CONSTRUCTOR CERTIFICATION: '

I constructed and/or accept responsibility for construction of this well, and its co■pliance with all WashillQton well construction standards. Materials used and the Infor.at on reported above are true to the best knowledge and belief.

Na1e: HIMEBAUGH DRILLING - OOYD BIHEBADGH

(Signed} Contract Registration No. BIHEBD099CK

, WA 98223

License llo 1877

Date 07/30/98

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FIie Ortglnal alld Flrat COpy wttll O.,,rtlNIII of Eooloff h-,:1 Co11V-Owner'1 CoPV Third Copy-Dr11ler'1 Cop, i" WATl!R W■LL REPORT y-_~ ·, W' . STATE OF WASHINGTON

Slart Card No. ________ _

~ . Water Righi Pe""" No.-----------~- -~

(1) OWNER: Ne _____ ,,-__,/_l ...a·-+--~---'--· _,("-)..;_J_· --=t:.=-------

(2) LOCATION OF WELL: Countr-~..___._.-._,........,--.."-±'""-~-~.....,.~+-<'T--- (2■) STAEl!T ADDDRl!88 OF WELL (or nHrHI addreu) _ _._.-.... -.-....... "---:....---1-.,_..,_._ _ ___._ __ ..._ _ __..__...._.....,..__'---_____ __._.,_. __ ------------------------------------------------------..... ~---~~~;/ (3) PROPOS!D USE: ~ Domeatlc lnduatrlal O M11nlolp11 0 ( 10) WELL LOG or ABANDONMENT PROCEDURE DESCRIPTION

. 0 Irrigation 0 DeW■ler Teat Well O Othet 0

(4) TYPE OF WORK· Owmer'111Ufflbero1-n

• (Hmore lll■IIOIII) ------------

Abandoned O New well 1i1f Method:

Deepened •□ Reconditioned D

Dug D Cable [!J Rotery D

Bored □ Oflven □ Jetted D

(&) DIMENSION : Dl■met■r ol well ________ r...__lnche■.

DrHled / / feet. Depth of completed well / / / . ..., tt.

(I)

(7)

CONSTRUCTION DE"t.AILS:

c■.ina ln■t■ned: & • 01,111. 1ro111

W■lded § LIiier INl■lled Threaded

Perforation■: YN

--- ' Diam. frDm

• Diam. from t.. l. .. L2 It.lo ft.to

It. lo

T,-pe of perforalor IIHd ---------------

81ZE ol p■rtor■.tlon, -------- In.by ______ p■r10,1tlOll1 lro111 _____ _ It.lo ______ perlor■llonl frolll _____ _ ft.lo

It.to

ScrHn■: YH

Manulacl ' q ' It.

It.

It.

In.

It.

It.

It.

T,-pe __ ...,...,..,... _____________ ,,d,INo /

Diem from I) r; It. to / / J() l ·, J J ,...-, ' . ' :I:; ,,__

D11111. from _ < I • It. I •

Or■vel pl1ced from It,.

Surface seal: Ya l}f !0 • To wh■J d■plh? ___ f--1.__ ___ ft.

M■t■riel Ul■d In ... , '71 I I :tn \ ' I c.,.

Did any- 11r111 11011111n 11nu1■ble water? YH O No 0 T,-pe of water? _____________ epthof ■tr■t._ __ _

M■thoct of H■Mng ■tr■ta off

Type:

l'orm■llon: D■aorlb■ by cOlor, char■oter, ■lie °' 1111tetlet and ■lrvclure, end 11'1ow lhlckn■H of 1qull■r1 and Iha kind end nature of the material In Noh ■trat- p■n■ lr■led, wtlh at le■et o,ie entry lo, ••oh oh■1111■ ol lllfoml■tlon .

(8) WATER LEVE~: ,~~•=~:i■■r::" ___ 'T'"'~~'f#.-r"'-JII!, 8t■t1o1-1 .,)._£ It. belDw top olW911 n---------------------t----+---- ArtHl■npr■Hur■ ______ 11,,.p■, ■qu■ra lnoh Dal■------ t---------------------t-----i----

Att111■n w■terle controlled bf-----,1..-ci--,-. ,,.-i..r-.-.itci-J,..J ____ 1------~-------------,..--.-'----'---...-..-/ Wofll ■tarted Ill. C

(9) WELL TESTS: Dr1wclt9 ••~w■1er 1eva11, 1-r~et,ttoi.vei_ WH ■ pffll made? YN~ No /N y11, by wh0m? ~ / I I', Ylelcl: __ ....,..__ g■l.l111ln. wllh It. dr■wdown ■lter _,.__,.__In.

Arte■len !low i:/r; g,p,111. Date

Temp■r■lura ot waler¥ WH ■ chemloal 1n■l,-1la made? YH □ Na.Kl, ECY080-HIO (101871 ·1329-

I f, • ONSt..f'UCTOR CERTIFICATION:

I conatnicted and/or acc■pt rHponelblllty for construction of thl■ well, and Its compHence with ell WHhlngton well con■tructlon ■t■ndarda.

Material■ u■ed end the Information reported above ■re true to my beat knowle~ge ■i,d beHel. ) .

NAME f I 11 It I ( I I I { I I , . 1,)

. : ""'f-·J•AM7 OR ~llptt I ~ ,.c IC / _ . __, !- //0( it._., r-- __ ., > AddreH • I , '=-t-. ~ ~, • l C. ,.-· ➔ ~ • , ,_., r , ·_,;;; ~\ , , ·:,, h ...... t, . '7 r; ? . 1

J j ({_· _.,,,,, ,1 /IL (Slgned)l ' / ~ ' · , Llc■n ■e No. '

<WELL OAIL.1.£1111) 1

Contractor'• Aegl■lr■tlon ) / ) - · --1 2 r-; I No. t •f)'), '' c ,{ /. · A....·Dat•---~~----, 1u...LJ

(USE ADDITIONAL SHEETS IF NECESSARY)

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Start card No _W_1_1_4_3_6_8 __ _ FIie Ortglnal and First Copy with I J \ Department of Ecology lf d V(.; t Second Copy - Owner's Copy D

WATER WELL REPORT .AAW 317

Third Copy- Driller's Copy '6 STATE OF WASHINGTON

11, OWNER Name Laurence Freese Address 1qo20 Nicks rd Arlin~ton Wa 98??3

(2) LOCATION OF WELL County _____ ~S_n_o_h_o_m~i_s_h _______ _ (2a) STREET ADDRESS OFWELL(orneares1address) ___________________________________ _

(3) PROPOSED USE ~ Dorneslic D Irrigation

□ Dewater

Industrial □

TestWell □

Municipal D Other D

(4) TYPE OF WORK

Abandoned D

Owner's number of well J (If more than one) ___ _,_ ________ _

New well ~ Deepened D Recond1t1oned D

Method Dug □ Cable JII Rotary □

Bored D Driven □

Jetted □

(5) DIMENSION,S D1ameterofwell _____ O ___ ~--- inches

Dnlled 7:, feet Depth of completed well ___ 7_5 _____ _ ft

(6) CONSTRUCTION DETglLS

Casing Installed Welded ~ Liner installed D Threaded □

Diam from__:_+_1:.___ft, to. __ 71-,5_,___ ft ____ " Diam from • ft to • ~ ft

____ " Diam from ft to ft

Perforations Yes D Type of perforator used _________________ _

In SIZE of perforations ________ In by _________ , ____ perforations from _______ ft to ______ _ tt ____ perforations from ft to ______ _ ft

____ perforanons from ft to ______ _ ft

Screens Yes D Manufactufefs Name __________________ _

Type _________________ Model No ___ _ ft Diam __ Slots,za ______ f.rom, ______ ft. to ____ _ ft Diam __ Slot srza ______ f.rom, ______ ft, to ____ _

Gravel packed Yes D Gravel placed from

Size of gravel _______ _

________ tt to ________ _ tt tt Surface seal Yes l1J: No D To wtiat depth? I 0 Matenal used In seal b 8 ni t e Did any strata contain unusable water? Yes D No -

Type of water? ___________ Depth of strata ____ _

Method of sealing strata off ________________ _

(7) PUMP Manufacturer's Name _______________ _

Type ____ -_-___ -__ -______ -_._-__ -_·HP ___ _

(8) WATER LEVELS Land sur1ace elevation above mean sea !evel, _______ __,,oc--,,-,.--,,= ft

StaticJevel 32 fl belowtopofwell Date 9-8-00 Artesian pressure _______ lbs per square mch Date _____ _

Artesian water 1s controlled by ----~.---.-~---- (Cap, valve etc )

(9) WELL TESTS Drawdown Is amount water level 1s lowered below static level

Was a pump test made? Yes D No D If yes by whom? _____ _

Yield ____ gal /mm with ____ tt drawdown after ____ hrs

Recovery data (time taken as zero when pump turned off) (water level measured from well top to water level]

Time Water Level Time Water Level Tima Water Leval

Date of est -------,---------- Baller lest ___ gal /mm with 4Q fl drawdown after 4 hrs

A1nest ____ gal /min with stem set at ____ ft for ____ hrs

Mes1an flow _________ g pm Date ________ _

Temperature of water __ Was a chemical analysts made? Yes D No ~

(10) WELL LOG or ABANDONMENT PROCEDURE DESCRIPTION Formation Describe by color character, size of matenal and structure and show tluckness of aqurters and the kmd and nature of the material In each stratum pene1rated w~h at least one entry for each change of 1nformatIon

MATERIAL FROM TO

Soil 0 2 hardnan 2 32 shail fractured wet "32 70 hsrd rock 70 75 n,CLR;::.H/,=:"I\

ut. t,; 1 lS 2nnn <

UtJJ I Of 1-1 'I 11 r II, , -

WorkSta~ed ~-15-00 19 Completed 11-1-00 19

WELL CONSTRUCTOR CERTIFICATION

I constructed and/or accept respons1b1llty for construction of this well, and I1s compliance with all Washington well constructIon standards Materials used and the infonmat,on reported above are true to my best knowledge and belief

NAME Ac a Drilling & pump Service

{PERSON FIRM OR CORPORATION) (TYPE OR PRINT)

Address 14503 23 av NE Arlinzton rla 98aa3 (Signed)~ lii~enseNo 0697

(W IL.LEA)

Contractor's Reg1str~II0Q~ No A u~.uRPSOOOKA Date _ _,1c.,,Q._-__,__1 """'5_-..,..0'-'"Q'-----'' 19 _

(USE ADDITIONAL SHEETS IF NECESSARY)

Ecology rs an Equal Opportunity and Aff1rmat1ve Action employer For spe cial accommodation needs, contact the Water Resources Program at (206) 407-6600 The TDD number IS (206) 407-6006

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IO'St..( t.5~ File Ongmal and First Copy with

Department of Ecology

31-kl? --;;2.1 P WATER WELL REPORT StartCardNo t,/1,,2.o'j&(

STATE OF WASHINGTON UNIQUE WELL 1 0 # IJ:GK 72/

Second Copy - Owner's Copy Third Copy - Dnller's Copy

(1) OWNER: Name J}-11 /.IA- 5'Cf/tlCH 0/...Z

(2) LOCATION OF WELL: County _:S)_,M~~'() __________ _

Water Right Permit No _____________ _

Address

J. I I ) ~ Ji;WM-/V'{,J 1/4 Alw 1/4Sec 2-I T 7/ NR._1c::2--

(2a) STREET ADDRESS OF WELL: (or nearest address) :;:s;;t)-M /.::- __________________________ _ en (3) PROPOSED USE: r;;Y Domestic □ lndustnal □ Municipal _ (10) WELL LOG or ABANDONMENT PROCEDURE DESCRIPTION .c 1:J lrngat1on □ Test Well □ Other Formation Descnbe by color, character, size of matenal and structure, .., D DeWater and the kind and nature of the matenal in each stratum penetrated, with at c least one entry for each change of information.

O (4) TYPE OF WORK: Owner's number of well (1f more than one) ________ t-----------------..-----...----

0 New well Method MATERIAL FROM C □ Deepened D Dug □ Bored 7 A 1 ,15 ,1

0 □ Recond1t1oned ,S. Cable □ Dnven , V ,- ()I....., TO

0 2..

:.::; -· ----:-----~~~~~--...... ------,.--.,.., ;c,.R_o_ta_ry.__ __ □_J_e_tt_ed ______ -t---,::=---:-:----::---,.----+-~=--+--r-------(U. E (5) DIMENSIONS: Diameter of well _..1,,,4 ,._"-___________ inches 1---1--"r +::..Q.,'CJ..JJ.X.. ... .u.'rA-.,u_A~H:.L) _______ .,__....:::Z::::.._..j.......,!E~-~ h ... Drilled & S: feet. Depth of completed well /.,, 2...,.

.S!: (6) CONSTRUCTION DETAILS

ft .

h C Casing Installed:

~Welded Diam from±.2.. ft to 55 ft 1--":::?"7'-("7/,'r /~-1.::r--f'V'71"'"L'A~v-r-----t---,--+---=-

2,2._

1 D liner installed D1am from ____ ft to ____ ft. t---1<:aol-=-JJ.;..i;::a:.....i....,.=..~.~------h.L..e.-+-"..e....L_ -:/ 2 <:"", i~~C:'

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Diam from ____ ft to ft. t-==----=-=--::-"."-:-:~:--~-+'---f--==-==--+-_.,_~!

------------------------1 e::;-.D~Jn ,Af"' n,;;!/,,'{;( w/ --- n

Perforations: D Ye~-~ No /""'LJP. - /i 1 ,.., Type of perforator used ______________________ ~___!l,..,,~!84'(/::::_ _ _u.rd_LJ_,Z~[.(~---t-----4---- SIZE of perforations __________ in by _______ ~ __ in. t-----------------,1------1----

D Threaded

S5

---- perforations from ____ ft to _____ ft. 1------------------+----I---- ---- perforations from ft to ft. t-----------------f-----+---- ----perforations from It to ft

Screens: )if Yes D No

Manufacturer's Name -1,~,1,{.~/=41:,e~.44....,....,~ ... ~---------------- t--------_--,,..._-r.--=v;.=~,•.,;:r 'i\i."'8:-:-f-'_.i;,~~'1""\\:::;:l!-r-----+---- Type 5c Model No

-s ;} 1:1 e-<' Z:! 1C' 11 ,..-~--= -r,.-"' Diam ~ 1 Slot size from J-L ft. to CP-..L- D1am _7l ____ :iots1ze ____ from _____ ft to _____ ft. ,.,n\l , ';1 LUU

,,~ ~~, r1G'< Gravel packed:

Gravel placed from

□ Yes ~~~~-S1z_e of gravel ______ -_-_---.---.---.--

. ft to _____________ ft

Surface seal: ~ fu D No ~~hat depth? __ ._/•~ y ______ _ Matenal used rn seal W b'A. i ""il-,'\A I J fk: .. ..., t-----------------,1------1----r- • In Did any strata contain unusuable water? D Yes , No Type of water? ____________ Depth of strata _______ t-----------------,1------1---- Method of sealing strata off ____________________ t-----------------f-----+---f7) PUMP: Manufacturer's Name ___________________ __r-----------------+---~---- Type __________________ HP. _______ t------------------+-----4----

(8) WATER LEVELS: Land-surface elevation above mean sea level ________ it. Mi /

Static level _2 Q ft below top of well Date / 0-2()-1)/ Worf< Startect/l{ - 7 , 19P.i_ Completed 1/)-20.19 0/.

Artesian pressure ________ lbs. per square inch Date _____ _ t----------------------- A rte s I an water is controlled by ------(C_a_p_, -va-lv_e_, -et_c_}_________ WELL CONSTRUCTION CERTIFICATION: ' ' , 1".: -

C (9) WELL TESTS: Drawdown Is amount water level Is lowered below stat,c level I constructed and/or accept respons1b1hty for construction of this well, and rts compliance with all Washington well construction standards Matenals used and the 1nformat1on reported above are true to my best knowledge and belief.

CU Was a pump test made? □ Y~s D No If yes, by whom? _______ _

E Yield _____ gal.Imm with _____ ft drawdown after _____ hrs

1:'. Yield· gal/min with ft drawdownafter ____ hrs NAMC/i:M1JJ./(;I W~LL-0/2/lL/N?

[ Yield _____ gal/min with _____ ft drawdown after _____ hrs (Person, Firm, or Corporation} (Type of Pnnt}

CU Recovery data (time taken as zero when pump turned off) (water level measured from well Address HJ. ~ (J "r? _ <:'j",,/1 )11{µ4()1) W/11 lf 1. J2 ~~~~-*'~~water':::~rLevel ~ -Waterl~vel Ti-;;- ~;;e;~;;;'~. -(S1gn~d} '~ _· : ~--- 1 _,c~ns.eNo {1(?//.

I- ___ ____ ___ ____ ___ ____ Cont ct s

-- -....-.,-#=-1= ___ ___ ___ Reg 1onNo C:.,(JHJ.JAl/(16-glIJa.te//-5' ,191:)' Date of test I Oj:i.O/o I Bailer test ---,~-- g:i /min. with -----:: drawdown after hrs AIrtest 5' gal.Imm with stem set at -~(dl_~c.....-__ ft for ~ hrs Atesian flow _______________ _,, a pm Date ______ , Temperature of water Was a chemical analysis made?~ Yes D No

ECY 050-1-20 (7/97)

(USE ADDITIONAL SHEETS IF NECESSARY)

Ecology Is an Equal Opportunity and Affirmative Action employer For special accommodation needs, contact the Water Resources Program at (360) 407- 6600 The TDD number Is (360) 407-6006

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