Building_500_-_Well_Construction_Report.pdf

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1. Type of W&11 a.. Sol"'ed_L Buried S1�:

Hole Diam.�in. Oepth�_ft . J20. :.a.rtn i'lateria.is ?a.sse<l ihrougn

Yes_ No..X.

b. Driven __ Drive Pioe Dia111. __ in. Oeoth_ft

c. - . - . . Finished in Drift __ ln Rod: __ _

TO (Ft.)

d. Gl"'out: C

-· well furnishes water fol"' h�n consumption? Yes� No __

3. Date we l1 dri 11 ed _ __./_./_-_..:2::...,,2,·_-...,C/__,_5" ___________ _ �- Pennanent pumo installed? Yes Date ______ _ No __

Manufacture!"' Type�------- Location�----------------------------------------------------- Caoacity pm. Depth of set�ing ft.

5. We11 top sea.1ed'? Yes_L No__ iype /l.a&&efc: /1/J

6. Pitless adapter insta1led? Yes__ No __

Manufa.ctun!r l'lode1 No. _____

How a.tta.ched to casing? ________________ _

, . We11 disinfect.d? Yes_:/;;_ No __ _

8. PIJll'lp �d equipment disinfected Yes__ No __

GEOLOGICAL AHO liiAT'ER SURVEYS liiELL RECORD

9. Ori 11 er (2" /(tJ J, /'I e rl License �o. @ c <::' &' tt? .}of/

10. lifel1 Site Address PL Urn )4// R<t. {,/SA.r:

11 .. Prooerty Owner u� _s;., �- ,C. Well No. ____ _

12. Pennit No. /le 3/CC;9f �te Issued //-/- 9i 13 . i.oca ti on : County SZ: (!.f .-4 /

Sec . ..3..Z. i ! 1 Twp.� ,1 · 1

Rge. 7W '14. Water fn,,n :;uJ/./,1) <( CL,ai at depth 3 C> ft fis . .'.:a.sing ano Liner Pioe / J to -J.i' ft

51nd and Weignt I from (ft)- To (ft)!

6N'(?A'e..;le A �-· a f z � / 'xi

Sh°"' l oca. ti on in section pht i I

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(}�,,gy

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.:ont,nue on separate sneet if necessary.

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'16. Sc:-een: Diam. ___ in, Length ___ in, Slot Size __

.i,. Siu hole below ca.sins ____ in. 18. Ground �1ev. ft ms;.

"19. S�tic level __ ft below casing top wnich is __ ft. at>ove

Signed fJbr. l?_Q� ground level. PU11Ping 1eve1 ft o,....,,nn """' fr,r h-.. -ueptn of I Depth of 700 . Bottom

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Building 500 Well Construction Report

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'IBEM:MENl' AND PIPIN'.; DllGRllM In Restrocm Building 500

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EXCAVATION DIP.GRAM

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Restroan

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WELL & PUMP SYSTEM

DIAGRAM

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