A - B1<r1*lsH (Ir > 1.mlB1x Milllsiri Well Construction Report Weston Water Wells Ltd. Well Closure Report 7779 Hwy 24 Well Alteration Report Lone Butte BC, VOK 1X2 250 - 593 - 4307 Ministry Well ID Plate Number: Ministry Well Tag Number. Confirmation/alternative specs. attached Original well construction report attached Red lettering indicates minimum mandatory information. See reverse for notes & definitions of abbreviations. ( or i ROT) Town Street no. Street name Lot Plan D L Block Sec. land) m and) or in air rotary cable tool mud rotary auger driving jetting excav Prov Town Twp R9 ating other (specify) vertical horizontal Ground elevation: ft (asl) Method (see note 4) Postal Code Land District Water supply wells: indicate intended water use: private domestic water supply system t i irrigation [. .! commercial or industrial other (specify): Lithologic description (see notes 1-14) or closure description (see notes is and 16) Watepbeamg l - l Ul l l l U Fit=.' l i =l Li VU L; Ul U U l Material uescrlptloll (use recommended terms on reverse. Estimated nuw uuseivauons leg. lractureu. weathered. ft (bg!) ft (bg!) Hardness List in order of decreasing amount, if applicable) (USgpm) well sorted. silty wash). closure details Casing details Wall From To Casing Material / Open Hole Thickness Drive ft (bg!) ft (bgl) in in Shoe Surface sealr Type: Depth Method of installation: Poured Pumped Thickness: lil Backfill' Type' Depth ft Liner PVC Other (specify) Diameter: lfl Thickness: in From. ft (bg!) To: ft (bg!) Perforated From ft (bg!) To ft (bg!) Developed by: Air lifting Surging Jetting Pumping Bailing Other (specify) Total duration: hrs Notes: Well yield estimated by: Pumping Air lifting Bailing i' I Other (specify): Rate: USgpm Duration: hrs SWL before lest. ft (bloc) Pumping water level: ft ibtoc ] Obvious water quality characteristics: Fresh Salty Clear Cloudy Sediment Gas Colour/odour: Water sample collected: L Well driller (print clearly); Registration no. (see note 20): Consultant (if applicable; name and company): DECLARATION: Well construction. well alteration or well closure. as the case may be. has been done in accordance with the requirements in the Water/ict and the Ground Water Protection Regulation. Screen details From ft (bg!) To Dia Type (see note 18) ft lbs!) l fl Slot Size i Intake L. Screen ,i Open bottom t Uncased hole Screen typet Telescope Pipe size Screen material: Stainless steel L Plastic ,1 Other (specify); Screen opening: l ! Continuous slot L i Slotted Perforated pipe Screen bottom; Bail Plug t Plate i Other (specify): Filter pack; From; ft To; ft Thickness: Type and size of material: Final well completion data: Total depth drilled Finished well depth - Final stick up; ln Depth lo bedrock: SWL ft (bloc) Estimated well yield ID ft (bg!) ft (bgl) USgpm Artesian flow: USgpm. orArtesian pressuret Type of weil cap. Well disinfected Ti Yes ' No Where well ID plate is attached: Well closure information: Reason for closure: Method of closure: I . Poured L . Pumped Sealanl material; Backfill material: Details of closure (see note i 7)1 Date of work (YYYYlMM/DD). Comments: PLEASE NOTE: The information recorded in this well report describes the works and hydrogeologic conditions at the tinle of construction ' white: Customer copy alteration or closure. as the case may be. Well yield. well performance and water quality are not guaranteed as they are influenced by a caOaFYi Dfillef cOpY Sheet of number offactors, including natural variability, human activities and condition of the works. which may change over time. pink: Ministry copy ,