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Well Owner Transit Mix Concrete Co. <br /> Permit Number: 56847-MH <br /> Form Name: gws-31 <br /> Page Number 3 of 3 <br /> Hole Number, LTC-GW-3 <br /> UTM zone 13S Greet/Ifentonhe screee well readipunipl.g Mt—tio. <br /> Casing Top SeallSand Pad lstereal <br /> Well 10. cl-Alo. Battam Maer4l CMT <br /> Top Depth channels Depth SMIc Water Level <br /> fasting 1.) No(rthm, (tt) below Gt bt ep Gl to belowQ UNe Thne betow Top of WG �A Method �11R$n <br /> (h) fh) Casing(it) <br /> d 9 Grout <br /> 9 99 B..—te pellets <br /> 9.9 Ilia 22-2o and 1,a 1 is 9/21/2017 946 AM 7.9 012 Peristaltic Punp 2 <br /> is 29 a..—,.P.D., <br /> ITC-Gw-I 508,916 4,219,868 2,062 29 415 12 20 sand 2 5 1 40 9/21/2017 9 46 AM 5 5 a027 peristaltic Pump 2 <br /> 41 5 54> B—te pellets <br /> M 7 10a1 I2-20»rid s b S l00 9/23/2017 9 46 AM 87 0 38 Peristaltic Pump Rowmg <br /> 104 7 1l'+4 Bere— Pe4ets <br /> iw 194 12-20 s,.d 2 a Igo 9/2112017 9 4b AM 85 0.18 Peristaltic Pump Flow,ng <br /> -AV ODEx Casing has OD of 6 S/8"and wall thickness of 1/4" <br /> "Ali CMT Casing has OD of 1 7"and wall thickness of 0 14' <br /> —Screen Mest-Size Is US Standard no 100 <br /> Grout Mix by weight <br /> Portland Cement 1 <br /> Water 2.5 <br /> gentonite 0.3 <br /> i . <br />