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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-4 <br /> U1M Lone 131 UtN(Top SaailSa+d Pack G.wVeac aterterval screen Weil YstwPiampin(Information <br /> bttar+ martial CBST <br /> Wall 10 tlevatlon Top Dolls Channels Dep11 SLtk Water revel <br /> E,s01s((wj n n( fftl bebw Gt Oep� w below cl. mte rime belmr,cop of WtGp d raetaod 0;` 1n <br /> (hl baiawGt Ilt) Caslnilhl <br /> 0 9.9 WOVt <br /> 99 109 8en1aea1e paters <br /> 10.9 17 1 12.20 sand 1 1 12 9/21/2017 12 35 PM 5.4 0.03 Peristaltic Pump 3 <br /> 17 28 1 Banttrete PMe1s <br /> 28 301 12-20sand 2 2 368 9/21/2017 12.35 PM 5.0 0.12 Peristaltic Pump 3 <br /> 381 481 Berber.Pe4e, <br /> t1c-w< 5D9.217 4 278 795 6,995 "1 592 12-20 sand 4 3 51 9/21/20171 12 35 PM so 0-18 Peristaltic Pump 3 <br /> 582 991 B—,...e pellets <br /> 89.1 303 12-20 sand 5 4 100 9/21/2017 1295 PM 5 1 0.18 Penstaltic Pump 3 <br /> 103 155 Menton.,,elks <br /> 155 :69 6 12-2o and 3,6 5 165 5 9/21/2017 12.35 PM 185 0.18 Peristaltic Pum Flow. <br /> 169.9 1795 Brntonrce pelkls <br /> 179 se 1"5 12-20 s,nd 7 6 1 290 9/21/2017 12 35 PM 29.1 0.18 Peristaltic Pump Flowing <br /> •Atl ODEx Casing has OD of 6 5/8"and wall thickness of 1/4' <br /> '•All CMT Casing has OD of 1.7'and wall thickness of 0 14" <br /> "'Screen Mesh Sile is US Standard no 100 <br /> Grout Mix by weight <br /> Portland Cement 1 <br /> Water 2 5 <br /> Bentonne 03 <br /> I <br />