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Well Owner Transit Mix Concrete Co. <br /> Permit Number: 56847-MH <br /> 'orm Name. gws-31 <br /> Page Number 3 of 3 <br /> Hole Number LTC-GW-1 <br /> UTM gene 135 �"Jg ` sore. We.rege/NwpMg Mfe ini. <br /> Cadit TM seevs"pads lnttl CNIT <br /> well,lD UeWUa Top�W O4etap MNaW Cbawneh Depth sutle W ner l4.el <br /> Esexng is^) rvw h g bel—GL Depth <br /> ID bde.GL W. Tbne bdae Tpp sd well YewM.w (HRS) <br /> bel-00 [it) CeEmg(N <br /> 0 27. Gl- <br /> 114 20 ee....pellet, <br /> io 35 12ao.ene L a 1 30 4/13/2017 1:40 PM 0.0 004 Peristaltic Pump 3 <br /> 35 47 Bentodu-111, <br /> LTC cwz 7 47 57 a-zdane 25,7 2 ss 9/13/2017 1.40 PM 0.0 0.04 Peristaltic Pump 3 <br /> si ,tt B.noldu cegets -� _ <br /> B2 n :2 20»nd 3 c 90 9/13(2017 1 CC PM a0 Gig Pens[altic Pump 3 <br /> 45 103 B.—M.begets <br /> •AII ODEX Casing has OD of 6 5/g'and wall thickness of 114" <br /> "AII CMT Casing has OD of 1 7"and wall thickness of 014" <br /> "Screen Mesh Slze is US Standard no 100 <br /> Grout Mix by weight <br /> Portland Cement 1 <br /> water 25 <br /> Bentdnite D3 <br /> i <br />