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Haldorson 970323RA57 n a <br />,ow 9a <br />+~~ 1NB1, CXNISTF~JCifON AND TEST RH'ORf <br />STATE OF COLOTY100, OFFK~ OF 7FE STATE ENGWE62 Frn ote4e Uae «ay ~ - <br />t. WELL PEf~tQt' Nt~I~Ft ~'-E rP $ o~-- <br /> NAAAE(~ al i'Son ctr,G 5on~ ~G <br />tratm,g Add~as ~~ <br />Gity, 6t Zfp 7 ) ~ <br />~ <br /> , <br />a>rore t )a- 55 <br />a wst LocA~rloN as oRn.I.EO: tJ F_y!a ~„~~la. sec.~~ Tw~.~ -~, aar~_L-..Y~L- <br />o ANCES FRO~e sEC. LA~E6: <br />D R from N f''(' sec. ru,e. and (D p R from E . ~+ne oR <br />SUBDMSION: tDT BLOCK FTLING(UNtT) <br />STREET ADOF~66 ATNRIL WCATION: <br />4 GROUND SURFACE ELEVATION R DA0.IJNG 6tETMOD f}i r Re f4r,.. <br />GATE COtAPLETf'D f - I$- O .TOTAL DEPTH 4I ~ R DEPTH COhPLE'TL~ 0 ~ R <br />R GEOLOGIC LOL,~ <br />O~p9h OwetSPSot~ @ Mdaid (1'ypq Sf~e. Color. Weeer 8 HOLE DIAM. (n.) From (E4 To pt) <br />~" _Q_ ~•S/ ~ <br />G" 3.5 (Dl/ <br />.S' .z+ - <br /> <br />~ . S '- S~S~' ., ~d . ~ _ son - aS 7. PLAAd CASING <br /> OD (m) Knrcl Wall Sits Fmm(ft) To(R) <br />~/ - 4~f' ~e...~/-5an - L•wJ.. ~ t5 ~~ ~~-e.e( ,fgg +1-S -S. S' <br />' ~ a., p~~ Aso + ~.s -,a <br /> <br /> <br /> PERF. CASNG: Saeen Slot Size: . 0 3 a <br /> PYG .350 la' 4 <br />~ <br /> _ <br /> <br /> <br /> <br /> 8. FILTER PACK: 9. PACKER PLACF]AENT: <br /> Mffieriai Pew ~aN <br />~( Type <br /> , <br />Sim 3/,[ <br /> IrLLer9ral /Q to G O' Depth <br /> <br /> t4 GROUTMQ RECORD: <br /> Amamt OetcsMy Irrtenral Placement <br />Ma<evgt <br />~• - 4. <br />t A tw ey jl, fy„~ eQ t <br />!L/!1!l'IT T /R caJ a fo s OO N <br /> <br />1 D!~,MIFECtlON: Type Amt Used <br /> W~~T,~'e; Chock beet ~iTest DaSa is subtnined w9 Fomn No. GWS 39 SupRtemental WeV Test <br />TEb`i1NG 1ffTHOD n o ..+u.'~t~ cnta,.an~tr~ <br />Smtlc Lerel R Daelli9ne measured i- /9 -a H . Pralucgon woes [5 wpm <br />Pumping fe+9ei R OaurTime mecrurad .Test lere9th (hrs.) <br />~~~ M <br />3l a~I1~Nn~ /Md ib1WA1NIY ~I~d~ IIM~IiI OII! t01CM 111Q COll~p ClOtet/. 111d ~461hOy MC bY010 I,Yy ITOF50~A. g+YINMi b SvCElon 29-4-f 06 j1,~ <br />v..+vn dM Illrl~ Ot fi1M /Wll4m I~MI Og1~ti4! pllfYN ~I tlls pCOllf1 O~fM Yld 16 pYM11~bk 6 L 41C5S 1 IIE~MIeRMf.~ <br />CONTRACTOR ~F ..' f,• ,f .,. Z.,c. Pritx9e 1 to 8'S G - b5B3 Lic. Na 1 a 8Y. <br />NamngITlle (Please type or pr;nt) <br />~( f <br />.7 ( n. .' sn .~: ~: 5igature <br />p~ /) • x.4,,,1 Dace <br />/'~'-'~'~ <br />