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V1E14- --==--•----- QA/QC Form <br />Well De i nation 14VJ-S <br />Date M r:50 15 <br />Inspector L.aa_,-, <br />Page 4 of 5 <br />C. Neat cement grout speci#<ations <br />i) Number of sacks cement used? <br />ii) Number of lons of water mixe with cement? <br />iii was c an fresh water use Yes No <br />E) Well head protection <br />1. Type of casing used? ?? '= 8 `?• 4t?lU`1 WALL <br />2. Dimesion of. casing? 8" S •"D. <br />6?1otE: ?ws-? 3 • Length of casing placed in surface hole? 7.3 <br />ao.( Fr of eASrm4 a) Is casing of sufficient length to extend a minimum of 1 <br />pQ,oRzo.u,?srRu?:?oH foot ad a maximum of 2 feet above the ground surface? <br />pr~,LLeD jZ.6 ?eoM Yes _ No _ Reason for variation. <br />?OCE ?eG??t?4 ??15r'QU?ro><1 . <br />b) .Was a single length of surface casing used? Yes No <br />If not were Joints-welded?, Yes _ No <br />F) Well Development <br />1. Length of time cement'-.was allowed to cure after cementation <br />of well casing was complete? a hr5 <br />Aie Li FT <br />2. Development using ^ <br />a) Length of time nece sary to develop':-well (minimum of one <br />hour)? ;EEFZ 63/4 hns, <br />b) Was development continued until clear, water with out <br />fines was produce?- Yes I-" No If answer is*.no, <br />what is reason for discontinuing development. <br />1f(31 4& <br />wzs <br />cw,4 atr• q¢' coel( iv ?e A/o •k 50 jjPm of wall?-r. P 14 <br />t 1 d ,MS v d s?? b, (? e a 8.o P rl wnce, rrec, f A <br />•