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(AJE«- QA/QC Form <br />Well De ig}iation -AW - <br />Date (% 7- <br />Ins ec or t- u • ??=???? <br />Page 4 of 5 <br />C. Neat cement grout specitoations <br />i) Number of sacks o0cement used? <br />ii) Number of =ater of water mixed with cement'? <br />iii Was clean used? Yes No _ <br />E) Well head protection <br />& <br />1. Type of casing used? I1 ST -L <br />" <br />2. Dimesion of casing? <br />r -rO T A1, -or ? ? . 4 <br />3. Length of casing placed in surface hole? <br />o . <br />S a) Is casing of sufficient length to extend a minimum of 1 <br />??drivev? ir,•?o wA foot and a maximum of 2 feet above the ground surface? <br />d' 'r dab Yes "! No _ Reason for variation.. <br />?•? °? ° L4 b) Was a single length of surface 3 casing used? Yes :No _ <br />?RoM a?'D• If not were joints welded? Yes _ No - <br />h') 'Rell Development <br />1.. Length of time cement was allowed to cure after cementation. <br />of well casing was'complete? .2q hrs <br />2. 'Development using surge block'and bailing. <br />a) Length of time necessary to develop:well (minimum of one <br />hour) ? 13/y Inrs <br />b) Was development continued until clear water with out <br />fines.was produce? Yes ? No If answer is-no, <br />what is reason for discontinuing development. _ <br />Sa q p ?v? o? wa?et. aN wos <br />u/3 f 98 r? devil ?- wt 1 vuo ?e 4o4 <br />?•- <br />w?aa/.?' <br />?? Pte,-A•??+r+c. . <br />