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Vv?-u 4A/QC Form <br />Well Des' gnation tAw-o? ' <br />Date 11 lq 48 <br />Inspector P. L, WL-,sr-v, <br />Page 4 of 5 <br />N?12CNM?IJTFl?.-. <br />Vo1.Gt.Ry CxrAmB FS #8c . grout specifications <br />by CETW /AC'C i) Number of sacks of G` used? - 314 sAC9 <br />oenurr <br />82©6?? <br />-Zo ME3N GKRNk?-AR ii) Number of gallons of water mixed with ??: ? <br />W ENToN 1?E <br />1 iii Was clean fresh water used? Yes r/ No <br />5.4 <br />?0 E) Well head protection <br />1. Type of casing used? STOEL PIPS <br />'S 'be-' GL, t <br />2. Dimesion of casing? 8 <br />De?v? 3. Length of casing placed in surface hole? 15-,4' <br />e` sr cAuN4 a) Is casing of sufficient length to extend a minimum of 1 <br />Yo K,,? °P foot aid a maximum of 2 feet above the ground surface? <br />Dung-+? ,?w+.i.r Yes _ No _ Reason for variation.. <br />b) Was a single length of surface casing used? Yes. " No <br />If not were joints welded? 'Yes No _ <br />F) Well Development C P_0WTI I,,* <br />? <br />1. Length of time cement was allowed to cure aftere?atIen <br />of. well casing. was complete:? 24 Pws <br />AVL u <br />2. Development using cur-ao i,i ock and_- 3 -„n <br />a) Length-.of time necessary to develop well (minimum of one <br />hour) ? /l r-s <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 />014(9s ---rw io.zs' <br />I??nel d..V el Vf c•-?+11 a.?- (.?f c sell'nadL c? w??l a <br />Less f-k a-r? 2.9 eNs P P µ W&.s c',1a1 du-rW ? ap <br />?tv,d S?° ? ? ?-3 ? ?e•rr?=? ? ..tee, . <br />r