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~: <br /> <br />~sra•lo,voo <br />star. waur control Boartt <br />r. o. do. 1 t t a3 <br />2111 Nwth Mamtlton St. <br />Rtchrrtortd, Va. 33270 <br />WATER WELL COMPLETION REPORT •owcM No. <br />(Certilication of Compi~tion/Cowry P~imit/ - <br />County/City ~~;~~~~ ,~j <br />• v vytnti Plary COOrdilMtfa <br /> N <br /> E <br />•lattlttol~ Lorpitudf <br /> N <br /> W <br />•Topo. Mttp No. <br />• E Nwtton rt. <br />• F oattauon <br />• L,MOlogr <br />• R wfr Baste <br />•Provtntl <br />• TrPI logs <br />• Cutut>os <br />•WNIr Analrus <br />•Aqutlfr Test <br /> <br />i/tiELL OATH: Nita ~ Rswcrktrd Offp«tfd <br />• Total opth a o 5 n. <br />•Optn to tlttdrotk a..O ft. <br />•MOI• Ma• (Alao iKltadl llaelld sO1Ma) <br />• 19 irttftfa from ~ to cl '1 It. <br />• ~_tnthfs trt>rtt ~ to ~ o S It. <br />• trtthfa from t0 ft. <br />•Caalnq ttaf 11.0.1 and mat«ral C <br />• , ~_ w-ccMs 1 rom CJ t o / 7 I t. <br />MaanM ~] "~ C r/) n~~ <br />Wt. plr loot 13 I b or wall thKkINN • I as in, <br />• trttMa Iron to ~~- It. <br />Matlrtal <br />Wt. Qfr loot or wall thtlKMta tn, <br />• mchfs vom w It. <br />Matfnal <br />Wt. plr foot or wall rhttkraaa ~~tn. <br />• ~Crfln ttaf ano rttlth for lath torN Iwh«f applitablfl <br />• inthfa from _ to _ It. <br />• Mesh tut TYW <br />• tnthy from <br />_~o It. <br />•Mtsh ataf TYpf <br />• ,nchts Iron to <br />It. <br />• Itdlih at2f Trp f <br />• ,rttnls Iron ~ to __~ It. <br />•Meah ttaf Typf <br />•Grawt oxt . <br />•From to It. <br />•From 'y -' to ft <br />• Grou t <br />•From _S` to ' S D It., Typf c7 ~ CLNCY <br />•From to h., TYPE <br />Gwnry/Gry Stamp <br />•owMr LA,~cQ, C.o~~ P+ <br />•WNI Ofspnatan o. Nump« <br />Addrw I I ~ 1 ~ ~c7 w ,,v, a ,.J ~ z 1 „~, rr --'~ <br />_ e51~o.J V A Sao `1 c7 <br />Phorlf <br />•Orillirp COntrattor GROUNDWATER SYSTEMS INC. <br />AttdrfM 12329 WASHTNRT(~N $RI .R R <br />FAIRFAX VA.22(1~'~ <br />t-hon. (703) 620-2040 <br />SWCB Ptlrrwit <br />COUet~r r«t11it <br />C«tifieation of ~ ttHit:ifl: <br />TAia wtNl t4o« doff ttt11 <br />mMt t:oONktw rfgyy~fl ~~. <br />s. <br />OaM~~ <br />Tau Map 1.0. Nw <br />Sutdwrtttow <br />Sftlrpt <br />91otk <br />Lot_~_ <br />Class wNl: 1 , Ilw _ <br />IIY X , I IIA . , 111• ~-~ <br />,WELL LOCATION: (lfft/IlNktf dinotiwU a <br />and flft/rtrlfa tdirfitionl of --- _ ~. • • •_~ _ <br />(11 posaolf plfaff irtektdf map sl-owirq katcatiow marlt~dl - --...... . <br />OaM artfd 4 - a4 ~ ~ (~ . O.M t:arttpla.d ~ - c3 S - `7 c~ Trp. rro ~u <br />2. WATfi11 OATH • Wat« tfrrtp«aturf _ _ <br />•Statie ulat« ktwl (urtpurrtpw ktwl•rtaasurartl w <br />sr- <br />•Stabllisfd mfawfd pumWrp watfr ktwl V S <br />•$tabilisttd rNld 3 O pprrt aU« ~ .~ _ n <br />NaturN Fkiutt: VM, No h , Iklw roy. <br />-~ ~~; <br />Cwttlltfet Oe gtrahlr__ __ <br />3.IMATE1120NE>c: FrttmlKO To~-`t `I <br />From 1~ S To / 7 y _ From _ To <br />f ram - To From ~~~ To <br />1. USE OATH: v <br />Trpf of uM: Orwtktrp /~ , LtvfatOttt WaNrtwE <br />Irrrgatton Food protftatrq. _~ . MOUMlt010 ~~ <br />Maltulattunrq . F atf MIRY _ , (;IOytwO <br />Rftrgr«on , AfslMtlC __ . Coolwy a ItYtrrlp~ <br />Inlft:tion_-~,Othfr _--- <br />•TWO dfacility' Damfstte _ C~ , Pupltt: ,,,,atyr ttrpplr <br />Pu01it iMtatHlioe Farm ___ , Inpwtry ~~~ <br />Comrrrrelal , Oth« __ <br />S. ~UMM OATH: Trpf _ • Ratf4 N. <br />•Intakf dpth -Capatttr __ _ s <br />i. WELLNEAO: Ttrpu w«l tifal ~ ~~ <br />Prfburf tank gal., Loe.__ <br />SampN tap . Mlpurlmfnt port <br />WNI wnt , PrfaaHrf rNul t-ahto <br />GaM valve . (;hleK vshn Iwrwt rfgHrrfpl ~~ <br />Ektctrical dtitafNNtt twttth On pOwM rNWr r-_ <br />7. DISINFECTION: 1hNl tlnmlfttfd .- __. __ rfa ~~ <br />Oatf ~_._ , Otstnlfttant usfA_ <br />Atttouet ~ , Ilourt HMO <br />~. AYANOONMENT Iwh«f applttaoNl •1rw rto <br />Cawrlo puNfd Yfa__ no. __~ not applteaolf <br />IkaOpirp grout from to ~yl <br />OVER <br />