Bloomfield Subdivision Site - Hydrostudy - Appendix A: Water Well Completion Reports

~~-~-~+•+-~+~ ~i :3~afa~}r~curvrurv WILL UK1LL11VCi 703 777 1334 `` " ~`" ~ /-I~11~: +/vb ~ COMMONWEALTH OF 19)1 10,000 Scare Water Control Board P O 8o>t [11~] ~ 1 1 1 North Hamilton St. hmond, Ve. 2]230 `off. VIRGINIA P.O1 WATER WELL COMPLETION REPORT •ewCAgNo __ (Certification of Completion/County Permit) i.Durt(y/CrCy ~ Q /d0 In CertlllcatlOn of Ins --- This well does pectlnq olf,clal does not County/City Stamp meet code/low r -"'--~ • V irq,ms Plane Coordinates eVuiremenls. S. N •owner_ Jeffery Gould Deh_ E L aill~de 6 l_ongllude J N w ° Topo Map No. •E~eval~on I1, • G G~mat,on •:~tnOlOgy •Rivtr 8aun •Prov~nce °Trpe~ogs~rl~~Pt' _ i •C~It.ngs i°1Yarl• Aralys,t_ - •~•::,, ter Tesl • Well Oeslgnatron or Number TS"0192430001 Address P•~.BOX 21 - PPShI 7TYT+ Va~7n 1 ')7 Phone •Drillinq Contractor Run On Well Orl 1 1 i n & Pum Cor Address P, 0. BOX 1726 r Y 20177 Phone. 777-2270 SWC6 Permit County Permtt Fo. 0/Iree Ute Taa Map I D. No. 61848106500_0 Subdivision Secl ion _ - ~ -- 8 loc k ~-- Class Well I _, _- ILA L I B _` , I L I A -- -- 11 1 8 X -~ WEILLOCATION; ~IIC _1110 IIIE .--~~ fleet/mites~_direction) of and Ieet/miles )direction) or Rt. 15W to Rt. 50 R St Louis_Rd L Foxeroft 111 possible please include map showing location marked) `-"---'-- -°- - • - • -• L Unison Rd R Bloomfield to intersecti Dale started 9/21 /05 • Dale completed 9/30/05 Air Rotary _._~ Type r.9 -- ----- t vvE l l DATA: New XX Reworked Deepened • Tolal depsn 600 r t. °~enln to bedrock~ _ a^D12 t~tt (Also Include reamed tones) ft. ° ~~-rnthef Irom 0 l0 75 It ° , 6 1 /$ Intnes Irom 75 to 600 . - tt. ° inches Irom - to It elating site II p l and material . •. ~gincnes rrom + 2 to 75 ~•ta lenal- _ S .PP ~ Il. - _ wl Per loot 13>~ or wau tnrckness 188 - . • •- rn. ~nche3 Irom .._-___ l0 I Aid tlt,dl I ril p!r IOOt - Or wau InICMneS3 -- ° _ In. mcnes rrom 10 It ~~aler,al _ ` ril Uer loot ___.Or wJll It,icknr33 ._ ° ~::een sire and mesn !or each tone I+vhere applicable) _ In. • _ inches Irom _ to ll •'•tesn si:e ------- T YPt . • - .Inches Irom to -------- Type -~-~^cnes rrom ___ Type • InMti Irom ` --' •Mesh site TYPt ~`_ °l.:ri'.el pack ° r 'Om - _- . 1O it. • GrOm `_-_ to ~: r,m _-~- ,° 75 It . Type Cement coin 'O ! --.h Tvpe 2, WATER DATA • Water temperature _ pF •Slatic water level lunpumped level measured! 30 _ __ 11 •Stabilited measured pumping water revel I1. •Stabilited yield 7 _ gpm alley _ 2_ ----- --- _____ hours Natural Flow Yes _ No XX rlow rare --- .~_`9 Din Comment on oualuv_ __ C1 ear _ __ 3, WATER 20NES: From 192 To 193 3GPM. - F-om_558 To 559__- ErOm 4GPM. To From. To _ ~-- --_-- From __ To 4. USE DATA -~- - TYPe of use Orlnk~ng- XX Lrveslock sNalrnng IrriQatron _ f ood processlnQ _, - M ~( • Manulacturln - ousenold _- 9 - F Ire safely. Cleanrnq _ Retrear~nn •__ AesthelrC -__ Coollnq or neallnp - Injection _. Jlher - •TWt of facility Oomestrt` X--Puollc water supply-__- PubliC Institution- .__ Farm.-_ . .. Industry _ CorTlmrrclal-~ Dlher 5. PUMP DATA: Type _ _ 0 Raters H P ----- - •Inlakedepth ICapacisy at---~----'- 6. WELLHEAD: T ~-'"----- _ head YPe well seal Pressure tank gal., Loc. ___ Sample tap Measurement pon _-__. Well vent pressure reli.l valve __ Gate valve , C:nect valve Iwnen re -- ElaKlrical disconn 4uued) _ ect switch on.power supply 7. OISINFECTION~ Well disinfected Date •- - . _ . vRS no ,_. Ouir;lectani used. Amount Ilo rs used 8. ABANDONMENTF.NT~re Y --. - appliCablll • y., no Casing pulled yes __ no --- nos applSCaole Plugging grout From ._ so_-- ,material OVER