Well Record Page 1 2 of \(.kon WATER WELL Govemment O.pattn,en1 Environment DI WelllD: DRILLERS FORM W1tu Ruourcn Section V•JtO YutonWattrW.IIRev(at,y To De assigned oy . Of Em,ironmenl Dept Metric Q Imperial @ Box Whitehorse, Yukon 2703 Y1A 2C8 INSTRUCTIONS FOR COMPLETING THE FORM 4. Please clearly In blue black ink. prinl or 1. Addilional information provided the bottom at this form 2. is at on page 5. Compleiion is and submission this the responsibility of form of Question can be 867 2. directed to Water Resources at 667-3171. the drilling contractor. construction 3. All ¥Jell measurements shan be rep0 \ R i \/-c i<... i) Sketch of In sketch, lndica1e s are below circleappropriale use g,ouoo surface. units, desctlptors prl1Vlded) 0 1r.ict: .tt.,'iH.om:c::J 10 (:::::J WELL CONSTRUCTION ,,;,_~onP•o;,, : Eqmplo c~;,!':: 12. C7 ["I IO &l 1 20050131 VYYVMM [j O C1 Drilling Method Iii A• Rotary (Co11Y&nlional) C2We11Type: .,_.,_,_a.,. D D Dug Olher ~IP«ilt/ ... Pf()duc:,lni ,-.k,cad'J 0 AeYerse Air Rotary Cable Tool ! ! D l2J,o~rnauRoeN oeDROcK D Rotary 01Aud Auger (Hollow I Soffd Sleml 0 Casing (dspihc.tow9«Mldsurtac..111uw~atJIJIOl)fiateut111,1 C7 ier Comments · Regarding Cutng: I CJ Ouulde Thlcknou r-7", C4 C"'ing M111r111 C517}fjll C& G~h lo: Diameteri_a.....J (cm@) (cmt€) L.¼QtmiO 00t, .. c:==::i Well Record Page 2 2 of WELL CONSTRUCTION (Conlinwd (n,m P•g• f/ Surface Environmental Seal I (tleplh gr,1und surface. circle aPPfoprlale below pleno units) C9 Diameter of C10 Depth rrom: Seal C11 Seal Degth to: C12 Volume Placed: CII SHI Materlal'lJ:pe: /Q !(cm@} j C7 !tm@ jBeflloni\i I I zr l1m. @ © ~-----' 1m• {la. &n!onllo) Gravel Pack tdtfpl.h below ground surface, ,:,1e11se c~ ,wropridls unit~J C13 Gravel NO yes. indicated depth ( m Pack: B · II (ii)) . Ma1erlal type: YES from: to. e ::hamater ial. l c::::J c::::J { c:::J lndical ol mater m.-n 11r@t,- {l,e.Sll1ca \ Well Depth from: Depth to: Slot Size/ Perforation Screen Information {~th belo#gr<>Und sunace. clrcu, appropnatpluse unUsJ C17 C18 Dia: 9 C140utslde C15ScreenM,terlal Screeni.~(m@ ~ t ~ m.@ ~lhQU. /rnml o· ( ) Ol,St1 unless Steel C16 Wire Wrap 2. m lamettr :@ ~~•:n!~:us Screen c::1:rI:J Im® C::7il[J f ® C!::J Tho!.i,, mm iir0s cm." 0 O : Steel Louver Screen Screen3. c::::](m@ c::::]1m,© c::=Jn.,,, 1m,n1;,@,, f'tastlc Perlorated D C19ScrNn 0 NIA Slotled Comments: L..---- --------------' D D Oftler Open Hole DEVELOPMENT AND STATUS WELL D5 Well Yield Estimate D1 Well Developed by 02 04 Well Completion Well Head Stlck•UP StaliC Water Level Head 03 OSurgeBlock I ( 4>5I House ,,~•""i' ,.,._,.°'"',_,, Water Jetting D : · OPil/essAdapto, ~.-,.mr cm@ C:ZWtm® I [iJ Air Jetting Air liNlng 0 Pit (NOT PERMIT{;~~ (Use~tMJilbDlowQf.JdeJ (Vsen6ga1iv-a//bt?-0Ng,.1,1oJ D None {well nol compleled) Well Abandonment Stal us Method Used 07 D8 to DPU!Tllli!!ll,-'---- 0 Otho, . ._[ ___ _, Eatimate Well Ylald Was well properly decommissioned the Airlilbng D 06 Final Wall Status wilh bentonlte grout? YES 0 OeatltnQ 0 D D O Waler Supply (In use) Not In Abandoned use D•) ONO D &~~I~,. : lfYES, Indicate Cale ,..,...,.,...,._ 8 8 ~::r!Z1i~d<•up) g:;~r'ne"'d'--~ s~tJs~ g :::::~,cW 0Ai1• «"dJoon3 t1..,t M O 0 Y V Y V M F1 Wall Water Leval DrawdownlRecove,y DATA PUMPING RECORD AND GROUNDWATER QUALITY TEST Orawdown Recovery (All dflPlhs belOw IP()Ultd. al)t)tOpftale units) t:in:le T~ Wt1tnrL~I nm. W•terL"""9i E1 PumplngTestlnformatlon l ·(mntl (rn lll fn, tt, l RECOMMENDATIONS '"'" '. Pumping TeS1 Start Date: 0(FWL) 0(SWL) Aecomm. Depth: PUR'1J 1 ..._ _,( ____ m@) t VYVVMMOO 2 2 _ Stahc Waler Level (SWL): Recomm. Pumping Rate: 3 . ,_ ____ _. tm t® 3 - ..._ ____ _,( Lpsl@,) - 4 4 Pump ln!ake Sel a t: If llowb19, pro\llde ra!e: 5 5 '-------'( Lps/ ~ ) 10 _ 10 Duration al pumpng: 15 .... 15 OhrsLJmln 20 20 Final Water Level (FWL) 2.5 25 a1 end of Pumping Tes!: 30 30 I j1m@ <4(J 40 GI GROUNDWATER QUALITY Turbidity/Sand Content 50 50 Field Data ·- 60 60 o.t11 Meaanments Taken - : D Slightly turbid/cloudy Bacteria Testing Wasasa"1)letatcen? D NO DYES YYYVMMOO Moderately lUrbid/cloudy D If yes. Indicate the Date samp1e Taken; namo of thB ~~rat0ty: : D Turbid/cloudy Eleclri calConductiVity:c::J us ..... _____ __,! ..... ___ ___, I I Trace sand present 0 pH:C:J YYYYM MOO ' No sand present D Temperature: C:J ·c Chemical Analysis of Water Well 0lslnfecUon Groundwater Type Was a sample taken? YES NO 0 D ll yes, fnaicate ths Cate Sample Takan~ narrte! of the labondory. Was the well disinfected upon ~etion pump D D of the Installation? YES NO Sulp""' I Egg Odou, 0 I I 11 ~Y-V--Y-Y--M-M-0--0-' D Or efty describe of dlsiftfectjon. ganic Taste I Odour Bd melhOd welt Melallic Taste O Otho,: ~---~ D CONSULTANT /II app/lcab/6) WELL CONTRACTOR 11 Company Name: .--------------.! _ t Ht Name Contnu;lor Drilling Company: Ltd. ot Cathway Water Resources 12 Company Address l============ll H2 Nam• or Orilll!w(s) ;, \i,ic;;anyi1"SLl~E=V=E=R~S,;E=,'i'r.;a.;='1==a;;;;;r.9;,;;;;;;;;;======l 13 Aelerence: Repo,1 l==============.-~I 14 Rapo,t Date: I YVYYMMOO y y V y M M O 0 Dolle Submlltud to I. Of Enwormenl Pen~onal cootoinu11 is AcceSJ mlormallon 011 !his lofm collecied untie, tho aulhonty 01 lhe lo ADDITIONAL INSTRUCTIONS w Informal/on P1ivacy {ATJPP) Act. ,1nd Section {c} wlll complhl a Prol«tion ol 29 and be ust:XI lo Upon r.omplellng lorni, Re, ~ecilon tns .. tet 111.>1.1tC(I$ IV-31 Ot, publ11; d•l11hue ol well and g,ound wale, turthe1 inloim11.1ton lnformallnn. Fot oon\act !he ph.1asemaA er fa)I ii D1tpa11mun1 E!llfll'onmenl, to: ol M.m1:1.9e1 of Hydrok)gy, Watw murcot. 687•3223. lnll lfeo within 'r\lkoi, Rm at {8671 Govemrutvit nt Yukon 80ll 2703, Wh teho,,w. 'rul