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Well Construction Report

Well Closure Report

Well Alteration Report

Ministry Well ID Plate Number;

Ministry Weil Tag Number:

Confirmation/alternative specs. attached 0*7..2 Original well construction report attached

Red lettering indicates minimum mandatory information. See reverse for notes & definitions of abbreviations.

Town Prov. Postal Code

Street no. Street name Town

R Of ! Lot Plan D L Block Sec, Twp Rg Land District

tor) randY

Ulrand;nw

air rotary [ ] cable tool mud rotary { 1 auger driving jetting excavating other (specify):

vertical horizontal Ground elevation: ft (as!) Method (see note 4) -

Water supply wells: indicate intended water user private domestic water supply system Y 1irrigation commercial or industrial li 1other (specify);

Lithologic description (see notes 1-14) or closure description (see notes is and 16) WatepbeamgFrom To Relative Colour Material Description (Use recommended terms on reverse, Estimated Flow Observations leg, fractured, weathered.

ft (bg!) f1 (bg!) Hardness List in order of decreasing anlount. if applicable) (USgPW well sorted, silty wash), closure details

Casing details WallFrom To Casing Material / Open Hole Thickness Driveft (bg!) ft (bg!) in in Shoe

Surface seal: Type: , Depth - ft

Method of installation: Poured Pumped Thickness; ln

Backfilli Type' Depth. ft

Liner: PVC Other (specify) -

Diameter: ln Thickness: ln

From: ft (bg!) To. ft (bg!) Perforated From: f1 (bgi) To: ft (bg!)

Developed by:

Air lifting Surging IJ Jetting Pumping Bailing

Other (specify); Total duration: hrs

Notes:

Well yield estimated by:Pumping Aarnmng Baumg other (specify)

Rate: USgpm Duration: hrs

SWL before test: ft (bloc) Pumping water level: ft (bloc)

Obvious water quality characteristics:Fresh Salty Clear Cloudy Sediment Gas

Colour/odour: Water sample collected:

Well driller (print clearly):

Registration no. (see note 20):

Consultant (if applicable; name and company):

DECLARATION: Well construction. well alteration or well closure. as the case may be,has been done in accordance with the requirements in the WaterAct and the GroundWater Protection Regulation.

Screen detailsFrom To Dia Type (see note 18) Slot Sizeft(bgl) f1(b9!) ln

Intake: Screen Open bottom Uncased hole

Screen type: Telescope Pipe size

Screen material: Stainless steel Plastic Other (specify);

Screen opening: Continuous slot Slotted Perforated pipe

Screen bottom: Bail Plug Plate Other (specify)

Filter pack: From: ft To: ft Thickness:

Type and size of material:

Final well completion data:

Ifl

Total depth drilled: ft Finished well depth ft (bg!)

Final stick up: ln Depth to bedrock; ft (bg!)

SWLL ft (btoc) Estimated well yield: USgpm

Artesian flow: USgpm. or Ariesian pressure: fi

Type of well cap Well disinfected: Yes No

Where weIl ID plate is attached;

Well closure information:Reason for closure:

Method of closure: Poured Pumped

Sealant material: Backfill material:

Details of closure (see note 17):

Date of work (YYYY/MM/DD):

Comments:

PLEASE NOTE: The information recorded in this well report describes the works and hydrogeologic conditions at the time of construction, white: Customer copyalteration or closure, as the case may be. Weil yield, well performance and water quality are not guaranteed as they are influenced by a caHSWZ DTlUEf cODy 5*1981 ofnumber of factors. including natural variability, human activities and condition of the works. which may change over time. pink: Ministry copy !

General

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£11 Mr -Y:st:'., sta£l'ia£f dan RN mar3

arid gmdetic Lise EE; Me Nath Amefipail aimla of 1983 (NAT 833. To <'ie!er'm€rl€< <*coorc!males using £

-1 Global Positiming System £GPS). set the dalum to NAS 83

Or };#mi£s(!e AM iml£tHEE1(!e L:(O€di'*- f1t€S - or'(imat€2€9 either Ui Qi(':(;r'l:€c. MENU ; $6 - * WE ce q., 500 2' ?1 (137"V xiv ;!e

degrees ce 9., 50 0391750)

For the method oi teimlirling gm;,nn<ii Gia/£€Eior:, enter. GPS. (!iffere:luEl' GPS. !evG&, aiti?ll€Bir;r, 150,000 rllap, 1.20,000 map, 1 10.000

map or 1:5,000 map

The classes and sub -classes of wells are shown below

Class Sub -class (ifapplicame)

Water supply Domestic; Non -domesticMonitoring Temporaryt PermanentRecharge or injectionDewatering or drainage Temporary; PermanentRemediation Temporary: PermanentGeotechnical Borehole; Test pit: Special type of hole; Closed loop geothermal

6 Well reports submitted to the Deputy Comptroller, or retained by the person responsible, as required under the Wate/Act and the GroundWater Protection Regulation. shal! be considered part of the Provincial Government records and is subject to the Freedom of lnformaffonand Protection of Privacy Act

How to Fill Out the Lithologic Description Table7 Each row in the lithologic description table represents either a depth intewal or depth in the well

8 A row could represent a depth interval (eg., from 0 feet to 12 feet). such as for a geologic stratum or a specific depth (eg., 120 feet)

such for a depth location of a water -bearing fracture

9 For a depth interval, enter the relative hardness of the material in the column "Relative Hardness," if applicable: Very Hard (VH)

Hard (H), Dense (D). Stiff (ST), Medium (M), Loose (L), Soft IS). Very Soft (VS)

10 For a depth interval. enter the letter for the overaH colour of the geologic material in the column "Colour," if applicable: WhSte (W)

Grey (Gy), Blue (BI), Green cG). Yellow (Y). Brown (Br). Red (R), Tan (T), Black (Bk)

l1 For each depth interval. enter the description of the geologic materials encountered during drilling in the column "Mater- ia! DescriptionMaterial descriptions should be chosen from the following recommended list of materials

Surficial materials (appruxinrale range of particle size)

boulders (greater than 10 inches)cobbles (2112 inches to lo Inches)gravel (80 slot to 21/2 inches)coarse sand (25 sio! to bU slot)medium sand (10 slot to 25 slot)fine sand (2 slot to 10 slot)

silt (less than 2 slot)

clay (much less than 2 slot)till (variable particle size)orgamcs leg" top soiY wood. peat)

Bedrock materialsconglomeratesandstoneshaleslltstonelimestonecrystallinegranitebasaltvolcanicbedrock

12 ln describing the material. list the material in order from greatest to feast and indicate what materials occur in trace (less than 5%) amountsThe word "and" means both materials occur in approximately equal amounts (eg, "gravel and coarse sand, trace silt")

l3 Under the column "X/Vater-- bearillg Estimated Flow (USgpm)," use "D" for "dry," "W" for "wet." or enter the estimated How in USgpm

14 If a water - bearing fracture is encrsualiereci. the depth of the fracture should be recorded in a row and the estimated flow of water in the

fracture can be entered in the column "VVaterbeamlg Estimated Flow (USgpm)

How to Fiji Out the Closure Description Table and the Well Closure Information Section15, Each row in Me closure des<t:li;Jtioll {able represents eitller a depth interval (e.g. from 0 feel to 12 feet) or depth (E:,g 120 feet) il. the weil

16 For a depth interval enter the type of backfil! or sealam materiai(s) in the column "Material Description

17. Indicate in "Details of closure" whether casing(s) or sm -een(s) were pulled or- left in place !f casing('s) were left in place, indicate whether it

was peliora1ed or ripped

Screen Details18. "Type" includes riser pipe. Kpacker screen, screen blank, or tait pipe

Well Driller19. Fill in the name of the driller who constructed the well

Registration Number of Driller Responsible20 FM in the registration number on the Qualified Wei! Driller identification card. If the work was completed by a drilier who is not registered

as sa Qualified Well DrHler, tile Qualified Weil DriHer who is directly sl.1perx/ising the work should fiji in their reg@stration number on theirQualified Well Driller iderltificat$<)r1 card, The Qualified Weil Dw

- Ner signs the form

Definitions of Abbreviatimls.%.4

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below 10; > Lu qasmgDame?[)w"c& L'

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ln inchesMAL) 83 North Anlerzcarl

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SecSWL

Mvp

Pmmm nMf;e*

RAMPC'(*x

stem? w,r' >

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! OWUPF

USgm MUS g;a!w();ls per minute

UTM Urlwersai Transverse

Mercator Grid

Updated: Fe!). 7. 2006

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Well Closure Report ~qi 0 ~ =1 -wT*< "xl £- su "'1iiSt'Y We' 9! Ta Number:("' ~

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Xverncal horlzcmal Ground elevation: Li (UCX ft (as!) Method (see note MG'? 8 - ~ <£,. e am *-1 ~ .)(.

Cr} ON So' - luv O-Water supply weiis; ind;ca1e intended water use private domestic i *.'.'ater supply system lrngaticn covnmmciai or industrial q other (specify)

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Colour Maternal Descnptszm (Use recnrnnlmlded terms on reverse. Estimated Flow Obsema1ions (cg., fractured, -.-.- ealrlnreo

List in order of <lecre£zssrzg zarmum, if apphmble) (USQME weil sorted. sim' :.-lash). cfosure demos

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Casing details Wall; From To Casmg Mmnrial / Open How Thickness Drive

fl (bg!) ft (bg!) ln Shoe

& 1 25*% Q >1' CG L 2S O Wes

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Surface sent Type~ gp; 4 -m ~, A =~-lap 7 Depth: t 5 +Method of installation: Poured 8 Pumped Thickness

BncWl: Type Depth

Liner; 1* ] Pvc Other (specify)

Diameter Thickness In

From i1 (bg!) To f! (bg!) Performed: From f! (bg!) To ft {bg! ]

Screen detailsFrom To

£ fl chai) €1(bg!)Dm Fype (see nom 18)

! ? % N -€ -~3 2.&€'7€( $ ~ - -DTLL L

K ' '?n <. €.€€ >

Slot SIZe

Intake: lScreen [ "? Open bottom 5 Uncased hole

Screen type: €*4 Telescope ; Pipe size

Screen material: ~ Stmnloss stee! Plastic O!hcr (specify)

Screen opening: ~ Continuous slot I Storied i Perforated pkpe

75Q*K

Developed by:

8 Anhhirlg*

; Surging 1- Jnt1ing Pumping Ul Bmhng

Screen bottom: ! 1BmI Plug Plate in 1Other (spccifmte~ ;A:,) ~Filter pack: From TU Thickness ln

Type and size of rnatminI

Final well completion data:/ ' (

Tom! depth drilled: ~ ~ ~ fl Finished well <}eplh;'1s 7 €1 f! rt;gh

Other (sneckiy) Total duratmn: X . hrs Final stick up ~~ an Depth to bedrock It (ng))

Notes SWL 1.7 l Fi (mcc) Estimmcd weu weld (9 USg;;;m

Ntersmn flow USqprn, or Aneslan pressureWell yield estimated by: ~ -

Type Of well capPumping #1 Airlifting Bmiirlrl Other(s;lcclfy) -3 . AK? L L; Well drstnfec1ed)@ Yes No

Rate Where well ID plate is attached: Ko @ eg; CAS X N (,USg;Jm Duration hrs

SWL before test ft (bloc) Pumping water level fl (bloc) Well closL1re information:

Obvious water quality characteristics: Reason for closure

Method hf closure ; Poured Pumped~ Fresh ! 1Salty Clear 1 Cloudy Sediment ( ,,1 Gns

Scnlant nmturnal Backfill nlatermlColour/odour Water sample collected: ?

T Details of closure (see note 17)

Well dfillef (print c!early)Z ri' ~

xXc;c&EG=w. 'rxCLcsI6';Registration no. (see nme 20):XA 5 0 SOS' K UK cD K Date of work (YYYY/MM/DD)

ConSul!ant (if applicable; name and company) -:1QK(EBh1 :1€,'€(£-s(w

DECLARATION: Well construction. well aitcrulion or wet) closure. as me msn mn'; huhas been done ln accordance with the requirements On the WulorAcl and the Ground CommentsWater F'rotcction Regula1inn

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PLEASE NOTE: The information recordcd~ this well report describes Hm works; and hydrcgnnlngxc cumhhnns nt thu lyme of cmstruclrun. Mute: Cuslcmor copyaitemtion or closure. as thn case may bu. Well ymld. well performance and water quakty am nel guamnit- nd ns they am Influenced by n

~

Canary; Unifur copy Sheet [ ci ~number of factors, mcludmg natural varmbiMy. human aclivmes and condutiorl of the v.*o:k1£, which nw,' clmngn over timo punk: Minislry copy

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WATER WELL RECORD ~C~ ML NO

MINISTRY OF WATER. LAND AND AIR PROTECTION VICTORIA. BRITISH COLUMBIA LI; =1€JLEGAL DESCRIPTION - LOT 5 E C T P R 7. L LAND DISTRICT P L AN "ICTDESCRIPTIVE LOCATION L l CE NC E NO DAT E

Z X Y NO.

OWNERS NAME ! ADDRESS.#;, -,

DRILLE ~ S NAME ADDRESS DATE COMPLETED NAT. TOPO SHEET NO

EL EVAT l 0 N ~ ESTDMATEDDE PT H OF ~ SURVEYED C A 3 l N G O ! A M L. EN C, T H PRODUCTION TEST SUMMARY

METHOD OF CONSTRUCNON CASDNG OIAM LE N G T H DATE

SCREEN LOCATION SC R E E N 5 R Z E LENGTH TY?& TEST BY

BAWTEST PUMPTEST' DUPAUONCWTEST

SANITARY SEAL YESC NOCJ SCREENC SIZE LE NGT H T Y ? E RATE D PAW DOWNi -

PERFORATED CASING Cl LENGTH PERFORATlONS FROM TO WATER LEVEL AT COMPLEUON OF TEST

AVAWLABLE DFZAWDOWN SPECIFWC CAPACWTY

GRAVEL PACK ~ LENGTH ! A M SHE GRAVELETC PERMEABlUTN STORAGE COEFF

DISTANCE TO WATER ESTlMATEO WATERLEVFLLTRANSMISSWlTYESWMATE WELL YIELD

F 9 OM MEASURED ELEVATION ARTESIAN VRESSURE RECOMMENDED PUMPING RATE

DATE OF WATEP LEVEL MEASUREMENT WA T E R U 5 ERECOMMENDED PUMP SETTiNG

CH EM $ 5 T R YL l T H OLD G Y

FROM To ~ DESCRI PT l ON

T E 5 T B Y DA T E

TOTAL DISSOLVED SOLIDS mg/7 TEMPERATURE % OH SILICA (S#Og! mg/l

pmhos /cm- - - 1.

CONOUCTANCE AT 25- C TOTAL lRON(Fe) mgM TOTAL HARDNES5(COCO ~ mQA 1

TOTAL ALKALrNlTY(CCo,) mqh PHEN ALKALHNTY(CcCO;) mqA MANGANE3E(Mn) mg/l

COLOUR 0 D 0 U R TU R 5 I O 1 T YL

%

+

A N I ON S mg/ l 8 p Ml CA T i 0 N 5 mq/ ? 8 [) TM

1 {CARBONATE (co,) ~ ii

~

* - ~ CALCAUM (cm

BICARBONATE (HCO,) "

~

- -4 - - 4 MAGNESIUM (Mq) I

-1 1

SULPHATE iSO,) fSODIUM (NO) L

CHLORIDE (CI) 1POTASSIUM (K) 1 L

Nd; < NO, (NITROGEN) + ! RON (DVSSOLVE 0)

0 TKN. (NITROGEN)+

-+ i

~

~

PHOSPHORUS (P) 1 ]1 1

TKN - TOTAL KJELDAHL,NlTROGEN CHEMSSTRY SITE NO+

NOZ - NITRITE NO, = NlTRATE F

CHEMiSTRY FIELD TESTS%

- -

TE 5 T 8 Y D A T E EQUIPMENT USED

CONTENTS OF FOLDER

CJDRILL LOG PUMPTESTDATA CJCHEMKCAL ANALYSIS

CJ ~ EVE ANALYS ~ CJGEOPHYSlCAL LOGS EJREPOPT

0 T HE R

fSOURCES OF INFoRMATIoN