Document 2510564

, 5026
.6entrap
lf L-99
WATER WELL RECORD
Fraction
LOCATION OF WATER WELL:
S€ction Number
SW 7r
NE
SW
v<
8
vt
Distance and diroction trom nearest town or city street address ol well if located within citv?
Approxlmately
3 ml1es west of Deerfleld
Kansas Geological
Survey
RR#. St. Address. 8ox #
1930 Constant AveWATER WELL OWNER
Boardof Agriculture,Divisionof Water
State. ZIP Code
ApplicationNumber:
LOCATE WELL'S LOCATION
A N " X ' ' I N S E C T I O NB O X :
D E P T HO F C O M P L E T E DW E L L . . . , . I 7 5
tt. ELEVAT.oN;. .gnkpowt
Depth(s)GroundwaterEncountered 1
. . . . . t t .2 .
. . t t .3
WELL S STATIC WATER LEVEL .24 ..7.7 . . . ft. below land surface measuredon mo/dav./vr L2-Z-:99
Pump test data: well water was no.t . chr.d. tt. after
h o u r Sp u m p r n g
Est. Yield unKnowrbpm:
Well water was . .
tt. attef
hourspumprng
N
t
I
I
-r.{f--
I
I
I
II
=w
:
7
I
t--
I
I
I
I
t
I
I
- _ Nt_I
I
I
_ _ 5 E_ _
I
I
mrtted
Water Well Disinfected?Yes
TYPE OF BLANK CASING USED
1 Steel
3 RMP (SR)
4 AAS
B f a n kc a s i n gd i a m e t e r
5 Wroughl iron
8 Concretetile
6 Asbestos-Cement
7 Fibergtass
9 Other (specifybetow)
.2,
......in. to. .
148
ft.,Dia
2+
.
. ..in., weight
TYPE OF SCREEN OR PERFORATIONMATERIAL
1 Stsel
3 Stainlesssteel
5 Fiberglass
2 Brass
4 Galvanizedsteei
SCREEN OR PERFORATIONOPENINGSARE
'I
Continuous slot
3__t,ljl!_9]9!__
1.10
6 Wire wrapped
7 Torch cut
148
NoX
Wetded.
rhreaded. .
..ttto.
169...
12 None used (open hote)
8 Saw cut
11 None (open hole)
9 Drilledholes
10 Other (speciiy)
ft., From
...fl.to.
ft
From.
..tt.to.....:.......
ft., From
tt. to
.
GRAVEL PACK INTERVALS:
From.
140
.ft.to.
180 ..
ft., From
...tt.to
From
tt. to
From
ft. to
ql GRoLrr MATERIAL:
2 cementgrout
3 Elentonite
4 other ...Be:rt.onl-te
llclepJ-';g
^ 1 Neatcement
e r o u tl n t e r v a l sF: r o m . . . 0 .-.f l l "
-.135
... ft., From
. . . . . n . t o . . . . . . . . . . . . t r . , F r o m . . . . 1 3 5 . . f 1 .t o I
What is the nearestsource of possiblecontamination:
'|
Septic tank
4 Laterallines
2 S€wer lines
5 Cess pool
3 Watertight sewer lines 6 seepage pit
a
n
c
U
n
!
r
rt.,Dia.
...into
. . . t b s . / f tw. a l t h i c k n e sosr g a u g eN o . . . . 2 O 3
?_PVq
t0 Asbestos-cement
_
8 RMP (SR)
11 Other (soecif_v)
I ABS
5 Gauzed wrapped
From
C
l
CASINGJOINTS: Glued . .X . , Clamp€d
6 Concretetile
4 Keypunched
SCREEN-PERFORATEDINTERVALS:
fi
2L.....in.to.....I7.3
Casing height above land suriace. .
2 Lowered shutter
gpm
gpm
Bore Hole Diameter. . 6
. .in. to .
L75
. .tt., and
. . . . i n .t o . . . .
WELL WATER TO BE USED AS:
5 Pubticwater suoolv
I Air conditionino
1 1 I n l e c t i o nw e l l
1 Domestic
3 Feedlot
6 Oil field water supply
1 2 O l h e r ( S p e c i f yb e t c w )
9 Dewatering
2 lrigation
4 lndustrial
7 L a w n a n d g a r d e no n l y 1 0 M o n i t o r i n g
well . ... ObSefVa.tlQn.Wel1.
Was a chemical/bacleriological
sample submittedto Department?yes
N o . . . . X . . . . ' l f y e s ,m o / d a y l y sr a m p l ew a s
I
2 PVC
.n.
tl
ft
ft
.t+O
10 Livestockpens
14 Abandonedwater well
7 Pit privy
11 Fuel storage
8 Sewage lagoon
12 Fertilizer storage
9 Feedyard
13 Insecticide storage
15 oit weil/Gaswell
16 other (specify below)
None kr.rqifi
C1ay,
tan,
gravel
. n
streaks
Clav. br
Clay.
lay.
tan
qreen.
sra
Clav, black
C1ay, bluer
qreen
streak l28r C1ay, gray, sand streaks
CIav, dark gray, gravel
streaks
Sand and gravel,
medlum,
flne
CONTRACTOR'SOR LANDOWNER'SCERTIFICATION This water well was (1) constructed,(2) reconstructed,or (3) plugged under my jurisdictionand was
and this record is true to lhe_bett of my
Water Well Contractor'sLicenseNo.
.
185
Record was compfeted on (mordqf{rl/
|
of
C1arke Well
&
INSTRUCTIONS: Us tyFEwrateror ball fpint
ol Heaith and Envirmrent Bureau ol waler, ropeTiliiiilEToh-i
uipment,
Inc.
Teteptrm:913,29G5545
send ooe ro WATER wELL owNER and rerain 6e
ror your recoros
I
U
rr
c
,
CLARKE
WELL& EQUTPMENT,
tNC.
WELLRECORD
DESIGN
& CONSTRUCTION
SHEET
r7o
JOB NUMBER
- WELL owNER
WELL USE
KansasGeologicalSurvey
Obsen'ationWell
LOCATION
T 24
5026
sw
S, R 35
1/4
NE
W
1t4
SW
Keamy
1t4, SECTTON
NO.
COUNry
STATE
" DtA.
I
2 rt2 " DtA. .203
sTzEScREEN;
o
l z _ Eo u r ( E t r r r _ z t l z
SECTION
WALL; WT. 1.10 LBS/FT
.o,il-.r,,
..DlA.
.203
SCREEN ryPE
PVC
*oil
w
ALL;
M i l t Slot
slnt
Mill
TO
8
Kansas
FEL
SIZE HOLE
FROM
Bentrap#1-99
APPROPRIATION
NO.
trql
SIZE CASING
WELL No.
MATERIAL
PVC
MATERIAL
O P E N I N GS I Z E
FORMATIONDESCRIPTION
NIUANEUT
.032
CASINGAND
SCREEN
FROM TO
0
6
6
t6
C'lav hrown
t6
21
Clay, gray
Screen
r48
168
20
21
1A
Clay, tan
Casiag
168
173
5
.,4
Topsoil
u45urB
58
Clay, green, gray
58
64
Clay, blue, green
64
92
Clay, black
92
lul
Clay, blue, green
107
t12
CIay, gray
r12
129
Clay, gray, sandstreak 128,- l2g'
r29
144
CIay, gray, sand streaks
t44
1 5 8 Clay, dark gray, gravel streaks
158
1 5 9 Clay, tan
Casingleft aboveground
CONTINUEDONBACK SIDE
0
lr+6
lr+6
Clay, brown
)l
FROM
U
ruv tA\rtr
Total Casinqand Screen
z
n5
WELL COMPLETIONDETAILS- GRAVELPACKAND ANNULARSEAL
TO
DESCRIPTION
FROM
TO
DESCRIPTION
1 3 5 Neat Cement
135
1 4 0 Bentonite Holeplug
140
1 8 0 Gravel Pack
StaticWater Level 24.77,(12-2-99) Chlorinatedwith
None
What is the nearestsourceof possiblecontamination?
Directionfrom well
None known
How manyfeet
ls waterlevetmeasurement
tubeinstalleoZ
l-lyes
D E S I G N EBDY
Quantity
Mf.fo
DRILLEDBY
NOTE: All measurements
are from groundlevel
EdwardCass
DATE
t\A/gg
ContinuedFormationLog Dataof Well pi1s.
FROM
TO
Bentrap#1-99
FORMATION
DESCRIPTION
159
too
Sandand gravel.medium, hrie
100
t75
Clay. tan. gravel streaks
THICKNESS
CASINGAND
SCREEN
FROM TO
rUU
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