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WATER WELL REPORT

ECY 050-1-20 (Rev 08/19) If you need this document in an alternate format, please call the WATER Resources Program at 360-407-6872. Persons with hearing loss can call 711 for Washington Relay Service. Persons with a speech disability can call 877-833-6341. WATER well REPORT Type of Work: Construction Decommission Original installation NOI No. Proposed Use: Domestic Industrial Municipal Dewatering Irrigation Test well Other Construction Type: Method: New well Alteration Driven Jetted Cable Tool Deepening Other Dug Air- Mud-Rotary Dimensions: Diameter of boring in., to ft. Depth of completed well ft. Construction Details: Wall Casing Liner Diameter From To Thickness Steel PVC Welded Threa d | in. in. | | | in. in. | | | in. in. | | | in. in. | | Perforations: Yes No Type of perforator used No.

pumping or drilling, or a nearby well that is pumping. Include the date the measurement was taken. Artesian pressure is the gauge reading of a flowing artesian well with the valve closed (shut-in pressure), reported in psi.

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