Well ID: 202989

MULTI-PURPOSE WELL COMPLETION & PLUGGING REPORT

Oklahoma Water Resources Board
3800 North Classen Boulevard
Oklahoma City, OK 73118
Telephone (405) 530-8800

Legal Location
North

x

«——— One Mile ———»
Each square is 10-acres

WELL ID NUMBER: 202989
Quarters NW-NW-NW	Section 18	Township 13N	Range 01WI

Latitude 35.6080833	Longitude -97.3534333
Date collected(latitude and longitude), if different from date the well was drilled: 08/21/2020
Method latitude and longitude was collected: GPS - corrected data (WAAS)

County Oklahoma

Variance Request No. (if applicable) n/a

WELL OWNER - NAME AND ADDRESS

Well Owner SILVER STONE HOMES

Phone

Address/City/State 10000 E MEMORIAL RD JONES OK

Zip

Finding Location

Well Name

Water Rights #:

TYPE OF WORK: Groundwater Well

USE OF WELL: Domestic

NEW WELL CONSTRUCTION DATA

Date Well or Boring Was Completed 08/21/2020

Number of wells or borings represented by this log 1
* (Borings are within the same 10 acre-tract and with the same general depths and lithologies)

Hole Diameter 12 inches to a depth of 20 ft.

Hole Diameter 8 inches to a depth of 300 ft.

CASING INFORMATION *Note: If surface casing is used please indicate that on the appropriate well casing information line.

Surface Pipe Material: PVC / Plastic Surface Pipe Diameter 8 inches Surface Pipe From 0 ft to 20 ft

1) Well Casing Material PVC Casing Diameter 4 inches Casing From 2 ft to 300 ft

SCREEN OR PERFORATION INFORMATION

Type of Screen: PVC Type of Slots or Openings: Factory Slotted From 280 ft to 300 ft.

FILTER PACK INFORMATION

Filter Pack Material: Gravel 1/8 inch (pea gravel)

Filter Pack Interval:

From 60 ft to 300

WELL SEAL INFORMATION

Type of Surface Seal Cement Grout/Bentonite

Surface Seal Interval: From 0 ft to 20 ft

Type of Annular Seal Bentonite - Hole Plug

Annular Seal Interval: From 20 ft to 60 ft

Filter Pack Seal Material n/a

Filter Pack Seal Interval: From n/a ft to n/a ft

TYPE OF COMPLETION: Pitless Adapter

HYDROLOGIC INFORMATION

Depth to water at time of drilling 300 ft

Estimated yield of well 25 gpm

First water zone 120 ft

LITHOLOGY DESCRIPTION

MATERIAL	ENCOUNTERED		SATURATED
MATERIAL	FROM (ft.)	TO (ft.)	SATURATED
SOFT SOIL	0	17	N
CLAY	17	40	N
SHALE	40	120	N
SANDROCK	120	140	N
CLAY	140	160	N
SHALE	160	240	N
SANDROCK	240	260	N
SHALE	260	280	N
WATERSAND	280	300	N

WELL LOCATION TO POTENTIAL SOURCES OF POLLUTION

Has this well been disinfected after completion of work? Yes

Are than any potential sources of pollution or wastewater lagoons within 300 ft. of the well? Y

Distance of Well is 51 - 75 feet from possible source. Type of possible source: House

PLUGGING INFORMATION

Date Well or Boring Was Plugged n/a

Total Depth of well being plugged ft.

Was the well contaminated or was it plugged as though it was contaminated? n/a

If the well or boring was plugged as if it was contaminated, was the casing removed or perforated? n/a

Was the grout tremied? n/a

Backfilled with n/a

Backfilled from _ ft. to _ ft.

Grouted with n/a

Grouted from ft. to ft.

Grouted with Cement

Grouted from ft. to ft.

Firm Name AQUA WELL DRILLING

D/PC No. DPC-0708

Operator Name BRANDON BAKER

OP No. OP-2153

Date 11/08/2020

Comments: BENTONITE INSTALLED AT 120 TO 130 FT ISOLATE BOTTOM; 20 FT SURFACE CASING AND SEAL INSTALLED