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Home My WebLink AboutSewer Abandonment Paperwork V1(�1�E IDIAN� APPROVED Form 38(4)-2 02/2014 re", ^° deage of 2 D.W. _ soecions. Permit Number: m RECEIVED MAY 2 4 2021 INA ,�11 RESNCES y r�cSTEM ON ID NUMBER None State of Idaho Department of Water Resources AUTHORIZATION TO ABANDON (DECOMMISSION) A WELL 1. WELL OWNER INFORMATION: (The well owner is the person who legally owns the property.) Name: Granite Excavation, Inc Current Mailing Address: 225 Wooddale CitV: Eagle, Telephone: (208 ) 382-4188 e, Ste. 115 State: Idaho Zip Code: 83616 2. WELL LOCATION: (GPS required in Degrees Decimal Minutes.) Twp. 04N , Rge. 01 W , Sec. 27 1 /4 SW 1 /4 SW (10) (40) Gov't Lot No. County Ada Lat.43 38.9771 Long. Street Address of Well Location: 4924 N Blackcat Rd City: Meridian Lot, block and subdivision: 3. TYPE OF WELL: 0 DOMESTIC ❑ MONITORING ❑ IRRIGATION ❑ OTHER 4. WELL INFORMATION: (*Casing size, well depth & static water level data are required.) 1 /4 (160) 116 27.1882 (Describe) Well Tag Number: Previous Drilling Permit Number: Water Right Number: - Well Log on File? (Provide if available) ❑Yes ONo Temperature: ❑less than 85°F ❑greater than 85°F *Casing Size: 6" *Material: Steel *Well Depth 112 (measured) *Current Static Water Level: 9' _(measured) Flowing Artesian? ❑ Yes 0 No 5. REASON FOR ABANDONMENT OF WELL: No longer needed 6. PROPOSED METHOD OF ABANDONMENT: (Must be consistent with IDAPA 37.03.09. This Application must be reviewed prior to commencement of abandonment.) Perforate & Pressure Cement 7. Drilling company name: McLeran Well Drilling LLC company lic. No. 641 8. Date of abandonment: 5/24/2021 9. Applicants signature:,��%- - 10. Title: Owner/Manager date: 5/24/2021 ACTION OF THE DEPARTMENT OF WATER RESOURCES This application for abandonment has been reviewed by IDWR on S / 25 / zo21 This review does not constitute an endorsement by IDWR of the proper abandonment of this well. Pursuant to Section 42-238(12), Idaho Code, all abandonments must meet the requirements of the Administrative Rules for Well Construction Standards. Abandonment of this well will require the services of a wt, {I• r It�r,,tlicensed in the State of Idaho unles a waiver has been granted. V;. 1-9ES0UPR j'E AGENT Siod &e of Authorized Department Representative Title (-�,frE APIDIAN- PROVED -Form -page .ftso D.W. _ eci,ons. Permit Number: m 4)-2 02/2014 2 RECEIVED MAY 2 4 2021 ID NUMBER None wn 4rSnU ,r,=c Wate�aldaho Department of Water Resources AUTHORIZATION TO ABANDON (DECOMMISSION) A WELL 1. WELL OWNER INFORMATION: (The well owner is the person who legally owns the property.) Name: Granite Excavation, Inc Current Mailing Address: 225 Wooddale Ave, Ste. 115 City: Eagle, State: Idaho Zip Code: 83616 Telephone: (208 ) 382-4188 2. WELL LOCATION: (GPS required in Degrees Decimal Minutes.) TWp. 04N , Rge. 01 W , Sec. 27 1 /4 SW (10) Gov't Lot No. County Ada Lat. 43 39.0269 Street Address of Well Location. 4644 Delphine St City: Meridian Lot, block and subdivision 3. TYPE OF WELL: 0 DOMESTIC ❑ MONITORING ❑ IRRIGATION ❑ OTHE 1 /4 SW 1 /4 (40) (160) Long. 116 27.1099 (Describe) 4. WELL INFORMATION: ("Casing size, well depth & static water level data are required.) Well Tag Number: Previous Drilling Permit Number: Water Right Number: Well Log on File? (Provide if available) ❑Yes RNo *Casing Size: 6" *Material: Steel *Current Static Water Level: 9' 5. REASON FOR ABANDONMENT OF WELL: No lonoer needed Temperature: ❑less than 85DF ❑greater than 85°F *Well Depth 184 (measured) _(measured) Flowing Artesian? ❑ Yes 0 No 6. PROPOSED METHOD OF ABANDONMENT: (Must be consistent with IDAPA 37.03.09. This Application must be reviewed prior to commencement of abandonment.) Perforate & Pressure Cement 7. Drilling company name: McLeran Well Drilling LLC company lic. No. 641 8. Date of abandonment: 5/24/2021 9. Applicants signature: 10. Title: Owner/Manager date: 5/24/2021 ACTION OF THE DEPARTMENT OF WATER RESOURCES This application for abandonment has been reviewed by IDWR on 5 I '2-15 / 2.021 This review does not constitute an endorsement by IDWR of the proper abandonment of this well. Pursuant to Section 42-238(12), Idaho Code, all abandonments must meet the requirements of the Administrative Rules for Well Construction Standards. Abandonment of this well will require the services of a vW0 H�T�I� er� led';irj t"f to of Idaho unless a waiver has been granted. J� �1f RE Sid to of Authorized Department Representative Title �fE IDEZ IAN— APPROVED m�es a<MA 1 23 e;aon°: 2 c reP°n Permit Number. m 4)-2 09/2010 2 ite Excavation, Inc. ABANDONMENTPROCEDURES: NUMBER: ABANDONMENT REPORT Must describe all details of work performed, including perforations, sealing materials, and how casing was removed. PROCEDURE: FROM: TO: WEIGHTNOLUME: 4924 N Blackcat Rd 112' Depth 9" Static Perforate well every 6' (4) Perforation per row 7 100 Pump cement/bentonite grout through tremie 0 112 585 Gal Day 2-Topped off with Bentonite Chip 200 Lbs DRILLER'S CERTIFICATION I/We certify that all minimum well construction standards were complied with: Drilling Company: McLeran Well Drilling LLC License # 641 Principal Driller: �� Date: 7/6/2021 Operator: Date: