HomeMy WebLinkAboutCC - Riverside - Well 3 Abandonment Report-05282026083126 R E C tE IVE D ^\� f DAHO DE PA 2TM ENT OF
Form 238(4)-2 0712025 4J WATER RESOURCES
Pagel
of 2 Z'Lo ID NUMBER
K1� <:^tn;Cel9tate of Idaho Department of Water Resources
AUTHORIZATION TO DECOMMISSION A WELL
1. WELL OWNER INFORMATION: (The well owner is the person who legally owns the property.)
Name: Toll ID I,LLC
Current Mailing Address: 3103 W.Sheryl Dr.Suite 100
City:Meridian State:Idaho Zip Code: 83642
Telephone: (208 ) 424-0020
2. WELL LOCATION: (GPS required in Degrees Decimal Minutes.)
Twp.03N Rge.01W Sec.4 1/4SE 1/4NW 1/4
(10) (40) (160)
Gov't Lot No. County Ada Lat.43°37.7118' Long, -116*27.8551'
Street Address of Well Location: 4000 Morgan Grove Ln.
City:Meridian Lot, block and subdivision:
3. TYPE OF WELL:
❑ DOMESTIC ❑ MONITORING ❑ IRRIGATION ❑ OTHER (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 ®No Temperature: ✓❑less than 850F []greater than 850F
*Casing Size:6' *Material:Steel *Well Depth 32�t (measured)
*Current Static Water Level: *11 (measured) Flowing Artesian? Q Yes No
5. REASON FOR DECOMMISSION OF THE WELL:
Development-Day Springs Subdivision-Toll Bros.
6. PROPOSED METHOD OF DECOMMISSIONING: (Must be consistent with IDAPA 37.03.09. This Application must
be reviewed prior to commencement of the decommission.)
Convert top toArtesian Control Tee. Perforated and Grout to WAADC Specs.
7. Drilling company name: Riverside Equipment Services LLC company lic. No. 333
8. Proposed date of decommission, April 13-24,2026
9. Applicants signature:
10.Title:Well Drilling Manager date: April 6,2026
ACTION OF THE DEPARTMENT OF WATER RESOURCES
This decommission application has been reviewed by IDWR on: I
This review does not constitute an endorsement by IDWR of the proper decommission of this well. Pursuant to Section
42-238(12), Idaho Code,all decommissions must meet the requirements of the Administrative Rules for Well Construction
Standards. Decommissioning of this well will require the services of a well driller licensed in the State of Idaho
unless a waiver has been granted. SENIOR WATER
RESOURCEAGENT
Signature of Authorized D artment Representative Title
Form 238(4)-2 07/2025 I D A H O D E PART ht ENT OF
Page 2 of 2 j WATER RESOURCES ID NUMBER: 924 85
State of Idaho Department of Water Resources
WELL DECOMMISSIONING REPORT
This form reports the activities of a licensed Idaho well driller and serves as the official record of work done for a well decommissioning. This form is to be completed by
the driller and filed with IDWR within 30 days of completion of the work.
Sealing Material:
Seal material(grout,bentonite chips,etc.I From(ft) I To(it) quantity eb:.baga,n9 Placement methodlprocedure(pumped,poured,etc.)
Neat Cement +2 320 164 ft3 Pumped
3/8" Hole Plug +2 18' 5 sacks Poured
Casing:
Was the casing perforated? F Yes No
If yes, list number, depths, and method of creating perforations:
From(ft) To(ft) Number/ft Size Method created(mill knife,perforate,etc.)
5 320 0.6 Mills Knife every 5' - 3 to the round
Was the casing removed? Yes If yes, indicate the amount of casing removed (feet): 7
❑ No
Was the casing cut at or below grade? I V/1 Yes
❑ No
Narrative:
Well was perforated from 5'-320'with a mills knife 3 to the round every 5'. Tremie was installed to the bottom and
159 bags (47 Ibs)where mixed and pumped. Overnight cement was tagged at 79'. Tremie was reinstalled and 96
bags where mixed and pumped to surface. Overnight cement settled to 18'. 5 bags of 3/8" Hole Plug where
poured to reach surface. Casing was excavated and cut 5' below surface and buried.
DRILLER'S CERTIFICATION
I/We certify that this well was decommissioned under my direct supervision, according to all
minimum well construction standards, and this report is complete and accurate to the best of our
knowledge.
Drilling Company: Rivers' quipmen IceerG s LLC License # 333
Principal Driller: Date: May 27, 2026
Operator: Date: