Gaston_Well Abandonment_20230515

E O LO G I G WELL ABANDONMENT FORM
E PLORATION
RI G !, � g,c k -70 DRILLER >�1 ` �� #
CLIENT I 1 V �J� �IELD REP
PROJECT a-t e-� DATES ONSITE -aU` TO
LOCATION PAGE OF .' WORK ORDER#
WELL# DIAMETER DEPTH WATER DATELEVEL ABANDON LATITUDE LONGITUDE
PO
GROUTER DAYS WATER TRUCK DAYS
GEOPROBE GROUTER DAYS WATER TANK DAYS
LABOR - REMOVE PADS HRS GEOPROBE HAMMER DAYS
LABOR - SPREAD TOPSOIL/STRAW/SEED HRS ELEC JACKHAMMER DAYS
LABOR -PLACE CONCRETE/ASPHALT PATCH HRS ASPHALT SAW DAYS
JACKHAMMER/AIR COMPRESSOR DAYS GENERATOR DAYS
CONCRETE BAGS I ASPHALT PATCH BAGS GRASS SEED BAGS
PORTLAND CEMENT BAGS I TOPSOIL BAGS WHEAT STRAW BAGS
DISPOSAL OFFICE: YES/NO I DUMPSTER LANDFILL 55 GALLON DRUMS AMT