L

3* W'*

1

3

- I

#

A

E

G~ ~

E

fa T ? U FM?

SCHEDULE 2

REPORTING REQUIREMENTS FOR WELL IDENTIFICATION FOR A WELL THAT IS FOR

THE PURPOSE OF SUPPLYING A WATER SUPPLY SYSTEM

1. Well Identification Plate Information@ *;£,.Q A ~-

Dalte:.{=-;..(...i Well Identification Number: Q

£

Plate attached by; TTJ<I? ..3/ .*.1) £

Description of where plate is attached (usually azmched to the well casing or well cap): - * i { .(! ( H"' /

2. Water Well Information

Name for the Water Supply System Well jag., "Township OjLangley #8")2.. ii' ? = ! ! L ; ..s A -M £€ & X O HM K<

V .! - :N, ~ @ V

. 4

2> V, X {3 (' ~V V k~

Well location description or address:.

"x

Latitude (degree/minutes/seconds):..l ..r 7!

Longitude (degree/minutes/seconds):. Of ~

,

~

{Tx~

, ~ { a

7 rc,,,€;£7'ivx}UTM Northing to within 33 feet (lo m):

UTM Easting to within 33 feet (10 m):..

Source of Latitude/Longitude or U l M coordinates {check one):

GPS IN 1:20,000 map [ ] 1:50,000 map [ ] Other (please specify) [ ]

Legal Description of Well Location

Township; {.7 Section: lg'')9District Lot: . Range;. PID - ? ..T 2 ? 2 .1..~ .f %.

Lot., Block:

If well construction report is attached to this form, please check [ ]

3. Water Supply System Information€ C £

,. 112 VL/£<

Water Supply System Name:

Owner Name: -.~ ,9 /( / ( £ ( MY} ",'],/lt 7(42 ~

-

VQ/ "

] A ?"

(/ (.

li? Ci (? fr} if (£ £€ >7 L'7 /1 , (V');->

(Mailing Address:

City or Town );,lT--r! IQ' (/1€;

?SU 'TY 9 { $3<Phone Number; [ j M.-

Nj 0 ~ [ FX," 0

Postal Code: ixl 0 6-€ L€1/ ( )

EM .1rwyf /~m/a £W£:={:~ ( (iii' €/£'z,:£"w/££1. *1€€€1/*31 :

24 of 36

* Please provide UTM ZONE with UTM COORDINATES

Well Depth: (ft €' m)

Well Di£lmete1:g

'illchce; cm)

{Hm).!

€ 4'M-?

! " , ,

1,'> < : ~ Uti

Mj /L<,

*3

i

EXAMPLE Please usc the space above to sketch the well locationand proximity to roads, buildings, waterways, etc.

Schedule 2 Notes:

W'el1 Identification Number

This is the number found on the stainless steel plate attached to the well. It is not thenumber the well is assigned in the WELLs database, called the "Well Tag Number"

Well Location:

Provide the Land District (e.g. New Westministcr) for the well location and include in""Legal Description ofWeli Location'" scct1on.

Geographic Coordinates:

- Ensure the GPS map datum on your GPS unit is set to "NAD 83"'* Ifusing UTM Coordinates, please include the UTM Zone (Zone 10 for Vancouver-

Coastal and Fraser Health Regions)- Latitude and Longitude can be expressed as dcgrees/minutes/seconds (50/30'/40") or as

decimal degrees (50.5 lo).

Supporting Documentation:

Please include copies of any of the following documents, if available:well construction reports/logs

- pumpmg test reports- documents that include infomlation about the well, local geology, well location, etc.

Please send completed forms to: Deputy ComptrollerMinistry of EnvironmentPO Box 9341Stn Prov GovVictoria BCV8W 9M1

(

DKIHSHCOLUMB1A

En;EbnHMMH

WATER WELL

€ M; * * V'1" 1 . . .1;.

Water Management Umsm

RE C 0 R D Ocr = .(2 [ r

~ 7 ( Q

WELL Nv - .;.,J.J:

1 )* : M W 1Lf1I HZ

~

~

iL Ev' ' *

W Eli

Fl Our = 3 Tw

,TAM"Muucv

- ux Nome 6 Acurtsx -~.~.'( ££2 WEST J'B'I€

Ml C L F

La; <.1

ax C€;€up - .an 3 Addrzn ' #£2 ,MME. ?. $2 A yewz'v%AmnuriA,@!, r;,"££u mimi ,4.1. B aim/AJ 0 U~= £££)£.e!,,21

* ' ? , XlT

£*nvc LQrunon ~JStill!/ P = 1 L Me - WEi 2 CC;;rdl!luFCS 9 CASiNG

F' WORK J Ceepmld I [J -lbownor- eu

VURK1 ,me mol 2 Bono J qelud

4 E l HOO£ ~otllry a LJ md ? ~~;r C Urcvcrec

C mw

vM [ H 1 Mmuam 2 MmEk = rl 3 nr4qunuH L USE4 [Q'Cm1m A ul Clher

:Ru;LmG AODIMVES ,MME

2 ;Cu - cm/rt J UWGGG

Q PlUsElc 5 CcncllHOmu

WEASUREMENTS MOM 1 ~ ';Vr:;' Hug! 2 ?Up uP €.9 > *nq

mu Magi How 90Ur) Ml ..~ - .~ - T

,MT,l HQH

fl - mn - An

3 : vr € fc 1.

,Dm.

I

- .

~ ~

. ..WT

- , -

!!

DO

* -7 % l

f-' [ 1 € k Pr 5 S

* - LI - 1

4wi: V

./2,9. 1( F !

PMBM Un 1 , - .#17 1 OOJH 2 b-USB gr0u 13 inc!~eldrc 2 CCMMMGO J TNem!Q = ,1 ~#8 2 LH -J

*H T"- .? G WELL LOG DESCRWNUN

1 EAUZAQMLZL

5 av L

/ J

( L A )/ LEA/5*65L 1£s'.,..Lm££ELZ,4£/0,G/EA;£E L £

Calm; £,5.1 Can ,v Ex )?£/5,.57

t

!

- l-

I"' -?

~ +] 1

-!

T Y . 1-1

NMGYG -

VOWs

Silct vs) - giftOpcr Mir, hum no L)l3ID: - it'

Groul

WO. SCR EEN ? 1 Manual (Tebwnmf L'FtPD< Su =

),< .Ef(;1hnum# Sc JPer:rLw1 £ LJ [, ; L - 1 (

OlhtrMulmni 1 iFf$1mNeu Stew 7 Mor € ! JCm.Er

SGf from . .( TO !' urow qfww war!

HAM, SCREW li. maris ,il 'B ;-i- - -- 4-- -~ <

r {- gm; IN Ir

T)'am I D - Fl 3l

sm sm 54I

~ ~~

- ~ -~

- i

(rom 9 ~ '

! 1

"

[ .- ;1£1; I !

FYmrqs,1oD ~ AA AES 22 ~ ZZbut ' £ tw ?

Gravel Pun

Il. CPr€.0PED bY: ! s£,;;rg 2 Jmzm.; J ~1. =

6 ft Um 1 iq 5 Pumpmq C Omg. (

l2 TEST! LJ ;> .mn 2 CUM 3 (VA OBIE ~ / (3 Z { L

FB1102 fusqw NM '( SWL b<Eonc leu ~~m~~

WA; LWQI 2 1£ 5 fl chu ru' cY hf s

ma'. -.DOwH yu r @ BEC<3*JE Wv M lu

(,1 -;;1

W L mm g W L Ml rmm 3% . rTLHS : 'fl ,

7 1{ .

* I ; 11;; ,

L L- ,- ,.(

- [-5;; ga y en. UI] . =>1w ! l v Pr WLLLB B L nu ,l vipt I r u =[-u:u.Ballc tu ANNA *

I3 L££@HEM€£€ :ag A fin {' 7=7 4s

1

/nc . WAT EH TY PE : ' f~m 2 [ Bern J Or rv 4 F< -€:

!

colml,7, ~ ... WEI! ; qc L 1 fi YES 2 ~1

Es. WATER ANALYSIS >11, Lll18*,@.K , A 4 "Wi* coNsuuAm

1 NHL. * ;' -L ! mg, .3 .;c L

.3 Id r ! ! $4 1ui' L, ,1..L- j UM t

d WL LOCATION SKETCHSi TE l 0 No L ct Law

Ib. HNAL WEL; COMPLETION CAN Hi- 'f'.

-cm Occln Liu Wig]" WetT '(MIL!.

S i / 1 ~i~ Us 7 [, m

Eiuhc Wow Lzvci'

MY mr" 9

Pu e

US ;sm N :1., I - L.

Such Ii md -/

We:' mod Como zhou

) u H 14 B I£7. (MILLER ?

KLH L Km f £5 1/ 1 £ L ,,hf - L - ,pi -1 ,

1 EH ! 54 li !

/ . .Slqnom: ~"

2 ~.1

lb. CONTRACTOR,'J v C > E ,4; SCIILBLI DRILLING

/" lose Mabel Lame Pm ml B29//~ Lumoy. Uc. wc £L.0

Hgfrlhr', U (1% W cJ 4*- - .P;CS JUG

. /

Blair, Tamm! ENV:EX

From: Lyons, Laurie A ENV:EXSent: Fri. October 27, 2006 12:02 PMTo: Blair, Tammy ENV:EXCc: Bennett. Kevin A ENV:EXSubject: Well Plate ld 12809

Tammy,

Kevin attached Well Plate 12809 to the Medallion Meats water supply well on Oct 24th. I filled in part of the Schedule 2

and left it with the Quality Control Manager to complete and submit.

Medallion Meats is located 5 km South of Westwold on Hwy 97C and Pinaus Lake Rd. The company address is: KourHoldings Corporation, 1861 West 58th Ave, Vancouver, V6P 1X1 .

Laurie

1

BeGs MAP [ { 1/ ~PL' " 1' ' ' ' ' 1 lil*, - ; - 4 - 1 1*4

Ti 7

WTN !j

" ,1

WELLNO Lyi

WATERMINISTRY OF WATER, LAND AND AIR PROTECTION

LEGAL DESCRIPT lON * LOT 5 E C T P R

WELL

UL

RECORD

LAND MSTRICT

DESCRIPTIVE LOCATION

OWNERS NAME

DRlLLEPS NAME

ELEVATIONDEPTH OF

WCTORM,BRWK%ICOLUMBM

PLAN

I C E NC E NO A T E

/

METHOD OF CONSTRUCTION

4 ADDRESS

ADDRESS

~ ESTIMATEDSURVEYEZD CA31NG DEAM

CASING [NAM

DATE COMPLETED

2 [ J WELL No ~* [ ~VAl

LTL;1;L;l =.l;Zj1Lil

[=ITlf;IIj;1Z X Y N 0 .

NAT TOPO SHEET NO

SCRE EN LOCAT iON SC R E E N

SANITARY SEAL YES NOS SCREEN

L ENCTH

LENGTH

PRODUCTION TEST SUMMARY

5<ZE

SIZE

PERFOPAYED CASING CJ LENGTH

GRAVE L PACK ~ L ENG T H [HAM

LENGTH

LENGTHPERFORATIONS FROM

SiZE GRAVEL, ETC

l YPtTY PE

Tn

DiSTANCE TO WAT ER ESNMATEO WATER LEVEL

F R O M MEASURED E LEVATD ON ARTESIAN Y~ ESSURE

DATE OF WATEP LEVEL MEASUREMENT

CH E M l 5 T R Y

T ES T 8 Y

WATER U5€

7*ATf' EST BY

HAM TFQT' "UM" TEST f*W,FlATWN OF TESY

HAVE

WATER LFX/FL AT COMPLE HON OF TEST

AVNLABLE DRAWDOWNPEFWEABNUTBrRANSM!SSMTYFSTWMATL WCLL WELUHF COMMENDED PUMPWG RATEFQFCOMMLNDED PUMP SETTN(

()?ANf)<V.'N

bPEC'F*C CAP/UJTNT') =TAGr, $£1)*,Fr

TOTAL DISSOLVED SOLIDSpmhos/cm

CONDUCTANCE AT25T

TOTAL ALKALlNlTY(CCo,)

COLOUR

mg/1 TEMPERATURE

TOTAL IRON (Fe) mq / %

'C pH

DATE

SlLQCA ($102)

TOTAL HARDNESS (COCO,)

mg/! PHEN ALKALINITY (CG C03)

ODOUR

ANDONS mg/l e pm

CARBONATE (cO,)

BICARBONATE (HCO,)!

-

SULPHATE iSO,)CHLORIDE (Cl) i

No; € No, (NITROGEN)

. Tr(N (MYROGEN)

PHOSPHORUS ( P) 1

TKN - TOTAL MELDAHL MTROGEN

NOZ - NKTRlTE NO, = NhTRATE

CHEMISTRY FIELD TESTSTEST BY DATE

i*1

]

mg/l MANGANE3E(Mn)

TURBIDITY

CATEONS mg/!

CALCSUM (Co)

MAGNESNWMQ) 1SOD!UM(NO)

+-

POTASSAUM (K)T

IRON(DISSOLVED) #T

mq/ l

mq/1

mg/l

8 DET!

~

i

34

FROMT+

1

+

1

%

+

TO

CHEMISTRY SITE NO

EQUIPMENT USED

CONTENTS OF FOLDE R

D 9 1 L L LOG

StEVE ANALYSIS

0 T HE R

SOURCES OF l NFOR M AT l ON

PUMP T EST DATA

GEOPHYSICAL LOGS

CHEMTClIL ANALYSIS

REPORT

4

+

1

+1

L+

+

J

%

lfT

$

f

!

%

4

#

#

$

1

i

!.

L

i -

i

!

f

#

1--

+L

1*L-

%

L

i

LITHOLOGYDESCRIPTION

J%

-i

-4

%

i

TNORTH

L

WEST

CARD BY -,- -

SOUTH

mMM42Elo:

K

!!

'1

*)€I

EFEK 4