CHAPTER A - THE TECHNICAL BASIS FOR GROUNDWATER PROTECTION 



Cape Cod Aquifer Management Project Final Report Page 22 



OBSERVATION WELL INTEKTORY 

 WELL DESCRIPTION FORM 



Hell Identification 



Status Lat./Lonq. 



• Accessibility 



Hell Completion Date Well Ownership 



Casing: Outer Dianeter Inner Diameter 



Material 



Screen: Diar.eter Length 



* Width of Openings * Material 



Depths: Depth to top of casing frox M.P. 



Depth to bottoa of casing from M.P._ 



Depth to top of screen froai H.P. \ 



Depth to botton of screen fron H.P. 

 Depth, total of hole (ft below LSD)' 

 Depth, total of well (ft below LSD)' 

 Depth to water level (ft below LSD)] 



Top of casing segnent below LSD \ 



Bottoa of casing segnent below LSD_ 

 Depth to bottom of grout below LSD 



Elevations: Elevation of top well casing above MSL_ 



Elevation of land surface datum above MSL 



Elevation of ground water ref. to MSL ^ 



Measuring point elevation_ 



Measuring point height above. LSD 



Drilling Method Drilling Fluid_ 



Method of Developcent_ 



T>'pe of Surface Seal Packing Material_ 



Well yield 



Available Logs 



Well use 



Method of Water-Level Measureaent 



Source of Water-Level Data 



Sample Type and Frequency 



Remarks: 



Figure 4.1 Observation Well Inventory Well Description Form 



