Well ID: 205084

MULTI-PURPOSE WELL COMPLETION & PLUGGING REPORT

Oklahoma Water Resources Board
3800 North Classen Boulevard
Oklahoma City, OK 73118
Telephone (405) 530-8800

Legal Location
North

x

«——— One Mile ———»
Each square is 10-acres

WELL ID NUMBER: 205084
Quarters NW-NW-NW	Section 14	Township 02S	Range 11EI

Latitude 34.387541	Longitude -96.127348
Date collected(latitude and longitude), if different from date the well was drilled: 03/16/2021
Method latitude and longitude was collected: GPS - uncorrected data

County Atoka

Variance Request No. (if applicable) n/a

WELL OWNER - NAME AND ADDRESS

Well Owner Jay & Deborah Harper

Phone

Address/City/State Box 360 Pauls Valley OK

Zip 73075

Finding Location 206 N. Mississippi Atoka, OK 74525

Well Name PSB-1 & 2

Water Rights #:

TYPE OF WORK: Geotechnical Boring

USE OF WELL: Soil Evaluation

NEW WELL CONSTRUCTION DATA

Date Well or Boring Was Completed 03/16/2021

Number of wells or borings represented by this log 2
* (Borings are within the same 10 acre-tract and with the same general depths and lithologies)

Hole Diameter 8.25 inches to a depth of 20 ft.

CASING INFORMATION *Note: If surface casing is used please indicate that on the appropriate well casing information line.

Surface Pipe Material: Surface Pipe Diameter inches Surface Pipe From ft to ft

SCREEN OR PERFORATION INFORMATION

FILTER PACK INFORMATION

Filter Pack Material:

WELL SEAL INFORMATION

Type of Surface Seal n/a

Surface Seal Interval: From n/a ft to n/a ft

Type of Annular Seal n/a

Annular Seal Interval: From n/a ft to n/a ft

Filter Pack Seal Material n/a

Filter Pack Seal Interval: From n/a ft to n/a ft

TYPE OF COMPLETION:

HYDROLOGIC INFORMATION

Depth to water at time of drilling ft

Estimated yield of well gpm

First water zone ft

LITHOLOGY DESCRIPTION

MATERIAL	ENCOUNTERED		SATURATED
MATERIAL	FROM (ft.)	TO (ft.)	SATURATED
clay	0	5	N
clay	5	10	N
clay	10	15	N
clay	15	20	N

WELL LOCATION TO POTENTIAL SOURCES OF POLLUTION

Has this well been disinfected after completion of work? n/a

Are than any potential sources of pollution or wastewater lagoons within 300 ft. of the well? n/a

Distance of Well is n/a from possible source. Type of possible source: n/a

PLUGGING INFORMATION

Date Well or Boring Was Plugged 03/16/2021

Total Depth of well being plugged 20 ft.

Was the well contaminated or was it plugged as though it was contaminated? Yes

If the well or boring was plugged as if it was contaminated, was the casing removed or perforated? Yes

Was the grout tremied? Yes

Backfilled with Native Materials

Backfilled from 0 ft. to 3 ft.

Grouted with Bentonite/Cement Grout

Grouted from 3 ft. to 20 ft.

Grouted with Cement

Grouted from ft. to ft.

Firm Name GRATEFUL DRILLING, LLC

D/PC No. DPC-1027

Operator Name JUAN BAZAN

OP No. OP-1222

Date 03/23/2021

Comments: Well report represents PSB-1 & 2 being drilled & plugged.