Document VJxrOYakwRjVkN1jNO0RM80Do

Well ID: 159475 Legal Location MULTI-PURPOSE WELL COMPLETION & PLUGGING REPORT Oklahoma Water Resources Board 3800 North Classen Boulevard Oklahoma City, OK 73118 Telephone (405) 530-8800 WELL ID NUMBER: 159475 Quarters SW-NW-SE Latitude 36.67007 Section 04 Township 25N Longitude -96.34019 Range 09EI Date collected(latitude and longitude), if different from date the well was drilled: 02/27/2014 Method latitude and longitude was collected: GPS - uncorrected data ---------One M ile---------- Each square is 10-acres County Osage WELL OWNER - NAME AND ADDRESS Well Owner Osage Nation Address/City/State Pawhuska OK Finding Location ___ Well Name ___ TYPE OF WORK: Geothermal or Heat Pump Well Variance Request No. (if applicable) n/a Phone _______ Zip ____ Water Rights #: ___ USE OF WELL: Heat Exchange NEW WELL CONSTRUCTION DATA Date Well or Boring Was Completed 04/10/2014 Number of wells or borings represented by this log 99 * (Borings are within the same 10 acre-tract and with the same general depths and lithologies) Hole Diameter 5.5 inches to a depth of 267 ft. CASING INFORMATION "Note: If surface casing is used please indicate that on the appropriate well casing information line. Surface Pipe Material: Other Surface Pipe Diameter 6 inches Surface Pipe From 0 ft to 1 ft SCREEN OR PERFORATION INFORMATION Sierra Club v. EPA 18cv3472 NDCA Tiers 8&9 http://www.owrb.ok.gov/wd/reporting/printreport.php?siteid=l59475(8/22/2017 10:06:15 AM] ED 002061 00172014-00001 Well ID: 159475 FILTER PACK INFORMATION Filter Pack Material: __ WELL SEAL INFORMATION Type of Surface Seal H. S. Bentonite Grout Type of Annular Seal n/a Filter Pack Seal Material n/a TYPE OF COMPLETION: _ HYDROLOGIC INFORMATION Depth to water at time of drilling __ ft Surface Seal Interval: From _0_ ft to 267 ft Annular Seal Interval: From n/a ft to n/a ft Filter Pack Seal Interval: From n/a ft to n/a ft Estimated yield of well 15 gpm First water zone 160 ft LITHOLOGY DESCRIPTION clay sandy shale sandstone sandy shale limestone F \ ( OI MT.KFD ! ROM TO IH.S (it) 0 18 18 47 47 219 219 267 S \ I l ii \ 1FI) N N Y N WELL LOCATION TO POTENTIAL SOURCES OF POLLUTION Has this well been disinfected after completion of work? No Are than any potential sources of pollution or w'astewater 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 n/a Total Depth of well being plugged ft. Was the well contaminated or was it plugged as though it was contaminated? n/a If the well or boring was plugged as if it w7as contaminated, w7as the casing removed or perforated? n/a Was the grout tremied? n/a Backfilled with n/a Backfilled from ft. to ft. Grouted with n/a Grouted from ft. to ft. Grouted with Cement Grouted from ft. to ft. Firm Name VENTURE DRILLING. INC. D/PC No. DPC-0215 Operator Name AARRON RECTOR OP No. OP-1665 Date 05/07/2014 Comments: See attachments for hole locations. Also, 96 holes were drilled to depth of 256 feet and 3 were drilled to 267 feet. Again, see attachments. Holes were grouted through a tremmie to the bottom and HS BH20 grout was used. Sierra Club v. EPA 18cv3472 NDCA Tiers 8&9 http://www.owrb.ok.gov/wd/reporting/printreport.php?siteid=159475[8/22/2017 10:06:15 AM] ED 002061 00172014-00002