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WELL OWNER AND ADDRESS <br />, <br />WEJ/L LOCATION SECTION LOFT- BLOCK <br />DRILLER'S SIGNATURE DATE <br />D ILLING COMPANY ADDRESS <br />SIZE OF WELL__ INCHES <br />WELL DEPTH---.. <br />CASING DEPTH- -.--------_-FEET <br />-.__-_--__.._FEET <br />WELL RECORD <br />VILLAGE OF ORONO <br />CRYSTAL BAY. MINN. <br />PERMIT NUMBER <br />- TELEPHONE <br />WATER LEVEL._-- l y - _ . _ __FEET <br />DRAW DOWN_ _- ._FEET AT __._GPM <br />CAPACITY GALLONS- 12 a0___PER/HR. <br />DEPTH OF IMPERVIOUS FORMATION__._ _---._FEET CASED WITH <br />rr <br />SCREEN- �_ FEET_-Z. ----_INCH ES�BY_.-..�1_-_-__..INCHES WELDED JOINT O <br />MAKE AND TYPE MATERIAL: ,t / //- j �Z_ ,y SCREWED JOINT L�r' <br />REMARKS <br />(OVER) <br />KIND OF FORMATION <br />COLOR <br />STARTED <br />DEPTH <br />ENDED <br />DEPTH <br />THICKNESS <br />OF <br />FORMATION <br />REMI)RKS <br />C <br />l <br />1 <br />EXTERIC,q SPACE AROUND CASING SEALED WITH: 0 CEMENT GROUT PUDDLED CLAY O OTHER <br />DISINFECTANT USED---- - ------�--- - .--._--..- -- - ------ -- -- - <br />t <br />HOURS LEFT IN WELL--------- -- --- ------------ -- ---- - <br />(OVER) <br />