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WELL OWNER AND ADDRESS <br />. = /444 �l <br />wEkC L CA ION SECTION <br />DRILLE?'S" IGNATURE <br />5—mm 1l_COMPANY <br />76 <br />LOT BLOCK <br />DATE <br />WELL RECORD <br />VILLAGE OF ORONO a <br />CRYSTAL BAY. MINN. <br />PERMIT NUMBER <br />.23/ <br />TELEPHONE <br />., �, I <br />SIZE OF WELT .3 INCHES WATER LEVEL 30 EET <br />WELL DEPTil FEET DRAW DOWN— FEET AT G GPM <br />CASING DEPTH 3 FEET CAPACITY GALLONS PER/HR. <br />/ 2 � CASED WITH <br />DEPTH OF IMPERVIOUS FORMATION FEET <br />WELDED JOINT 0 <br />SCREEN ��FEET INCHES/BY Z INCHES <br />MAKE AND TYPE MATERIAL: y—rC' ,) " AfC1<' SCREWED JOINT 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 />REMARKS <br />/0 <br />/d <br />? <br />d <br />EXTERIOR SPACE AROUND CASING SEALED WITH: r.] CEMENT GROUT w PUDDLED CLAY 0 OTHER <br />DISINFECTANT USED � / - <br />HOURS LEFT IN WELT 2 <br />(OVER) <br />