HomeMy WebLinkAbout1983-08-31 Water Well RecordSTAn QF m[rvAMnTA
LEPMTFETfT OF HEALTH
I. LOCATION OF vKLL
County liar Mettoo
t-M 1
Dlatslea ead DLreetlon from Rosd lot I-. or
E
II S
.. FORMATION ur,
NI:NVEJMA 1TI4UE WELL Nr'. I -_
WATER WELL RECORD for votarsa'pie i 127306
Vinnesatu :�kttutae :$F.7. ?I-.^F
M Number ]Uoas4f0 Nusbar flange Number 'TOPtFTY �V'1.� `1AC-------_
d lei =3 M;tzv'�rl�,�o®tts
N, or S. E. er ': —�
fre+s end City of Mal Loeat ion ' ray,&Lt,C 777�
n-aa rirA -A.- Sketch mmD of -11 location. ;igpTTt�c -lit. Date of Completion
�..... �_. .... Z%Z�
Iu Cable t-I Ap Reverse 7[:] Driven IDQ Dug,
A �$oRollrnd 50 At <- gored I1� -
n Rotary as Jetted 9E] Pc er A w r
2:. oMstic Public Supply 7V industry
-HAMW_ OF L]:rrtaati- SQ Air Conditioning, Fa Coewrcial
COLOR I FORNATQ• _.
_ - '[� Test Well
-•^ CANING ove%Delve
DIAN.
Threaded AI Welded Q3 Surfacs�_-____ ft.
Slack Oaly.
!n. to-ft. depth Welg,ht-___lbe./ft.
to depth
_ft.
_in. to_ _ft. depth Orlra Shoe? Tea At to
Or open hole-------�
Mnke a.ig,leak wawa fM! _ft. to ft.
, �_--
-'—TTTxcst
.et bet -en ft. and .9 :e.
---.--
4_�_ fe, and le.
ff. and H.
--... UAe dyo
.5. RIGIARKf`,,-ii DATA, etc.
---- -
LOCAL COPY
9. STATIC WATER
LEVEL
^•�' ft. A bel- U above Date Measured
land surface _—
e -land-our ace --- -��
't. after_ 4 hn. Dt®DtnR_
`--_ft. after_ hn. DuaPlng, _�__-.._A•D•m•
11. WELL HEAD COMPLETION
41Pltlsa■ adapter 2E) Saasmnt offset 30 At least 12" above
12. Veil NroutedT
4] Teo No Cu. TN. __-- _
1❑Neat cement .:O8"tonito X]1kchapa
Depth: from` _ft. to —_ft.
from ft. to ft.
13. Nearent eource of pwalble eMt-inntion
feet direction
Wall dleinfected upon comipletlm7 Tea 2 No
14. PINE ----
-_ Date Installed_*m
Not Installed
Manufseturer's Nnae
Model Number
;,.AU, of drop pipe it. capacity-�_�it. P.M.
Ma -.trial of drop pipe_
_.__. Type: 128u1mrslble IOL.R. Turbins SO Roe 1pr«attnN
'Q Jet Cj Cmtrifugal eQ
17. WAMM VF3,L CdfTRACTOR'S CERT'IFICATI M
Thle Vel: vas drilled under ay 1-11,1letion and thla report !a true to
the best of V kn-ledn and belief.
SW 5TUMI A ThIUL YlLM=G 00.. INC. 172
Addrena15306 1bg . # 7. Make, Him. 53%3
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Autnorl eed :!e; ree er.tnt!re
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