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WELL OWNER AND ADDRESS <br />WELL RECORD * <br />WELL LCStATION SECTION (/ LOT // BLOCK VILLAGE OF ORONO <br />CRYSTAL BAY. MINW. <br />DRILLER'S DATE PERMIT NUMDBR <br />S'/'//'r 6 <br />ADDRESS TELEPHONEDRILLING COMITY <br />Size OF WELL .INCHES <br />WELL DEPTH.^5iJ^ <br />CASING DEPTH. <br />..FEET <br />-FEET <br />WATER LEVEL .FEET I <br />U.CDRAW DOWNjLLili!L:rr:FEET AT ----K': GPM <br />OCAPACITY GALLONS..PER/HR. <br />DEPTH OF IMPERVIOUS FORMATION ___________________ <br />SCREEN __________FEET___________INCHES/BY -------- <br />MARE AND TYPE MATERIAL: V A X <br />FEET <br />INCHES <br />CASED WITH <br />WELDED JOINT □ <br />SCREWED JOINT ^ <br />REMARKS: <br /><OVER) <br />/ KIND OF FORMATION COLOR <br />STARTED <br />DEPTH <br />ENDED <br />DEPTH <br />THICKNESS <br />OF <br />FORMATION REMARKS <br />JE^ <br />/yy <br />..ajJ /« <br />EXTERIOR SPACE AROUND CASING SEALED WITH: Q CEMENT GROUT Q PUDDLED CLAY Q OTHER <br />DISINFECTANT USED. <br />HOURS LEFT IN WELL <br />(OVER)