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WELL OWNER AND ADDRESS <br />rdI i NRs 9fry SA . re- J- I w& <br />WELL LOCATION SECTION LOT •LOCK <br />WELL RECORD <br />VILLAGE OF ORONO <br />CRYSTAL SAY. MINN. <br />DRILLER'• SIGNATURE DATE PERMIT NUMSER <br />l.- al k"Aw <br />DRILLING COMPANY ADDRESS TELEPHONE <br />r <br />41 <br />SIZE OF WELL_ INCHES WATER LEVEI �O —FEN► <br />WELL DEPTH / _FEET DRAW DOWN�FEET AT�GPM <br />CASING DEPTH / 7 (' —FEET <br />CAPACITY GALLONS--PER/HR. <br />DEPTH OF IMPERVIOUS FORMATION FEET <br />8CREEN4'FEET INCHES/Sy 'y INCHES <br />MAKE AND TYPE MATERIAL: S7s I.I % % S <br />(OVER) <br />CASED WITH <br />WELDED JOINT ❑ <br />SCREWED JOINT j( <br />KIND OF FORMATION <br />COLOR <br />STARTED <br />DEPTH <br />ENDED <br />DEPTH <br />THICKMEu <br />of <br />FORMATION <br />REMARKS <br />ei <br />EXTERIOR SPACE AROUND CASING SEALED WITH: O CEMENT GROUT ❑ PUDDLER CLAY OTHER <br />DISINFECTANT USED <br />HOURS LEFT IN W[L' <br />(OVER) <br />