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WELL OWNER AND ADDRESS <br />n / n WELL RECORD <br />WELL LOCATION • SECTION LOT BLOCK VILLAGE OF ORONO <br />-7/O — — -- CRYSTAL SAY. MINN. <br />DRILLEP'S SIGNATURE DATE PERMIT NUM0ER <br />DRILLING COMPANY ADDRESS TELEPHONE <br />SIZE OF WELT____ _—INCHES WATER LEVEL—_ __-/ -0 -- ----FEET <br />WELL DEPTH__ _. 1 _� =L---_ _FEET I DRAW DOWN __—_ OFEET AT._ —2—D GPM <br />CASING DEF fH / 0 0—FEET I CAPACITY GALLONS—Al-4_0 o PER/HR. <br />Q CASED WITH <br />DEPTH OF IMPERVIOUS FORMATION /_/ — —FEET <br />SCREEN— FEET____ — _INCHES/SY 2 —._INCHES WELDED JOINT ❑ <br />MAKE AND TYPE MATERIAL: SCREWED JOINT J( <br />(OVER) <br />KIND OF FORMATION <br />COLOR <br />STARTED <br />DEPTH <br />ENDED <br />DEPTH <br />TRICKRus <br />OF <br />FoRMATIOR <br />REMARKS <br />Q <br />f <br />/o <br />EXTERIOR SPACE AROUND CASING SEALED WITH: 0 CEMENT GROUT (x PUDDLED CLAY OTHER <br />r rL <br />i <br />DISINFECTANT USED_ T 1,41 _ ----_.----- - <br />HOURS LEFT IN WELI _ --- <br />___. __ ._ (OVER) _ _ <br />