Laserfiche WebLink
coma '` WELL CONSTRUGHON AND I EST REPORT. For O11io•use way <br /> nws.r <br /> STAI E OF COLOnADO, OFFICE OF THE STATE ENGINEER <br /> i. wEL.L i3mmir NUMB ME <br /> 2. OWNER NAME(8) _ /!ol a.m 1-i•�C. <br /> Msffivj Addr'en e►o o <br /> Cky,lit.Zll) CD Z <br /> Plwlra ( 1 2 <br /> a MI IaCAIM A*Dta1LL40 SE 114 Se 114,6ea. 1 77 Tvq)._ /7 S ,Rare G 8 l� <br /> DISTANCED FROM SEC, LINES: <br /> �—R. Irotn-v&4v6ww$ec, Iltle. and 7SD (t, Iforn,_�:K_Sec,hie. OR <br /> BUBDIVI316N: LOT BLOCI( FlUNW(UNtT) <br /> STREET ADDnESS AT WELL LOCATION: <br /> 4. GROUND SURFACE ELEVATION_'.�G .it IL DRILLING METHOD 061 r- — <br /> DATE COMPLETED 8 -TZ- 9 TOTAL DEPTH 7a IL DEPTH COMPLETED i• k <br /> f3. GEOLOGIC LOG: 6.HOLE DtAM. (In.) Flom (n) To (It) <br /> Usp1l+ Dagiption of MtledW(fype,St:o,CoW,WAw Loco" g o <br /> QF <br /> 7.PLAIN CASING <br /> 1zc ., s..�, s o.,rt OD (trig Mid Well S140 From(R) TOM <br /> Rw—.CAf3INM-Sarewi Size c.alo sa. <br /> p Vc <br /> a FILTER PACK w PACKER PLACEMENT: <br /> mwte w Est j ica Jaw Tree <br /> sin o• <br /> 11L .GROU1'M RECORD: <br /> Mule Al awt Density btaval Plemnent <br /> i DMINF O ION: T Moo— Arnt Used <br /> IE�I1�6Ti 0 Clied box A Test Date Is sub�on FolitRt ft GM 39 ewpletrlw"Woo Test. <br /> T®BM MEMOD NA <br /> Mc L om l9,se R DAW[Inte mt'tawred 9-//—`l�,��Praductim Rate nam <br /> Pwf ft bvai It. Date rkm measugd Test length PM4 <br /> Relatrka , . . <br /> 3r I Mrs l*W tM Ndemands m@49 hwr, wW kfraw do ooltwh Mt•eA and(hn(tlnl►we tmw to My t wMWga.IPutamw to Sodom 24+104(14 <br /> ats,Mn 1t+skkip of ••Wraonb hallo oorrtltuta•pN}ury to tlt•.•o•nd d•�t•••nd M ptrdsbabk.••olaa 1 n�icd•m••nor.) <br /> CONTRACTOR .� �. �,.,� Phalte, 7 �2�uc.No. <br /> + .. <br /> 14 <br /> 4arne M (Please type or print) Signature Date <br />