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war.3,72 <br />THIS 'DAM MUST BE SUBMITTED <br />WITHIN BO DAYS OF COMPLETION <br />OF THE WORK DESCRIBED HERE. <br />ON. TYPE QR PRINT IN BLACK <br />INK, <br />WELL OWNER <br />S'• 11 j <br />COLORADO DIVISION OF WATER RESOURCES <br />300 Columbine Bldg., 1845 Sherman St. <br />Denver, Colorado 80203 <br />WELL, COMPLETION AND PUMP INSTALLATION FIFPORT <br />PERMIT NUMBER R J i' 4" Q i <br />%ofthe <br />ADDRESS p1.- 1.- — L C J1 T. <br />DATE COMPLETED r ''mi" 9 , 19 P HOLE DIAMETER <br />WELL LOG t t in from <br />From <br />To <br />Type and Color of Material <br />Water <br />Loc. <br />• 1 <br />It <br />3k <br />3G <br />Lt <br />v <br />9 o -J 6.4 P „fob: <br />e' 4.4 ,stArd,41.,A. get"( <br />• <br />:TOTAL DEPTH __-. <br />addifi_euapages necessary to complete log. <br />V \. <br />t <br />f <br />QQ <br />J <br />too <br />RE.CO <br />ROOMS <br />S;AtE BMW <br />of Sec .79 <br />R, _ 7 Tv <br />• _ in. from . to • <br />in from <br />DRILLING METH <br />c it, ft <br />ft <br />OD <br />CASING RECORD: <br />Size 1.1. & kind <br />Size & kind <br />Size.. & kind <br />Plain Casing <br />g'f L -from to / ft <br />from to ft <br />from to . ft <br />Perforated Casing <br />Size & kind St. -LPL -from ! <br />Size & kind <br />to trft, <br />from to ft <br />Size & kind ,from to ft <br />GROUTING RECORD <br />Material . s...Q A/i <br />I ntervals 1,, ah 044 iity <br />Placement Method r 8 C <br />GRAVEL PACK: Size <br />Interval <br />TEST DATA <br />Date Tested , 19U <br />Static Water Level Prior to .Test, r ft <br />Type of Test Pump <br />Length of Test <br />Sustained Yield 1 Metered) <br />Final Pumping Water Level <br />r I. <br />