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(5) f HE L I;i:A i It;-'•t 0F "rfyE PROPOSED WELL and the area on (6) THE WELL MUST BE LOCATED BELQW <br /> which the water will be used must be indicated or. the diagram below. by distances from section lines. <br /> Use the CENTER SECTION (1 section, 640 acres) for the well location. <br /> 2165 ft. from South sec. line <br /> {- — �' "_ + — �— — —S_ .—. — + -- —� (north or southl <br /> �t--- t MILE,5280 FEET—•—� 1773 ft. from East sec. line <br /> (east or weft) <br /> rt + + ) <br /> LOT N/A BLOCK N/A FILING , N/A <br /> � I <br /> _ NORTH SECTION LINE _ SUBDIVISION N/A <br /> I i � <br /> (7) TRACT ON WHICH WELL WILL BE <br /> w i _ I _ _ m LOCATED N/A <br /> NORTH Owner: <br /> r Z� T ' ' D I No.of acres N/A Will this be <br /> �; I m ' the only well on this tract? N/A <br /> yr—�T z (8) PROPOSED CASING PROGRAM <br /> X I r- I Plain Casing <br /> Uj <br /> V7 <br /> _L <br /> I -- — 4- — m 211-2 in.from 2:5 ft. to 17:0 ft. <br /> I i i I 2 in. from 22.0 ft. to 24.0 ft. <br /> .� I — �_ ' Perforated casing <br /> T — SOUTH SECTION LINE rt <br /> I j 2 2 in, from 17.0 ft. to 22.0 ft. <br /> in. from ft.to `t. <br /> I l <br /> j i I (9) FOR REPLACEMENT WELLSgivedistance <br /> and direction from old well and plans for plugging <br /> The scale of the diagram is 2 inches= 1 mile N/A <br /> Each small square represents 40 acres. <br /> WATER EQUIVALENTS TABLE (Rounded Figures) <br /> An acre-fnat covers 1 acre of land 1 foot deep <br /> 1 cubic foot per second icfs) .. .449 gallons oar minute (gpm) <br /> A fam.)y of 5 will require approximately 1 acre-foot of water per year. <br /> I acre-foot. . 43.560 cubic feet.. .325.900 gallons. <br /> 1.000 gpm oumoed continuously for one day produces 4 a2 acre-feet. <br /> (10) LAND ON WHICH GROUND WATER WILL BE USED: <br /> Owner(s): N/A No_ of acres: N/A <br /> Legal description: <br /> (11) DETAILED DESCRIPTION of the use or ground water: Household use and domestic wells must indicate type of disposal <br /> system to be used. Water Quality Monitoring Wel l <br /> (12) OTHER WATER HT used on this land, including wells. Give Registration and 1'Vater Court Case Numbers. <br /> Type or right Used for(purpose) Description of land on which used <br /> Commercial Drinking/Sanitary <br /> Permit #64684 - Decree W6915 <br /> (13) THE APPLICANT(S) STATE(S) THAT THE INFORMATION SET FORTH HEREON IS <br /> TR E TO.THE BEST OF IS KNOWLEDGE. <br /> SIGNATURE OF APPLIC T(S) <br /> Use additional sheets of paper if more space is required. <br />