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3-e~3 <br /> <br /> <br />Halo No. <br /> <br />Townehlp <br /> <br />(tamp <br /> <br />Section <br />Owrtsr <br />Section <br /> <br />EkyaUon Hde <br />Depth <br />IFMU HoN <br />DlrMtsr <br />Ilndbel Type of <br />Comers/ <br />Seeleii[ <br /> <br />w-~ 2 w NE 23 J .,.t. <br />Sw-I 3 ~$ Z w o 2 <br />sw-2 6S~ 23 5w E. 7 o z V -t. <br />SW-3 £~ 23 w W6 to z3 1 <br />$w= 3 Fl 23 w N6 23 eA/ <br />w-' . 33 ~( 23 w NE ? l0 2 <br />Sw- ~ 3 Sl z3 w rJE z to i3 t. <br /> <br /> <br /> <br />Hole No. <br />Amount and Volume of <br />Cement or Sealant <br />Irrtervsts whore taster <br />ors, Encountered Method of Drilpnp <br />(Coe, Aupa, taster, <br />Foam, etc.1 <br />w-ID t~ S - 1 t a/ <br />w_I <br />w-I t t <br />SW-L .g .tit. - 2 « <br />$W- _L3 cet <br />Sw-4 -.Z. ct v <br />w - - L set <br />sw-L SS-2 ea+ <br /> <br />~~~~ <br />Signature~ii Autta ed Representative <br />Q~,cw.+-t Loorel,)n~-~nr <br />Tdle <br />~v 1 ~_ 2y "Zv o 0 <br />Date <br />m:~coeAShare~tormel~drole.ar 8/B3 <br />