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,~. <br />Grot3 37 <br />taw w~.t. co~~ucnc~t ~~ -r~sr err' <br /> <br />83ATE OF' CDLORACIp, ©FFtCE QF TWE STATE ENG1NtR Fa~G ~ on~~ <br />1 ~, ~~ ~~~ MH-432fi5 <br />;?, Wld$R NAME{g}Crinnle Creek & Victor Gold Minine Comoanv <br />lr€2dtltig Addres& ox <br />City, 9t. 21p actor. o or o <br />Phone { 7 4) - <br />3. WELL LE3CATON dR D: ~ 114 ~ iJ4,.3aC. 29 Tqp IS S ____.w~ Ran9e_ 64 W <br />ItlIiTANGES FROM Slap. LIt3ES: <br />-. t inn tt. from ~3aa line. and . - hnn . ft horn ~,~Sac. line. OR <br />suBntvtSK3N: Lor~s~.rrG-c N/A . Pt:r~~aGN-~0'}.zYLA..~ <br />STREET ADpRESS AT V+IELL LpCA'110F1: <br />4. GFIOUMA SURFACE EI.EVAT[ON 9900 fj, pFi11,L(NC4 OAETHpA Reverse Circulation <br />PATE COMPLETEp Anri19.2004 .TOTAL REPTH 140 h. ~7EPTN G.CiMPLETEA 140 ~, <br />S. t~DLORIC LOQ: <br />Aepgt Thsutp6on m-1otoAol iTYP0. Sae. Cdee. Wa1or t,ocRllon} t3. tiOlH DIAM, {tn,} From {ft) ro {tt) <br />8" 0' 140' <br /> <br /> 7. Pt,AiN CASIfJG <br /> Oq (tn) Klnd Wak 8¢e From(ti} To(ft) <br /> 4" PVC Sch 40 +3' 100' <br /> <br /> <br /> PERF. CASINCa; Screen £~iot Size. 20 Slot _..__ <br />"' <br />" <br />" <br /> 4" PVC Sch 40 " <br />""""`Tt3Pf'"" <br />"'T~ <br />i' <br /> <br /> <br /> <br /> ti. FILTER PACK: ~ PACKER PLAGENFENT: <br />_ Matt;riat Col. Silica Sand <br />~"-." <br />' Tye N/A <br />~_ 16J <br />~0 <br /> tnfsruat to neptn <br /> ' <br /> ia. GROUI <br />iNQ REaaRp: <br /> Matsrlal Arnourn Aenatt~ lrnarval place~mem <br />REtviRRK$• , t e 3!8" hydrated bentonite chros 10' 90' <br />ortl~ eC ment ~`"~ ""0'""'""" ~"` <br /> <br />1 plB1NFECT70N: Type N/A Amt. Used <br /> YyF ~ ~,~F. S,T p TA: ChOCk tx+~c ~ Test pate is submitted on Ftomt Na. GW5 39 SUppferctanEat WBtI 76bt. <br />TE5TlN43 Mi=TN00 N/A <br />Sisetic Lsvei h. Aatejfune maestxed .Production Rate gpm, <br />Pumping [eve! K. flatP.fRme measured .Test length {hrs.} <br />Ren~rks __ _ _ _ <br />~ <br />--~ <br />"d i tnnre toad the 6SAtxtnatNO snoda t~ararn •nd J<rww thr< aaRrnta ttxr+ot, and Msat they ars trw w my knnw4sdgo. <br />lpursuaq 1o SecCan zea~tos (13] <br />GA.S, the maktnp d {atsa elah~rds Iwruin cptuSYatides perjury b the eoax,d detiree wtd is punishab{c of a ctesa t ttucaor.l <br />CC~NT#4AGTrJR N/A Pfxand {_.._._1 ..__......._. Ltc. f,1o. <br />Mel' <br />NameJTitlp {Pisses type ar prl~? <br />Timm Comer. Chief Environ. Coordinator Slgrtatu ~ <br />~~ ~~yl,~_ Aare <br />02107!05 <br />