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,• <br />.: a ~ <br />• <br />'z~ <br />Hole Hole <br />Hole Quarter Depth Diameter Type of Cement or <br />No. Townshi Ran a Section Section Ft. (In.) Sealant <br />Ol TSN I R86W 29 ~ SE 100 36 ~ No. 6 cement 1/2" CaCl <br />/~ <br />Sig/nature of Nuthorized Representative <br />F,U J/OQ Me.9T-r.. J /n.,P Ll i w1 .. sn~ <br />Date <br />Title <br />(Rev. 5/83) <br />Doc. No. 3073 <br />Method of Drilling <br />Hole Nmount and Volume of Intervals Where Water (core, auger, water <br />