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<br /> <br />-~- <br />Hole Hole <br />Hole Quarter Depth Diameter Type of Cement or <br />No. Township Ranae Section Section (Ft.) (In.) Sealant <br />1~ <br />`t <br />Y~ <br />Y~ <br />`l <br />>u I 4S 4) ~ G ~.~o~.tle ells <br />w z 5K.5 <br />vU ~ <br />.oV ~ <br />~. 5 5 ` <br />'~6 y <br /> <br /> <br /> <br /> <br /> <br />Method of Drilling <br />Hole Amount and Volume of Intervals Where Water (core, auger, water <br />No. Cement or Sealant was Encountered foam, etc.) <br />) ~ - d3 tf~ow~ <br /> o.~q <br />~ •i~ <br /> y. <br /> .-~ <br /> ~ . 1 LI v <br /> <br /> <br /> <br /> <br /> <br />Signature of Autho <br />Representati ve <br />~0~6-~~ <br />Date <br />>.(s <br />TitleV <br />(Rev. 5/83) <br />Doc. No. 3078 <br />