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Naldo~son 97D3238851 p.4 <br />.. <br /> <br />-~" N0 :~i t,~il#ICItON AND TSST Rl~(M3f <br />,ate„ STATE OF COIARADO, OFFK:E OF TF~ STATE HJ~' IffR F« ~ use Dien <br />. <br />~ ~. WELL PEitYB'T NUS ~ t'3'~v `~`'~' <br />z oaa~w~tE I rsbn Sonsln~ <br />Mon os,° c.iZ $iLt~ <br />Atone ( 4) 32 - 553! <br /> <br />3. ~! <br />MIELL LACATiON AS DRS, NCi 1/4 ~-1(4, Sec-Twp.~~N ,Range (C) 1~ <br />D{~TANCES FR~1 ~C. WES: <br />`l0-I it.from N~1 Sec.Sne.and i3Dd rt,irom EASac.Gne.OR <br />SUBDiVtStON: LOT BLOCK FlllNC~(UNfT) <br />STRUT ADDRESS AT 1ME7.L LDC.AiION: <br />4. L3AOUND 9VAFACE E~EIIATION 8. DRIlING METHOD ~: i IQ-o~wr~^ <br />DATE COMPLfiTED I ~ .TOTAL DEPTH ~{ ~ t DEPTH COMPtF"TED G a ~ R <br />5. GEOLOGIC LOG: <br />!yl>N Deea¢dNn of tlkmrid (rypa sae. cotes, Wetsr Low6oN 8 HO1F DY+M. (m.) From (R) To (!I) <br />R •, O 3, S' <br />V' 3,5 h~l' <br />~ - '~ ~ re w [ <br />.s a -! <br />jg,y <br />,, <br />,9 <br />/ - a ~ <br />- - 7 PlAW CASNJG <br /> OD (rtt) Wrut Wau sim From(ii) To(~ <br />d$= 4<J' a~~,.~_1 _ Sahel' -ca es. Gshr s+r.~r , ~sx + t,s - ,s <br /> <br /> <br /> <br /> PERF, CASMG: Screen Sbt Size: , O 3 a <br /> <br /> <br /> <br /> <br /> <br /> 8 F)LTl3i PACK 9. PACKER PLACEMENT: <br /> Matenm !fie a. 9 i avc~ ( Type <br /> .ALB ! ~ <br /> Irueml ~L/ fo in ~ ~ <br /> <br /> ta. ~ouraN~ T~EpoRD: <br /> Matsaria! Amaxn Detsity Interval PYdcerrdns <br />t3EtRAgi6S: - Ca a o. l <br />L/4f'L! Fin Ge...a~~~f~; <br />/4 f.CMtn'F ~ b~5~9/ ~~ ~IJO U~e.~ <br />~ <br />I <br />77 DlS1NFECi)ON: Type Amt LLsed <br />'t2! WALL Tom' , DATA Ctrarir bmc i Tesi Uade is suhmdted on Foim No. GWS 39 Supplernernal Web Teri. <br />TESTtNO NETHDD ~, i - /.'~Ft <br />b`mtic level s/' 8 LUteJTime ir>ea~ed / - l~SI- D ~f // = 3 a. ProdYacl3~ Rate I a gpm <br />pumping ievei ba ` 7L DaMJi6r~e ti1BaSUied__ _ _~~e~~~ _ _ , ~~ ;'moo .Test 1en91-+ ltxs.) / <br />Rernarts of ' -o d teat.'„ <br />3 t IINe iead firo eta med.Iretein Wld tQrsw 4~e wfeesee Need, eirt tielfifiy me true ie oy is~ssiod3a [PpuenS to ~es5oa 2aa-la nm <br />Git.3,, fee mettllp dfebe dabreatra Meii eeneSeiM. pKjury in fAe coce,M dePsa ands punietrhie es a ciao i mbddoaoooc] <br />CONYTt14CTOR f,~/~(r~e ate- ,f~ii~ i~ /~1~~ 7n G, Pitme (FZD) S 5G - (e 58 ~f tic. No, l~ 84 . <br />l~D. s d •. <br />Ntmne(T7t1e (Ple~etype or print) SSgntiutre - <br />T3.Y/ . fi:'sanv P~es.atc,.t Date <br />