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From To type a color of Matenal - " <br />Loc . <br /> y ,, ,~ ~ /J G ~/ <br /> <br />~, as ~ - .~~'~,.. <br /> ~ <br /> ya <br />~ ~.~ ~-,~ . <br /> 1 ~7S.~er, 5~,~. -m . <br />I • <br /> Use additional paper it necessary to complete log. <br />Type Drilling'r/,.L.~,.(C. ~.-n..~ <br />HOLE DIAMETER: <br />~in. from ~ ft. to o'' ~ I~ <br />t <br />~ in. from~_ft. to~~f; <br />in, from f[. to fi. <br />CASING RECORD <br />'~77 ~~yy--~~ Plain Casing ,1 nn <br />SizeL~~ kind~~6S~from}t. to~f~. <br />Size, kind from ft. to ft <br />Size, kind from ft. to f,. <br />Perforated Casing <br />Sixe_, kind from ft. to ft. <br />Size, kind from f[. to fl <br />Size-. kind from ft. to f~. <br />GROUTING RECORD ! <br />Material-,<1--,-:.._L.,,~,f-,~~, ~~• y' ,.,L ~ ;% <br />Intervals <br />Placement <br />GRAVEL PACK RECORD <br />Si <br />TEST DATA <br />. 7 ~~ <br />Date Tested S <br />Type. of Pump <br />Length of Test .3 <br />Sustained Yield (v~•rP.rd I ~~~~_ <br />Drawdown ~ ~~ ~, <br />WEL DRILLERS STATEMENT <br />The undersigned. being duly sworn, deposes and <br />says: he i; the driller of the well hereon <br />described: he hds read the statement made hereof , <br />knows the content thereof, and the same ~s true <br />of his own knowledge. <br />~' 7 ' <br />~tate of Colorado, County~~ ~ ~ ~ ~(' '~'• i'~`" 1 ss License NLLo.y / ~~ 771I <br />Subscnbed and sworn to before me this_ J' ,-'- ~ dey of JL ' ~ 't• ~L ~ . 19~ <br />JJ / -7 ~.; <br />My Commission expires '-"`~` I ~~ 19/ ~ l ~/Lfl1((~L /Jir /_ ~.t~ Q f.I <br />Notary Public <br />