Laserfiche WebLink
DIVISION OF WATER RESOURCES U <br />Ind•z No...-...... OFFICE OF THE STATE ENGINEER ~ JaN 4 ' 1965 <br />1.3.q...... ,.,~~I~o wA <br />IDWD....:2...'.:(...I.......... GROUND WATER SECTION ~ <br />u.. ............../.---•--........... COLORADQ <br />Reglstsred..(.,-.`!.-.~s. STATE ENGIN <br />LOG AND NISTOC~RY~O~F--W~EI~I~] <br />`7 ~/`I PERMIT NO~~Z "L <br />IN ,1/~~~Qa,~ ~_ WELL LOCATION <br />riller ////// _7 Lic. No. <br />J <br />Iwner ~a Q~il~ "- ~yf /r/~~ <br />L ~ r~i ~~ / h ~ _ • w _ .1 ~T'/1!,I -' `~ :.(/n'L/I.A COUnty <br /> <br />Tenent <br /> <br /> <br />Use of Water ~~.... <br />Per/J~ <br />ir,)~~ <br />On Or By JYYY S r ~ }/~~~ /~ a <br />G ~L~ ~Ql{I" J~ A~4 <br />lO~ /~7' <br /> <br />d <br />~' T <br />(de ipt{en of site o< lend) I / ~ / <br />~ 9 <br />~ <br />_ <br />. <br />Date Starte r <br />1912 <br />qq <br />d "' - ~ ~ <br />~ <br />~ <br />Date Complete <br />~ 19 <br />+ . <br />Yield / ~ GPM or CFS <br />WEII DESCRIPTION: <br />l'- n <br />Depth to Water ft. Total Depth .7~ ft. <br />(meerured Iron Around ruriece) <br />( from_~_ft. to___L_~_ft., y~ in. <br />D almeter lIl fronL~ft. to~fr., [Tin. <br />from fr. to ft., in. <br />.TEST DATA: <br />How Tested '' ~~ '' ~~ Pump or ~ Bailed <br />Date TestedL~, 19~ Length JJ hrs. <br />Rate~GPM Drawn Down 7 ~- ft. <br />PUMP DATA: <br />Pump Type Outlet <br />Driven by I <br />CASING RECORD: <br />Plain Casing <br />Size ~~~"•' Kind~'Tr• fron>~L<ft, to )'~ ft. <br />Sizes ,Kind from / ft. to ft. <br />Size ,Kind from ft. to ft. <br />Perforattrd Casing <br />... ~ r . <br />Size Kind~from~ft. to ' ~ ft. <br />. Size ,Kind from ft. to ft. <br />Size ,Kind from ft. to ft. <br />Twp.3. ~ aL, Rge}OL~~, ~PM <br />NwNr <br />wea <br /> 1 <br />, <br />----Nw yr -- --rt['q---- <br />, ' <br />' <br />, <br />r ' <br />~ <br /> i <br /> , <br /> `~ <br /> <br />. _ SNr pe. _ .. . _ _ _ ~.~_ _ _ - <br /> r <br /> r <br /> <br /> <br />South <br />Earr <br />ABOVE DIAGRAM REPRESENTS ONE FULL SEC- <br />TION. LOCATE WELL ACCURATELY IN SMALL <br />SQUARE REPRESENTING 40 ACRES. <br />or <br />If the above is not applicable fill in: <br />No. <br />Steer <br />City w sown <br />or <br />Lot ,Block <br />(include liliny ar number) <br />TO BE MADE OUT IN QUADRUPLICATE: <br />Orlglnal Blue and Duplicate Green Copy <br />must be filed with the State Engineer within <br />30 days after well is completed. Whire <br />copy is for the Owner and Yellow copy for <br />the Driller. <br />FOR WEII LOG USE REVERSE SIDE <br />