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2009-09-25_PERMIT FILE - M2009076 (44)
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2009-09-25_PERMIT FILE - M2009076 (44)
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Last modified
8/24/2016 3:55:47 PM
Creation date
9/28/2009 3:08:15 PM
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Template:
DRMS Permit Index
Permit No
M2009076
IBM Index Class Name
PERMIT FILE
Doc Date
9/25/2009
Doc Name
Aquamap
From
Venture Resources
To
DRMS
Media Type
D
Archive
No
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}+:.. J.v yam' ^A' • .r .': u, "•yi.:. <br />{'. ? ? 4 Q :' ??• ..fir 1:'^ .. .S _ ' JFtaaa, ?, .A B 1. s'9r W ` of O LOO <br />: <br />DIVISION OF WATER RESOURCES rs:= <br />1 <br />iniex Nor1-Z?.. OFFICE 'OF THE STATE ENGINEER ? `l <br />IDWD.. -----------' GROUND WATER SECTION jFAN <br />Use.... .d?'WJe?.!vi??P? 1Pt??SER.? <br />Replstered..? LCD AND HISTORY Of WELL tOLO PAI <br />(For state Engineers Use) PERMIT NOAAE3 WELL LOCAc TE ENGmEm. <br />Lic. No__ <br />Driller <br />Q -r-; <br />(Owner °, County <br />.??.Z <br />'/4 <br />Street r} of _t/a of Sect <br />Tvr Rge. --r :-PM <br />Tent p. <br />Use of Water • <br />No.. <br />On or By .-.. -Acres <br />(desviptlan of site or (omd) of <br />Date Started 'ri ?JY1 / 19 r <br />Date Completeds,?' 19 <br />Yield .J-GPM or ...CFS <br />WELL DESCRIPTION:' <br />Depth to Water. _ A-ft. Total Depth ft. <br />(messurad from ground surface) <br />from ft. to__,-3_&ft., - in. <br />Hole Z&ft, to-1ft., -1. -in. <br />• Diameter from { <br />from ft. to ft., _. ..?. - -in. <br />TEST DATA. <br />How Tested Pump or L?_Bafled <br />Date Tested- . 19-43 Length hrs. <br />Rate f --GPM Drawn Down ft, <br />PUMP DATA. <br />West <br />NW* <br /> <br />, <br />r <br />r <br /> <br />r ? <br /> <br /> <br />i i <br />r <br />1 r <br /> - - - SE, ft- _ <br /> <br />r r <br />r r <br /> <br />BOLA <br />East <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 />Pump Type .. Outlet Siie in. <br />Driven <br />HP. <br />CASING RECORD: <br />Plain asing <br />Size- Kind.ca?Aom ft. to ft. <br />Size , Kind-from _-ft. to ft. <br />Size' Kind from_-_--ft, to ft. <br />PerPoratod Casing <br />Size , Kind- from ft. to _.._-,--ft. <br />• Sizp _ Kir?d from ft. to fit. <br />Size, Kind-from ft. to- ft_ <br />Street <br />City f own <br />or <br />Lot. Block.. <br />Subdivision <br />(include filing or number) <br />TO BE MADE OUT IN QUADRUPLICATE: <br />Original Blue and Duplicate Green Copy. <br />must be filed with the State Engineer within <br />30 days after well is completed. White <br />copy is for.the Owner and Yellow copy for <br />the Driller, SIGN BLUE COPY <br />FOR WELL LOG USE REVERSE SIDE j `?
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