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i <br /> -. .:rwi8'',<'fc' ,. ;d.:-�a'F� ,."c.8s`:•. Ju ._... - A'`2, .. -... s , _ ..y. 1 xi„o... ,a <br /> A <br /> �4 <br /> t:Irrn /� �y , . - <br /> (I 5 M rs�s..w STATE �I FF 1.O�,0 11 A D(� •, ) r <br /> Inds: t•to �a! S:;___. DIVISR)N OF WATER RFSO)C•kCES <br /> It)�'Q: ' OFFICE OF T1fE STATE ENGI' EF,R <br /> � '•. ', :, , < zs, GIM17N(1 WATER SF.CT'ION <br /> ` ( .•.': (,rad _. _ L(1(; AND HISTORY OF WELL <br /> I.ir.. <br /> Drilled by <x� .�1• ," _, No. # +`i W,:I.L LOCATION <br /> Owners �� r /. / ' �`i t-r <; 't ' _ _r _ .:... Count%- <br /> ki <br /> Addreas���� L - - 1 sl., ' ,4 �' f of r � of Sect -e-- <br /> Truant Twp. <br /> ' Used for 1 ,� /s / G :.r LOCATE NVELL ACrCRATF,LY <br /> IN THE SMALL SQUARES REP- <br /> on or by ` ,' _ ! PR ESLNTRtiG AO ACRES <br /> (description of site or land) N <br /> Date Started 41 19 <br /> ✓ Date Completed;f / `' 19� t <br /> Date Tested < < % 196 <br /> �t <br /> `Yield Rpn. !< '� /( /�1 cfs W e I E <br /> Pump type�:`_4? :Outlet Sire <br /> 1 <br /> Driven by / IIP(d RPM -- i <br /> Depth to WaterFt. Draw down " +Ft. <br /> Depth to Inlet Ft.; Bowl Ft. S <br /> Size and Kind of Casing: If the above is not applicable <br /> fill in: <br /> 1 <br /> From �` to '11 Type / Wt..:5 <br /> From to n T e �•' Wt, �-7!f Town or Subdivision <br /> From to Type—Wt. 3 reet Address or Lot It Block <br /> Perforations: Size and Type <br /> From to Type Size Ground elevation <br /> (u now-n) <br /> ' From �t+� ��! Typeia�. iZe liozv Dr3lircl: <br /> s4 From :`: to �`r ! "t+'I�e Siz, w �; <br /> Well descry(,tfcen: Total PeVJh___fC_.''_._ I't• <br /> (fro <br /> ro_ <br /> Hole in. Slz+;"-off' ,„ 1 is, —Off <br /> Diam. . <br /> + ' <br /> Ir(;'a' <br /> (from— to ,_. _in. V1 - T, <br /> •f `�'T"��.:S'"' "-""�3'r�iai r�ti�1T3iiY'STTa 3'i'C.". � d1r•i. :*-+91 " , i A.... ., ,. <br />