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0 <br />0 <br />0 <br />WATER SUPPLY WELL LOCATION SURVEY FORM <br />SECOR International <br />3017 Kilgore Road, Suite 900 <br />Rancho Cordova Califomia <br />(996) 861-0400 <br />May 10, 2000 <br />Well Survey Site Address i Lee_ <br />Yes No <br />0 <br />A water well is Present an the property <br />Q Domestic/Drinking water well <br />[] Agricultural/Landscape water well <br />Unknown <br />Yes No <br />0 � Is the well being used? <br />If known, please provide well construction details <br />Date installed - <br />Depth of well <br />Casing Type <br />Casing diameter <br />Screen interval <br />Survey completed by <br />Name '� �� '� no e�' LS <br />Signature <br />Date 5-12- - OLD <br />