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• <br />• <br />WATER SUPPLY WELL LOCATION SURVEY FORM <br />SECOR International <br />3017101gore Road, Suite 100 <br />Rancho Cordova Cahfomla <br />(916) 861-0400 <br />May 10, 2000 <br />Well Survey Site Address f '�7_�z EL' -4 <br />Yes <br />0 No <br />well is present on the property <br />DomestictDrin king water well <br />Agricultural/Landscape water well <br />0 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 <br />Signature <br />Date <br />