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• <br />0 '� <br />WATER SUPPLY WELL LOCATION SURVEY FORM <br />SECOR International <br />3017 Kilgore Road, Suite 100 <br />Rancho Cordova California <br />(916) 861-0400 <br />May 10, 2000 <br />Well Survey Site Address <z �z <br />YO <br />Yes No <br />0 A water well is present on the property <br />0 DomesticlDrinking water well <br />Agneultural/Landscape water well <br />[� Unknown <br />Yes No <br />0 EZ 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 c <br />Date �-)"A =Woo <br />