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SII WATER SUPPLY WELL LOCATION SURVEY FORM <br />• <br />0 <br />SECOR lnternabonal <br />3017 Kilgore Road, Suite 100 <br />Rancho Cordova California <br />(916) 861-0400 <br />May 10, 2000 <br />Well Survey Site Address 6 5--t' <br />Yes No <br />0 A water well is present on the property <br />Domestic/Drinking water well <br />Agricultural/Landscape water well <br />Unknown <br />Yes No <br />© 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 d i'l It e-1 <br />Signature 14 n <br />Date /L Cid <br />