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5TATG Oir CAL -I OFNIA <br />D z_ .F�Tr..ENT OF PUBLIC HEALI. ry <br />SMCsQQi7 <br />'WELL DATA (1) Identification-WLod2. City lrell'T6. 12 <br />(2) Location_ — 1412 S. Ilutchins St.� S. of Kettleman Zane ^ <br />{3Sou*•ce of Information Richard T. �IFztt _—mate__?iay <br />by ancon £ Sc,l-r edt -- - --- ._. <br />(3 ) <br />- <br />Number or Name_ — —_ <br />p} -r <br />__—.--_—_—..._.__._ <br />Date drilled <br />0 <br />(4) <br />Locltcon Neighborhood—_ <br />12'' <br />Distance to highest perforzt,ons <br />Size of ]at— <br />Surface sealed bes or no) <br />Distancc to Sewer___ _ <br />� _— <br />Second casmg depth_ ____ _— <br />SeR age disposaL..— <br />t <br />20'r <br />Abandoned well___ <br />_r <br />o <br />Nearest property Lne <br />5 n <br />(5) <br />Housing T) -pc— <br />F -rt <br />Cond,tion_ -- <br />Goo <br />Pit depth (if any)_,_ -- <br />9 V1 <br />Floor (��afer�a!) _ <br />ph <br />ea <br />Drainage --__ __ <br />Faii <br />(G) <br />Weld Depth.— <br />00' <br />rave <br />(7) Casing. Dcpt1L --_ -- ^ <br />400 r <br />__—.--_—_—..._.__._ <br />Kind--- — — -- — — --- — <br />.3kDszmetcr <br />Hcrght above floor----- __ __ <br />12'' <br />Distance to highest perforzt,ons <br />210' <br />Surface sealed bes or no) <br />Crarci'.aC, (�c, ii <br />Second casmg depth_ ____ _— <br />0-103' <br />Second easing diameter__ _—______ <br />20'r <br />Annular Sc31 (dCP1h) _ <br />(S) impervious Strata: Thrcicnc<s . <br />fDcptb <br />IrOs <br />Penetrated to -- <br />O <br />(9) Water Levels- Surface ___ —_ _ i <br />� �Depth to SWmtatic_..___ — �hen pupirb _ � <br />�10) Pump <br />Type..—,..-- <br />Capacity, g P m --- ---- <br />Lubrication <br />PON% er_ <br />Au=,liar} poc%er <br />Control <br />Ducharge locat�oQ____..___. ._._ <br />Discharge to.._. —_— <br />(I1) Frequency of Use_ <br />46 (l 2 ) Flood Hazard <br />(13) Retntrl's and Defrets .--_ <br />(Us 4 titer s,3e if necessary) <br />rr v <br />ted <br />iron Jc cz <br />SuiMer. s�b1 <br />1z�o -t 60 <br />�Tc�Cr <br />p,�ust�rc <br />71 tsr7 �t r <br />Tn :Z v': t Pr1 <br />sand trap <br />j,7,L.L LOG <br />_ 60 Brown sand <br />EIL --- Som___ _....�._. _ <br />rg� 1.2Q__.Prt7STA- <br />--T_J_3? —C? el" <br />-O _-x.08 _1%IF"_P� 2te----- <br />- --- A - 209 --16 IF _3-0 La_ ..-.. —_ ..._. <br />Thi * j; QJ.:1,_ shauld_gror3uce->r:ore r� �trr. <br />_ Checti;_sazing of panp, _dre.ciawn, - <br />-notox• horsepower.,- C -cc. Protec-_ _ <br />-tion fron vericul.ar traffic should <br />___be proviued as soon as possZbl.e._- <br />39-004 (12) <br />