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WATER SUPPLY WELL LOCATION SURVEY FORM <br /> POZO DE AQUA POSICION/ FORMA DE ENTREVISTA <br />' SECOR Internattonal <br /> 3475 West Shaw Ave, Suite 104 <br />' Fresno, California <br /> (559) 271-2650 <br />' October/Octubre 2004 <br />' Well Survey Site Address/Pozo de Sitio de Entrevista <br /> Street/Calle 0all-kK,41-n'-o 0 <br />' City/Cuidad D akl- <br /> StateARstado,Zip Code/C6digo Postal <br /> Yes/S No <br /> A water well is present on the property?Mn pozo de agua esti presente sobre la <br />' caracteristica(propiedad)9 <br /> Domesthc/Drinkmg water well/Pozo de agua Dom6stico/potable <br />' AgnculturallL,andscape water well/Pozo de Agua agricola/paisaje <br /> Unlmown/Desconocido <br /> No <br /> Is the well being used%Pozo el es usado? <br />' known,please provide well construction details/Si conocido,por favor summistre pozo detalles de <br /> construcc16n <br />' Date mstalled/Fecha mstalada <br /> Depth of well/Profundidad de Pozo <br /> Casing Type/Tipo de Cubierta- <br />' Casing diameter/Didmetro de cubierta <br /> Screen mterval/Intervalo de pantalla <br />' Survey completed by/Revisi6n completada por <br /> Name/Nombre Stephanie Furgal of SECOR for hom ownerlbusmess owner <br />' Signature/Firma 4-<K-L <br />' Date/Fecha L <br /> 1 <br />