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<br /> srwTe OF eA4tf oRNu No!,$UT lit �n �s-0-
<br /> GMINAL THE RESOURCES AG10i&"- N�
<br /> eW"h Mot D'EP'ARTMENT OF WATER RES[�UIiCE
<br /> V ��
<br /> WATER WELL DRILLERS R.Empcil State well r1n
<br /> Llw
<br /> (1) OWNER: (I1) "WALL LOrt r ` ^ " "�
<br /> #l41,
<br /> t Ntnte That t, ., Ft. IAOc1r.f e.reHrtd.ell r 6r
<br /> t',<'.Addms Fredrloka 6tribe is r.Mr eMwtr►dCal-if, 9c5366
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<br /> �tq r
<br /> LOCATION OF WELL: 8L� .d '
<br /> c—* '.>�",an Jo& n o...r•e.f,if.. .AO ' b�'Oltrt
<br /> K111 JL-7-3 Seg. 23
<br /> o;a. r..�:i,�.....d....i,...e...,f. Rat al
<br /> &e of Frederick 96 drown clap - 54
<br /> {s) :'TYPE of avoltx (check): brown cla s r
<br /> ;Nn/Wal (g DeeprninR ❑ Reconditioning ❑ Destroying 0 104 » 116 sand
<br /> irsfruesi a.druribr matfriel Aad procrJure in liew 11. 116 M 13P brown clay ��, �• i
<br /> Ie fw(4) PROPOSED USE (check): (f) EQUIPMENT: 152 15 6 sand
<br /> $'Domestic ES Industrial ❑ Municipal ❑ Rotary ❑ �
<br /> lmggtion C] 'Gest VC:?_ t-] Ocher C3Cable
<br /> Other
<br /> (d) CASING INSTALLED: ',
<br /> If gravel packed '
<br /> OTHER: �f
<br /> �s5v "y:QI/e6L[® DOUQLE❑
<br /> Ls � _ Gfge fN3neter - -- - ,
<br /> ed,ff From 'I'V or of Frain Tn '-r•
<br /> rt. Ic. Diem. V7s11 Bore !t. ft. .�_
<br /> yl rr` Siu el alY«w regi..n.: Y4X 1 6x
<br /> Buttweld-
<br /> + �`•(7) PERFORA'T'IONS OR SCREEN.
<br /> Roof ,
<br /> To r SR. roa well sea wa8Installed
<br /> Fran021=Y
<br /> raw it. in.x in. th! s well and I_am not rea Or ns a ;t r
<br /> ` an. altering or remOV1 g. r
<br /> 1s u e sea 02a
<br /> CONSTRUCTION.
<br /> }'rfif rwlar+.anira•r rnlp •,d dr. Yrr� fv.a__ Te�iu�h � 1.. � _ ��� 1
<br /> yr'I+,��f:rr any_drna xa'ri tRainrr pollue:.nT Y. _-_N` :r•ea•.wrd sA of.Fra.. ;• 7 ►T t
<br /> Er }.
<br /> From: _ H.F. ie. -
<br /> ft . - 72i s? .}
<br /> WELL DRILLER'S SPATEMENT.-,. e '• �"�
<br /> sY This wrU woo drilled ander my+nhdlrlrow mod ft r,reyoN a I•ffr fn ebr best '
<br /> `(9) WATEio R LEVELS: n/fayArmvlydae.wdberlrJ. *• "'
<br /> 6.
<br /> x�ft.I,icM•ant was F.F. !Hund if M.o.. .�_ !r. - � � ;4
<br /> NAMI John .Panes ' a ;
<br /> i -QtftdG8lAe!_-boom prl....in R. if„►.n.. �-
<br /> 1Stfrllt. dr.r f.ttdn fwd deo
<br /> (10) WELL TESTS;
<br /> Adam. 1 i 9 5 'Pan Allen
<br /> wnr.m*en...,d.ry Yo.L). N.W _It XT,
<br /> SCLC A21
<br /> T{d!s e.1.!..n.rrA �!•, (r.Arawde.n ester h.+. - _LStaf�itp < . .. f", f}� -. t<
<br /> en D111100
<br /> Taiseeacar ul
<br /> {—t- �'a..� cAenirl.ef! a MM6 Y. No 0 -— e�I� rf�,` 1,
<br /> license
<br /> :�,. '�`� +df}'•4j{� �f� �, ,.� 5
<br /> �v al.rarie IuF�arf_�I..Ii F v. [� ,:!rn,r+"A r.pr- -- —- se N _ 12Q 2 iDat
<br /> ' Pf:1
<br /> + SKETCH l OCATFON Of WEL•L.ON REVERSE SIDC
<br /> OWN tee reev ...., .nawrrs.ra:,w4ttirQfr+ri►' +,W
<br /> .t - ��_,:..• ....rv.ryT ray.;,,a.,.:. .a-.:,s�: win••:tom ��.`.ti�:srs.iawl;�4;rsFl�3�"�t:-+�� w�.�� � o.�t ' �'
<br /> � - ��` ., ti 13,E ��:•' c�
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