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TRIPLICATE ,T)Tl_ ,, , CIADWR USE ONLY - 00 NOT IN <br /> Owner's Copy FELL COMPLETION REPOR� I I I I I I <br /> LPage_+_of p— ISTATE WELL N0 STATION NC <br /> Owner's Nell \o• No.769119 <br /> C 9 9 g 9 C I _ <br /> Dldr Stork Bt-zan )G—:7 92 Ended nor 29 92 V J 11�7 LATITUDE LONGITl..=_ <br /> Local Pennit �,ZctRct can Tna,ni n /`.�u t• 7 til i r -jeo,T th ,7 ..t- I I I I I I <br /> Penlllt29PA 4 PermitDate �C_"o Q2�O. APN;TRS:OTHER <br /> GEOLOGIC LOG WELL OWNER <br /> OR E`lTATION Iii _VERTICAL _HORIZONTAL _ANGLE _ SPECIFYi Ngine '11rin(ipr =TEWal <br /> (L DRILLING <br /> =_PTH FROM METHOD `0&3FTV FLUID Water \laihns!Address114C1 Ni- 'Teat T.ane> <br /> E JRFACE DESCRIPTION ;c131 Ca 95240 <br /> D,`tr,i.. Iuat,rial. grain •c:. %rLrr. ric clry STATE z;- <br /> 14 <br /> IP <br /> n rl a• WELL LOCATIO\ <br /> Address 11 A 5 +A-t b�-[• <br /> 23 Ica% T ne9 i <br /> n� 7 -.ray -lay Counh ERM .70aqUin <br /> 27 47 -:ravel & rock APx Book page P.vicel <br /> 47 r,9 ^r.l V ?< brown Clay Tostmship Range Section <br /> ^91 A oanr? Latitude I NORTH Longihtde Es <br /> - <br /> 71 y Drown clay DEC MIN, SEL. DEG. MIN. SEG <br /> ` r LOCATION SKETCH ACTIVITT Io3 Sand — <br /> NORTH NEW :`;E'_: <br /> 125 36 silt brown clay <br /> MODIFICAT:CY REPA.- <br /> 136 38 sane <br /> 138 170 brown & ciray cla= — C--s, S�.� <br /> 170 172 d ak sand <br /> DESTF O" aeecoc_ <br /> 172 210 crown ora clayUmd., -ve LO Al :- <br /> ✓nae iEOLOGC___ <br /> 21 SdnCT PLANNED USES - <br /> 212 19 orown clay .2 Sandstone WATER SUPPv <br /> 21 " 7 sand sense in clAv — Domes: — n <br /> rigenc- <br /> 3 < NIC>JTORIN3 — <br /> ` Irl 773 Cour e blk & etc Sand –:WEL_ <br /> 773 90 'D n Ii '7rav clay CATHODIC P=z-ECne'. - <br /> 7 Q T our3e sand ra V,'l HEAT-1 CHANGE — <br /> n ^anf77 b ngray C13V DIRECT. PUS- - <br /> VAPOR et­�AGTIC%_ <br /> 271 $73 W f -*•av clay- SPARf FG-171 9 a � � SOUTH RE• DATIC• <br /> III I r-rt, 1, -t D..nn1 t❑Wit gnu ft 1, B Mi <br /> ZQ q AV f I v-Bir, /at 1, illspp u'mldlfir un) nprr:i OTHEF SPEMF <br /> nnnl.FEE AoE BE ACCO-RATE b C0IIPLET�. <br /> •704413 '-i n 1 ' <br /> q $22 brn clay WATER LEI EL k YIELD OF COMPLETED WELL <br /> ` 422 72 sand DEPTH TO FIRST WATER (Ft.) BELOW SURFACE <br /> -427 A^2 3ray bry, Clay DEPTH OF STATIC <br /> WATER LEVEL (Ft)&DATE MEASURED <br /> 1 & sandstone ESTIMATED I^EL0 ' (GPMI & TEST TYPE <br /> DEPTII OF BORING F-t TEST LENGTH IHrs.I TOTAL DRAWDOWN (Ft, <br /> FI <br /> D 'Tlf OF t.OMPLETED WELLF.-: '][at eat be:emresenrati:e ofa-aell?long-rens rir6l. <br /> DEPTH BORE- CASING ISI DEPTH ANNULAR MATERIAL <br /> ` ==.C',1 SURFACE I HOLE TYPE FROM SURFACE rypE <br /> DIA. z --1 = MATERIAL INTERNAL I GAUGE SLOT SZE CE- BEN- <br /> _' FL Incnes) a '_ 8 _ GRADE CIAf.fE3EE OR WAL_ IF ANY MENT TONITE FILL <br /> .Ivicez; THICKNESS Jncne= Ft. to FI, -'PEST_ <br /> (� <br /> r' <br /> b. <br /> I I <br /> ATT\CHNIESTS I'I CERTIFICATION STATENIEST <br /> I.the undersigned. certify that this report is complete and accurate to the best of my knowledge ar- Deliei. <br /> 6 Geoioolc Log <br /> — <br /> Well Cons;ructonDiagram NAME ?uryience 7­rill3rs Inc <br /> Geoonys�cal Log(s) =F=.SCN nRM. :3 'JRPORATION DPED OR PRINTF] <br /> — <br /> — SOIIVIa(er Chemical Analyses 17707 Twj; 2ti ` in,"er1 Ca 955335 <br /> AOOREa <br /> — <br /> Other dtt 5?ATE -. <br /> -CH 40DIPONAL VFORMArION. IF IT EXISTS. Signed <br /> . TROUTS GGTNOR13E0 RECR'_FFNidTIVE BATE SIGNED <br /> ` .I I, - IF ADDITIONAL SPACE IS NEEDED. USE NEXT CONSECUTIVELY NUMBERED FORM <br />