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G! � <br /> Well Condition Form ; <br /> Date: 1 a / l" Field Crew: �—"iV4—' ✓1 !�h � <br /> Project Name: Kearney-KPF,Stockton name '- • initials <br /> Project Number: F� i�. <br /> name initials <br /> If"No," note action needed and if remedied during visit. <br /> Well Label Well Completion Bolts Present/In Gasket for Well <br /> Locking <br /> Well ID Free of StandingWorking Lid Clean In Mechanism(s) In Well Cap In Good <br /> Legible g Clean/in Condition Additional Notes <br /> Water Condition Good Condition <br /> Condition <br /> Vy <br /> lil �iLc c c. rtk�Q i CUA <br /> (/ ✓ \/ <br /> llA Z 0I iAJ <br /> bl�ClGi <br />