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HORIZONTAL WELL DATA SHEET (Page 2 of 2) <br /> Co tete as much information as possible. Leave blank if infomation is not available, use N.A. if not applicable. <br /> 'Indicates items required for Source WaterAssessment <br /> •'Indicates additional items required for assessments and Ground Water Rule <br /> AQUIFER <br /> Aquifer Materials <br /> list all that apply, sand, sift clay, ravel rock fractured rock <br /> ' Effective Dorositv(decimalpercent) default= 0.2 or"UNKNOWN" <br /> 'Confining layer(Impervious Strata)above aquifer? <br /> "YES" "NO"or"UNKNOWN" <br /> Thickness of confining layer, if known ft <br /> Depth to confining layer, if known ft below round <br /> ' Static water level ft below ground surface <br /> Static water level measurement: Date/Method <br /> WELL PRODUCTION <br /> Well Yield m <br /> Well Yield Based On i.e., pump test, etc. <br /> Date measured <br /> Is the well metered? "YES" or"NO" Yes <br /> Production (gallons per ear <br /> Frequency of Use hours/ ear <br /> Typical pumping duration ourstda 6 <br /> PUMP <br /> Make Franklin <br /> Type Submerible <br /> Size h 3 <br /> " Capacity m <br /> Depth to suction intake ft below ground surface <br /> Lubrication Type Permanent Lub <br /> Type of Power. i.e. electric diesel etc. Electric <br /> Auxiliary ower available? 'YES" or"NO" None <br /> Operation controlled by: i.e. level in tank, pressure, etc. Pressure <br /> Pump to Waste capability? "YES" or"NO" Yes <br /> Discharges to: i.e., distributions stem storage, etc. Irrigation <br /> REMARKS AND DEFECTS use additional sheets as necessary) <br /> NOTES <br /> 1. Neighborhood/Surrounding Area (list all that apply): A=Agricultural, Ru =Rural, <br /> Re=Residential, Cc =Commercial, <br /> I =Industrial, Mu=Municipal. P=Pristine, O=Other <br /> 2. Conductor Casing-Oversized casing used to stabilize bore hole during well <br /> construction. Should be removed during installation of annular seal. <br /> 3. Annular Seal-Seal of grout in the space between the well casing and the wall <br /> of the drilled hole. Sometimes called"sanity seal". <br /> Well Data Sheet.xls/Huizmtal Well 3116/01 <br />