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License and Certification of Water Rights with State of Idaho Reclamation for Well No 3
t ~'M.. ~. ~. .1x. e.. ~ i..,ic~. - ~ - '~. _ w .... ;; ~~. ~, .- ~. ~ _ a ~. ~ .-~ ~ ~ ~ ~ ~ ~ ao ~ A; ~ V ~ cv3 cd ~ 5 '~ ~ ~ ~+ ~4 • ~, r ~ ~ ~ ~ ,~ b +;.; r _ ,~,.~ o p .G ~, ~,., y c, w ~" v~ ~ a ~' ~ ~ ~ ~ 8 ~ ~ ~ ~ c ~ ~ ~ o a o z ~ ~ ~ .N w r+ ~ •~ .~ ~~ Q) d H O ° ~ Ly ~ ~ ~ ~ ~~1 rt ~ v ~ O ~ ~ n J~ O ~ j, `,1~ C ~ ~' ~• ~ "~ ~y. ~j o~ ~ .~ ~ ~ ~ ,., o in Ts ca ti : x:. ~, ~~ N ~ V p ti , ~~ N F p ,., cd Qo ~ ~ ° ~ w c~ ~' pr7 ~ O S".."t ~ 41 d 5 a, N ~ ~ ~, cn ~ ~ ~ ~ •~ w ~ ~ c~ ~ ~ ~ ~ ~ ~ ~ U ~ ~ ~ rc?_~?., i1 . - - Y~' ~ ~.F , x:`2 - ll. „„$ ~ .. Y' f x +~ 'q ~M ,j ELF' $ ~r.~ ~~ ~ ~ ~ 1~ 1 a. ~ ~. -. ~ t ~ ~'~ ~j.Cti ~:/ ~. 1~ 1'`• M .e J _, 9..,. ' Q' f .~A ~ k ~ ~1 y J ~ ~ ~~3r Y l~ ~~ ~~ ' ~~ ,V i ~M~y~.,. ~ ~ ~ ~ ~ ti 1 - d '. 4 M ..t. w .. ~ y. 1 a.~,1 •s ~ .. ,.. r ~ , , w,. ° . ~ ~~~ ~ ~ e-~ EI - --P t,-.r~" - a~„, ' t ' , ., N ~`~iS.~, ' ~. } i _ ..y'(.. ~~ ' - ~ - ,~. ~ ~ t • r ~ ~~y ~ ~' '~ ' .ti ~ ~ v ~ ~ ~ ~ c ° ~ ~ ~ o :~ z ~ ti= t ~ ~ ~ U .~~ ~ . ~ _. . J y Y C. ~ ~ ~ w r.+ ~ ~ e ~ A ~ ~ ~ ~ ~ ~ w y, ~ ~ w a ~ ~, ~ ~ ~.5 ~ .., ~ ~ ~ '~ w ~ ~ ~ ~ w. ' ~ ~ ~. ~ ;' .A .~ ~ ~ ~ C ~ ~ ~ ~ x ~ ~' V ~,~, M ~; b ,~ 3 c° ' ~QQ' y ~ ~~ .~ ca ~ o * w9 0 ~R,r011 V ~ • a . r 0 r. . c ~ ~ [ ,~ •° •~ c C 1 ~ r O ~ . c F - ~ ~ t~ ;, .. ~ O ~ ~ '~ ~ ~ O ~ ~ ~ u ' , p ~ ~ QO ~ .~ a . ~ °' N ~ b ~ ~n - ~ ~ ~ ~ ~ ` o ~~ ~ y ~ s V V ^ .. }~t ~~A ) ZY ` 3 #y-. V a w o o ,~ -- b v o - ;r ~ ' .~ iA , F+ ~+ ,v G ~ ~ ~ ~ w '~ U r >, ~, o x "C O c'-d o 3 '~ ~ ~ ~ ~ c. ~ ~ ;~ ~ .... O ~ ~ 3 v 5 o ~ ~, °' ~ °' ~ '~ ~ v ~i. Q1 _ ~ h O y+ V ~ ~ ~ O ~ ~ ~ Go y, WWW ~ .~ v ~ N ~ ~ ~ ~ ~ 0 °. x o d ~ a ~ ~ ~ ~ a ' °, ~ ~ ~ ' ~ ~ ~ ~ "~ t~ c+ ~ 5 ~ O. o ~ ~ ~ p' t, ~ ~O ,~ ' ~ .o Q ~ ~ ; v '~ ~ '` ~~N . iM .O ~ K ~ ',r 'N , D IV r p ~ '9 '~ V1 b~ b ~ ~ co ~ ~~jj ~v ! ~ ` ~ ~~ Foam 22 Permit No.---- G-2~5Q6.-_-- f~rrtt~tr~te of f~n~plrt~nn of nrk~ TU ALL WHOM IT MAY CONCERN: This is to certify that--------~~'~=X -~F--3X,DIAI~I-------'---------- --- ---- ----- ------ --- - - --------------------------------------- of----------Meridian--- -------- ------ -- ----------------...---., County of......._,.~da--- -- -- -- --------- - ---- -------~ and State of __ode.~p______________________________-_-_- __-_-_..-___.__---.-, the holder_._-..-_.of Permit No..-.G-22 ~9~ issued upon Application hTo.('z-3C1~38-.bearing date of priority of..----.-February__11,_1952..----------------------- authorizing the diversion of -©ne - - - --------------------- ---------second feet of the waters of._a.We~7:..(subterranean._flow)------------------------- .:.. County of-.-.-Ada ------------------------ - ------ - _.----, State of Idaho, for.._----domes-tic---us.e-_£~r--the--Gity___o~..~e~idial purposes, ha-s____..._.fully complied with the provisions of the laws of the State of Idaho relating to the proof of completion of the works of diversion set out and described in said Permit; that said works are adequate for diverting and conveying to the place of intended use-----.-Clx~---------------------------------------------------------------------- -------------- second feet of the waters of-----said--well;------ ---- ----------- --------------- - -- _.-.---- ----- ------- ------- - ------ - ---- - --- __ ._ ------------------------------------------------------------------------------------------------------------------------------------------------------------------------ ----------------- that the point of diversion of said waters--_-is--_in__tha__SF~__SEQ..Sen-tion._12,.-Township--3.-hor#li~_--.__._- Range'---1 West-- B•--M'------------------------ -_and_that--aha.pl.a,ce--a~---use--o~--~ai~i--~tP-r- is -the--Git-y--o€--Me-ridia-n.-- --- ------------------------------ - n i g c Ana r~ ~. -- r `bo,t 1r• St ~.Jy. i~° ~~M~ Sh N,r ~~~ ~, d ~ Sp++w~ ~ Ce~S ~;~. Yl~o v "" / 93i~' ~, p~ 0. i ~.,~ ~ rC I~ _ Vi ~t ~. 1~/c,r t ~r..~w•r 1!- - l9b/ ~ ~ I~O~ ~N ~'~ ~ C~ vHe h t ~ ~ I ` ~-t r''' b ~~ r I ,~ RG 6 ber C~GK~ r ~G~~Q~ - ~9s, G ~ P. = P~ r-~~+-mil ~B'of~„ i~o~ rjQCYf f ~" lQ,pp~ I'7oC ~P/~ ~~~ ~i _l as dm~Op~ ~ o F ~ '~ < O dp O,~' O LEN J^RDAN GOVERNOR STATE OF IDAHO DEPARTMENT OF RECLAMATION MARK R. KU LP, STATE RECLAMATION ENGINEER BOISE February 18, 1952 RE: Permit No. G-22596 It1r. R. S. French ft~®rid isn .r p Idaho Bear l~;r. French: ':~~e enclose Permit No. G-27,596 in the name of the City of N;eridian and direct attention to the lii,:itdtions and conditions as given on the fourth page under approval of the State Declamation Rngineer. Very truly yours, IViARK R . KULP State Reclai~tion r~gineer By GZ~2~Vl,t;~ Ch f Clerk A:tg Eac. /~ ;Address all communications to'_ (Form No. 3) R.. 'S l..._FreY?ahS::..:..::. Meridian, Idaho. ', I, ~I'PLIC-~iTION FOR PERMIT TO APPROPRIATE THE SUBTERRANEAN WATERS OF THE STATE OF IDAHO Application No. G~:~.~~..:~2_9..:......---•---- ..........:.. Permit No. G--, ... ....----- --- ........................•--.... District No ---...,,-°---------- ... ---•-~ ................°------ 1. Name of applicant: Ci.ty....nf...Ddarl.dian. ---•---°--°.°-.........._------°-°----- :...................:.. ~....... -----.... r Post office address ....M r--------,-•------.-- -- ---I~ '•• I t~Z:1t1.1$II. County ......-•....-°.,. Ad&-........... State --° l3xL0...._..- 2. Quantity of water claimed: I.0_•_QUbiC'--_foot_•-per sec_ond_x•..•.--_-_•..._•_._.._--_--:.•-------------------_•-..,-- i (a) Rate of withdrawal in enbic feet per second .! ..:.................1 ~_~...:.....-..........................:.. or Idaho Miner's inches -------'-• ....................... ... or gallons per minute ....-...-----------°---°----.:..........-•--•---...............-:-............-....',.. (b) Annual withdrawal in acre feet per annum ---------°-----...-•--•-•-•-•----------------------°.........----...------°----------°-------... 3. Source of water supply: _... SUbterrgAei~r1..E'lODU, -_.. •:(PleII.) :. r ... 4. Location of point of diversion or well is in the .-....S~.~.4........:.1/a of-the '......_~?.E~.....-..-~i of Section ............._1:2. . , Tµ'p• --•---3.N......, Rge.........1-.W.---~ B.M., County of Ada, Ii 5. Water is to be used for:>.......DOm2St1C ~L1I'~OS.eS _for..the •City .Of -Merldi8211 6. If for municipal, industrial or recreational purposes give: City of Meridian, tlda County,; Idaho. I~ (a) Point of use of water is in the .........................irk of the ......................'/s of Section ....... .....- 3.N. Y.WT+. I Twp. ---°--,~..~..i..., Rge..-..l...e'.ew.----...., B.M. (b) Waste water or sewage effluent is to be returned to ........................................................................_-.-......:-. at a Point in the ................'k of the -..-........'/s of Section ....---------.-, Twp......--•.---...., Rge...------.....---, B.M. II ~. I{ind of 1Vo~P.:: _---.. ..... ~---]''......... -- ---•-----... .::... .......---.. ......... ... s: Estimated ooat of workaz $ 10- 000. 00_. Distri Lion system previously installed, ..-.• ~ ... bu ~' (a) Is reservoir to be used'+ •••-•• - ••------ ... ~~;, ~:...., ~ ,, a >~~, ~. ,. :. ~. i ... s, c~ o (b) 'Capacity of 'reservoir[ ...... ...., • •, . .; , .:::. ...:....: ..... ;.......::; ......... , .. -~---- '~ 10. The time royuii•ed 'for the completion of such ~~ork and complete .application off, the water to the {proposed use is .....:........`~VQ4:.........................-. years. i ~~1 ~~ f ~' .~"' il. If applicant is a corporation, give: 'I I. (a) Date and Place of incorporation:...--•-•---°--- .................................----° -- -... --- ---- -.-....-...--......--- -- .........- -° --......-... I (b) Amount of capit$~-~tock $------------° ....................°--(c) Amount paid in: $--...-------------....--°-----------....,.....' ......,...-:.. ~ (d) Names and addresses of directors :................°-.................--°---`--.......--°-- ...:.._°-----......--... -- --°-°------..... ....----...°- -- II. The financial resoaurces'of the applicant aie (a) dash on'hand: $ ..-::,:- ,----.:_.. (b) Treasury stock: ..----°.----° ..................................:..... (c) Bonds to be issued: -----........ (d) Other resourcea : ............:...:....:....._.......---.....-.~.......:......._:...:----`'--`---................------°---°'-- 12. The land to be irrigated is described in the following tabulation: (Give irrigable acreage in each 40-acre subdivision) 13: Existing water rights and/or valid permits appaitenant to the lands to be irrigated are :............ .:.- ...--_:.. '~ ::Existing..water right :,_ use:right:,.:used.: approx...._42_..ye'ars_,._., .._:__.. (a) .:.... .::.........(cubic feet pei•` second,""'inches or gallons per iiiinute) of" the water herein applied 'for ' is to be supplemental to 'the existing water rights. (b) ............................(cubic feet' per second, inches or gallons per minute) is for new lands. I Remarks:....-----..cS..llpp.1.EIIlB.ri~&_L.._tSl---.9.X1S.ti.1Ll~...YYQ.teST....T:a.~~,9.....~...-~.S?.x.---C~ 4d7Ae.S:~.]..C..--.L1.S-E%....----- ------------------------------for..._the....~i.~.y.---nf...Adari-d.ian,-••-•---------.....,--•------------............._....----------.......--------------....-- ..-.......- BE IT KNOWN That the undersigned hereby makes application for permit to appropriate the public waters of the State of Idaho as herein set forth. .........~i.~r....nf...Beeri-dian, ............ . ..........-- --_...-. v,,////{JJJ - _ / ..................... -APPlicant. BY -~..f.'~~,o-~.~lX4S%l~ .. Agent 1 Approval of"State Reclamation Engineer The number of this permit is~'!~:~'--..-~ ................... `~~~•`"~ LL' FFB 9 4 taF2 Recorded in Book ..-....~4-------°------. Page ..r,.t:ws).~.4~,. Approved ..-._..=•-• ....:..............~---•---.-....- This is to certify that I have examined the within application for a permit to appx•oprite the public waters of the State of Idaho, and hereby approve the same, subject to the following limitations-and conditions: Bond in the sum of'$ ...................-°---- to be filed before --....-.:........-..-...-:-.--:....-...-.°--`-°°°--•----..::.--....-.....-...--..........:..........------•----- - Work to begin on or before -:-....,{~T-1.L--~yy---1Q5:2 ....:.:.............................................::........;-and- to continue diligently and uninterruptedly to completion, unless temporarily interrrupted by circumstznces over which the permit holder has no control. One-fifth of the work above specified to be completed on or before -.February---~.1-}:--j..9~•~_----------------------------__.-.......- The whole of said work Lo be completed and beneficial use of water appx•opriated in accordance herewith, to be made oa or before ---•---~'.ehx718x',~-•~-r---~~-•• ................-------------•--~-------------:..----------°------...--------••---....-....-----_....---•--.-.....-...................- '' Witness my hand this ---------~~~-----°----- day of ...-...FebTl181y----• • ............. 195....-. State- Reclamation Engineer IN TESTIMONX WHEREOF, We -:....._LEN JORDAN•------_-------•----_---------•---------------- -Governor of the State of Idaho, , and -..IRA.-.R-.--~$~'~5-----------------------------------------------------------------::, Secretary of State of the State of Idaho; have caused this instrument to be executed in the name of the State of Idaho, and caused the Great Seal of the State of Idaho to be hereunto affixed, this .. 'rikl-....----.- day .- .ebbllaTY ......................... 195.---•• Coun rsig d• STATE DA O Secretary of State. Governor. .~ ~^ i ~iJ ; C 1(~ i ~? n~i t ~o z ~(_~J I~ a v / ~ as ro fV ~ ~; o ~! ~ 0.'i o d ~ o a °' c. O •~ \: y W ~ W `• ~" d .7 0 ~ 0 w W U . F• is P: ~ .~ 0 W F W U ~' ~ ~` ~ ~ ~. w ,~ ~ W w ~+ i ~ ~ - ~ ~ ~ vl y • ~ " ~ o ~ Y b v ~, o ~ ~ z b ~ v q ~`• N $ `~ 0.' y '~ F ~~ ~ ~ d 4 F d :r F ' ~1 () 13 FT I ~T 1 • 4 ^ .._ ~. NeMe of APPLICANT City of Meridian, Form No. 0 1 ' 1 ~-------- -------- ~ 1 ~ 1 1 1 ' - ~-------- -------1 ~ 1 1 1 1 1 1 1 ' - -------~------- - 1 1 1 1 I 1 1 1 1 1 1 1 ; -------~-------- 1 1 1 1 1 I 1 1 I ; 1 1 -----~--1-------- ; ~ 1 ~ , ~ ' ---- --------f---- ~ ~ 1 1 1 ~ 1 , 1 , 1 --------~-------- - 1 1 1 1 1 1 ~ 1 I 1 I 1 -------•-------- 1 1 ; 1 1 1 1 1 1 1 I 1 --------1-------- 1 1 1 1 1 1 1 1 ~ 1 1 --------~-------- ~ 1 ~ 1 1 1 1 ; 1 1 1 --------~-------- 1 1 1 1 1 1 1 I ~ 1 1 I --------~-------- 1 1 1 1 I I I 1 ~ 1 1 1 I --------f-------- I 1 1 1 1 I 1 1 1 1 1 1" I I --------~-------- I ~ 1 ~ 1 1 ~ 1 1 1 1 --------~-------- 1 1 1 1 I 1 1 1 1 1 1 1 ------••-~-------- 1 1 1 1 I 1 1 1 1 1 1 1 1 ~-------- -------1 1 1 1 1 ~ - 1 1 ; 1 1 1 --------1-------- 1 1 1 ~ 1 k I 1 1 1 1 1 1 1 I --------F-------- I 1 1 1 1 1 1 1 I 1 1 1 1 I I --------f-------- 1 I I I 1 1 ~ ~- -. ~~-~...: I I 1 1 1 1 --------1-------- ; 1 1 ~ -. ; - ~ 1 1 1 ~ 1 ~------- -------- - ~ 1 1 1 1 __. . 1 1 I 1 1 1 1 1 --------r-------- 1 I I 1 -. 1 1 1 1 1 I 1 1 1 1 --------~-------- 1 1 1 I 1 1- -- 1 1 1 1 1 1 -------- -------- 1 1 1 1 1 ~ 1 , 1 1 1 •-------- -------- ~ I 1 1 I 1 I ~ 1 1 1 •-----_..- -------- 1 1 1 1 1 1 1 I 1 I I `l~ N 13 ~. 1 . --------~--~----- 1 1 1 1 I I I 1 1 1 R. ~.W. -------r-------- 1 1 I 1 1 ~ ~ ~ T`~P• 3 --h-------- ------ 1 1 ; 1 1 1 1 1 I N. R j 1.E --------~-------- _1 I ~ 1 I 1 1 1 ~ 1 I --------~-------- 1 1 1 1 1 1 I 1 1 1 1 1 1 1 1 ; ~ 1 1 1 ~ ~ 1 1 ~ ~ 1 1 1 1 I ~ 1 ~ 1 1 1 ~ ~ 1 1 1 1 -------- ----_--- 1 --------~-------- I - •-------- -------1 1 --------T-------- 1 1 ----------------- I --- -- ---__- - '_---_-- _------- 1 ----------------- 1 I ~ 1 I 1 1 1 1 1 1 1 1 1 1 1 1 ~ 1 1 , ; ~ .M %1 ~~ a 4 i ' 1 I ; ' ~ 1 1 1 ~ 1 I 1 ' I 1 ~ 1 t R Qj , 1 1 1 1 1 1 1 ; ~ ; V ~ ~ J 1 ; ; ~ ; 1 1 1 t 1 1 ----------------- 1 1 1 I 1 ---------- I I 1 1 1 1 ,- 1 1 1 1 1 , 1 ,-------- 1 ~ I 1 1 Ppint 1 1 1 1 f Diversi 1 ~ I I 1 -- n 'dell ~ 1 1 1 I 1 1 I t 1 1 1 1 ; I ' 1 1 1 1 ~ 1 ~ 1 1 1 1 ------ I I 1 1 y I 1 I ------- 1 1 1 1 1 ; -------r-------- ~ 1 1 ~ 1 1 ------- r- -------- 1 1 1 1 1 1 1 1 --------T~------- *-------- 1 1 1 1 1 I 1 ," 1 1 ; + ; T- 1 ~ ' ~ ~- 1 1 1 1 I 1 1 1 ; 1 ; 1 1 1 ~ ~ 1 1 1 ~ I ~ 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 i 1 I -- ' ' ; 1 --------1 ------- ~ 1 1 --------~- i 1 1 ; 1 1 r-------- ~ 1 r-------- 1 ~ 1 1 --------T-------- 1 1 1 1 1 1 1 --------T-------_ 1 -------- 1 1 1 1 1 1 --------------- ; 1 1 1 1 1 T 1 1 1 1 ; 1 , ' ~ 1 , ; 1 1 1 1 1 ~ 1 1 , ; , 1 1 1 1 I 1 1 1 1 1 1 I 1 ----------------- 1 1 1 1 1 1 1 1 1 ; 1 ' 1 --------~-------- 1 ; 1 1 1 ' 1 1 ' 1 ~ 1 ~-----_-- -------- ~ ~ 1 1 ; 1 1 ; , , ; 1 -__-_---1---_--_- 1 I ~ 1 I 1 1 1 1 ; 1 ' "-------r------- 1 1 ; 1 1 1 ; ' 1 ; ; - r- -------1 ------ - ~ ~ 1 1 1 , , ; , , - *-------- - ------- 1 ' i ' 1 1 1 1 1 1 --------r-------- 1 1 1 1 1 1 1 1 1 1 1 1 1 I 1 1 1 1 1 1 1 1 i 1 1 1 1 ; 1 1 1 1 1 1 _-__-__-~-------- 1 ~ 1 1 1 ~ 1 1 1 1 1 ----------------- 1 i 1 1 1 ~ 1 i 1 1 1 ________ Y------- 1 ~ 1 ~ 1 1 ; 1 1 1 1 .- r__-_-__ -------1 1 ~ 1 1 1 , .. , 1 ~ 1 1 1 1 _ _ r-__-__ ------'1 1 1 1 ~ .., - 1 1 1 1 1 _______-r_______ 1 ~ 1 ~ 1 _ ________t_____-_- 1 1 1 1 1 1 1 ~ 1, - _ ..,- 1 1 - I .... i . 1 1 1 1 1 1 . 1 1 1 ; I`orm 24 STATE OF IDAHO DEPARTMENT OF RECLAMATION BOISE, IDAHO April 28 Re: ~errzit No. ~'i-.,2~~~5~ ................ ' •~~ .-City-- of- Yeridisr~•-••-.-•--- l[eridian, Idaho It appearing to the State Reclamation Engineer that the terms and conditions of Permit IVo..: a"22,1~~°' to Appropriate the Public Waters o,f the State of Idaho, have not been complied with as to ...._..._... --.----,---. ------------------------------ Compl®tior~----°--f--works February--lLt, • 1951 lt2-311 you are hereby notified in compliance with Sec.•~~B~i, Idaho Code wed that said Permit No, .._~2.2~9~ ................... is hereby held for cancellation. Yau are hereby required to show cause before they State Reclamation Engineer on or before forty days frgm date of this notice why said. Permit should not be cancelled. Said .Permit No. _..~2.2~Q~____.____ claims ,the use of .-........X110 ..............................___..___•- cuibic feet per s~ec~omd of the waters of ...5-xau--•--•-------------•-------------------•--°---••--•------•--------....-•----------•---•---------•-•--°---•------------~-..._... with point oaf diversion located ~I1---t~~-.S---S.~~---,~eatj.~Dn---]2-s---T~P~••---~•--Korth,..Ralzga...l..lNBSt~...H.---](.---------------- - and 1 - ---------------•------•---------•-•--•> - - _ -_ was apprgved .-----•F~bI'1182'x/_----•--~•--~s•.r.•E~ ... ........................ In Witness Whereof, I have hereunto set my baud and affixed the seal of my office at Boise, Idaho, the --,---------------------28~'!•.-------•-•- day °f -----•--~~~:~.~.---•---------•--------..... --......, 19~~..-• State Reclamation Engineer. Assistant. USE TYPEWRITER OR ~ ~~ BALL POINT PEN State law ., a y,,. ~ _ _ ....1#~. .. ...~; State of Idaho pepar_X~nelc~t of Water Administration WELL Q ;LEER'S REPORT requires that this rt be filed with the State Reclamation Engineer within 30 days 8~ft~ ','ompletion or abandonment of the well. 7. WELL OWNER { ~ ~~ ~ Name ~~'~~ ~~ ~`'~ 7. WATER LEWEL Static water level ~ feet below land surface Address ~"~~~`""'~ ~~ ~ `~!~ Owner s Permit No. Flowing? ^ Yes ^ No G.P.M. flow Temperature ° F. Quality Artesian closed-in pressure p.s.i. Controlled by ^ Valve ^ Cap ^ Plug 2. NATURE OF WORK ^ New well ^ Deepened ^ Replacement 8. WELL TEST DATA ^ Pump ^ Bailer ^ Other Dischar~ G.P.M. Draw Down Hours Pumped ^ Apandoned Idescril~a. t~-ethad of ~abar~,dpttir#~1 ~~' ~ ~ ' ' ~ Es ~, . 3. PROPOSED USE ~ i r~. ~. I, ,, ~ ^ Domestic ^ ~Irr `p ^ Test t ~ ~' 9. LITHOLQ~~C BOG . ~ Fr ~. Hole De~ t~ Water ^ Municipal C7 Indtls'~~i~l,'~; ^ StoCk i~ j ~ 1' ,~ Diam. From -'I~bF Material Yes No 4. METHOD DRILLED , '~~~,,',: ~' ~= ~'' '"~;O ;,',X'~",~'~i't O ~,~' able ^ Rotory ^ Dug ^ Other tip ~ ~Z ~:~ ~: ~ O ~:4r. +~t+ii'~O ~~'t"~~3' C 5. WELL CONSTRUCTiO~';. G iO ~;~"~3 ~.',~` Diameter of hole inches Total depth, feet Casing schedule: I^, Steel ^ Concrete ness ~a F r ~ inches ches feetfeet ' -- ' ~ inches ; i ches feet, feet inches inches __T;feet feet inches inches feet ~- i#~e'f i ~a~~l . feet i~he_s__.- ~ ~~ f_ ,. __ -~h~. - , : _. _ ~,... __~_ - - '~ ~y ~ ~(es ; Was a packer or seal use~~' ~ ~ l Y~ ,Per#orated? + ~ ~~,~~ How perforated? '_it ^: Kr~ '~~1J.~_ " Size of perforati®m inches.. by __~ ~__, incf~s , ~ Fr ,ji i 1 ~ - . feetfeet foratrons Y ~ . feet perforat~~ns feet~ Brats ;E;.;;. feet ~~ #eet ~~~ h' i ~ Weil screen installed? ^ Yes Nsi;t ;E ., ail Manufacturer's name I' ~ Type Model No. ~ ~'~ '~ Diameter_._ Slot size ~,. S~t;from feet to feet Diameter_Slotsize~.Set,from feettp~~feet _ ~ ~~~~~ Gravel packed? o Size of gr ~~~~N feet to ~ feet Placed from Surface seal? ^ Yes ^ No To what depth feet. Material used in seal ^ Cement Grout ^ Puddling clay