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STATE OF OREGON <br /> WATER: gU~PLY WELL REPORT <br /> (~s m~r4 by ORS <br /> <br /> (1) ' OwN~R~ We~ Numar <br /> <br /> (~) 'TYPE' O~WORK <br /> <br /> (3) DRI~L'M~HOD: <br /> <br />[~) (s) ~o~g HOL~ c6N~'Y~UcT~ON: ..... <br /> BOL~ <br /> <br /> , I <br /> <br />WEIu~T,~T$~. M~ mum testing Um~ ~ ] h~ur <br /> <br /> water Dep& An~i~ ~w Found <br /> <br /> (ST^RT ¢^R~) # F//?qs ...... <br /> <br />(9) LOCATION OF WELL by legal deScrlptlo.: County ~Latit ud~ ........... <br /> Town~p ~ N 0? $ Rang~ 1W E ~ ~. WM, <br /> S~o. 11 RW 1/4 .... <br /> <br /> L36gR R~LEN R~ .............. ,,,,,~ ...... <br />(10) STKfIC W~rER LEVEL: <br /> <br /> A~ian ~0~ lb. ~ ~quam tach. <br /> <br />L)~pth al wltloh wa~t was flr$~ found A ~ A ~ ~ <br /> 'lb E d d ~o R <br /> <br />(12) WELL LoG: <br /> Ground Elcvafion ~ <br /> <br />0[~ w~ is ~ ~t w~& Omg~ wa~r lupply wc~ <br />Ma~Is us~ a~ [~O~ <br />and ~C[, ".. <br /> <br /> WWC N~,~r 1487 <br /> <br />(b0nd~) ~a~er W~ll Construclor Certiflcatl~; ' ' ' <br /> I ac~ m~slb~ty for ~e e~st~Cdon, ~zer~on, <br />~ffo~ an ~ well dur~g ~a e~Stmcdoa d~ ~ sb~e. ~l wo~ <br />~ffonn~ do~g ~i5 t~ i~ in ~np~anc~ wi~ O~gOn wa~r su~ly w~ <br />¢omtm~ st~d~. T~ ~*~ {s <br /> <br /> <br />