HomeMy WebLinkAboutWELL-10-2015-065330.TIF Apr. 12 . 2016 02 :29 PM DOUG KEEVER 7049661175 PAGE. 2/
• A F,.�IDEIVT.�A.G WW.corlstRvczuON RECORD
J1 North CaIOIm.Thcpatmlaa of Envisions=and Naomi Mans-Division Of Rta1v Quality
a, 5.9q _
WELL CONTRACTOR CERTIFICATION N _ u`
I f. t' Tlrp4� JL G Amman VCZ:a .
1. 'l P_ 9. WA ZONES%sr:
ear. C. � 1 �O Y" To
'Wm Gflada( )Noa To F!vR_._-
- t . .maA ell a Il•J . To_____ fens T
1 From Tt From To_____
sTR (ADDRESS [] 30 Dolph l a e • a. CASING: (7O Xh
_Shorn° s r9(o� MC aRG�3 . F� T; _ It_
AST}�_a 3 , ."1/(3,±)-- - Cols Fly. To Ft
• Ara/t>tldrt• Rae lw tthr' T. GAT. Matte, Mace WELL OfFORILATTOM /11 o40 3 _ O O 0nt1 ON Nlr To 1 SITE W .Vgswbk) r/1 0 I. From
om_To Pt
STATE WELL PERLAT/NMolkear) FIIHI.--^Ta FL .
DMA or ona Pestar to=Net 8. SCREEN: Depth ohenaer SIN Man Mal Mal
FIosTa Ft, In. _,__Pt.
WELL USE(Cher* ^ Ras'ids/W Water ONO F�_To FI,__In ^o••
DATE DRILLED Ay RIM To Fl___ht ,h
TIME COMPLETED 1 010 /WO PM 0
4. 8A1016MVEi.PACK:
Depth Seto Nvrtd
1 WELL.LOCATION: . Flat Tq_ __,FL
CITY: S h ctrl !J �orc� couNTY Ca-1.4 wloa ^TQ Fl
Todd sfiwtr n of RCan73 Fn>L —Ta FL
(Wee Rene N oSseo.coomunay.&RA..bl Lot m.Prod.a Car
TOPOGRAPHIC I LAND SETTING: 111.DRILLING LOG
O Slope oWan Opal CPAs. Corer Ftom To • Formation DCawllAND
5 e)35 �e.in.�
LATRUCE s pirlp�,srrerdra
LOIKSTUDE 1 1 Cc Ces, 75 to adecant aaaa f'Dvr
•LayprWbngitdtSotaca OOPS O1.01 map
(bmeLUi dataamt be sham on a USGS aro map fra r
Waded todE Rem redrmlv�) • A' Ps
`WELL Veer john Bon)S
OWNERS NAME
91 b3 0kfstC flh11 •At rock.ei5Karrr,Ib Felt) n 244.73
City A Town state 71jr Cab Jr
Nsacode- Phone maim •
11. REMARKS:
a.WRL DETAILS: t7 O
1 a TOTAL OEPIlt
b. DOES WELL RERACE EXISTING WSW YES a NO a
IOO�Ttaa R Maria WLLMAa 00111117W=9)M ACCORZ ICE WITH
a WAT�i(Use .tmoMTapdC C FT. UMKCrCT...a 1.COrIIIMILCIO1aTANDMICI 7AMIN,ACOw®ren
(Use'e i A�Q Top of Moro ma aabHosesessa TOW WELL OMER (,� Q f
d. TOP OF CASING IS ('s FT.Mom Land&at ' Io F To) ) Jfp�.`ilfa l `U-16
-ran d.ms tIllTenba IMd SW toad oSe mR 'ale S CBCiIIso W91"CCNYRAaYOR �IA�
e WrtanroN MD ISA MAC S.cne.
e. VELD(Wray. 0 METHOD OF TEST PreSSU�- `�-(j'+�C��7 ISJI 6P
1 PFIRW NAME OR PERSON COFBTPUCTING TUE W61
Q..i.w.r K.......'....'....a... f&..T..T..._ -..ala...�P. ' aW._ ...� . .. ..