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Drawdown _________ ft. after _____________ hours pumping _____________________ G. M. 12. Use: Dom., Stock, PS., RR.,_Ind.,@ Obs. _________________________________________ _

Adequacy, permanence _______________________________ .: ____________________________________ _ ---I---I---! --- ---1

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Drawdown _________ ft. after _____________ hours pumping ___________ _ _G.M.

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Date ---___________________ ,

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Field No. ____________ _ Record by _____________{_______________________________________________ _ Office No.}_{____________}_{_}

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surface 10. Pump: Type ___________________________ Capacity __________________ G. M. ______________ _ Power: Kind ________________________________ . ______ Horsepower _______________________ _

11. Yield: Flow ____________ G. M., Pump ____________ G. M., Meas., Rept. Est. ________ _

Drawdown _________ ft. after _____________ hours pumping _____________________ G. M.

12. Use: Dom., Stock, PS., RR.,.Ind.& , Obs. _________________________________________ _ Adequacy, permanence _______________________________ ~ ____________________________________ _

13. Quality _____________________________________________ . ________ Temp _____________________ 0 F.

Tas'te, odor, color --- ______________________ Sample 1~s ______________ _ Unfit for ______________________________________________________________________________________ _ 14. Remarks: (Log, Analyses, etc.) ________________________________________________________ _

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surface 10. Pump: Type ___________________________ Capacity __________________ G. M. ______________ _ Power: Kind _______________________________ .. ______ Horsepower _______________________ _ 11. Yield: Flow ____________ G. M., Pump G. M., Meas., Rept. Est. ________ _ Drawdown _________ ft. after _____________ hours pumping _____________________ G. M.

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WELL SCHEDULE

Date ---___________________________ ,

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Field No. ____________ _ Record by ---____________________________ Office No. ____________ _

Source of data ___________________________________________________________________________________ _

1. Location: State ---:--- County 7--- ___ . __ . _____________ _

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DATE HOUR DEPTH TO ELJI:v _ OJ' WATER

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MEAs·1 REMARKS WATER SURUCE BY (Nearby wells pumping, etc.)

2. Owner: Address ___________________________________ _ Tenant Driller Address ___________________________________ _ Address ___________________________________ _ 3. Topography 4. Elevation ------ft.

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6. Depth: Rept. _______________ ft. Meas. _______________ ft.

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surface 10. Pump: Type ___________________________ Capacity __________________ G. M. ______________ _ Power: Kind _______________________________________ Horsepower _______________________ _ 11. Yield: Flow ____________ G. M., Pump ____________ G. M., Meas., Rept. Est. ________ _ Drawdown _________ ft. after _____________ hours pumping _____________________ G. M. 12. Use: Dom., Stock, PS., RR.,_ Ind.@ ., Obs. _________________________________________ _ Adequacy, permanence _______________________________ ~ ____________________________________ _ 13. Quality __________________________________________________ Temp _____________________ 0 F. Taste, odor, color ~ ________________________________________ _ Sample ~~s ______________ _ Unfit for _____________ --- ---_____ -________________________________________________ _ 14. Remarks: (Log, Analyses, etc.) ________________________________________________________ _

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