HomeMy WebLinkAboutCAMPBELL HEIGHTS BLK 5 LT 20A
Well
Log
· /,~ ~0~ ~40~, .~. -..~..u~?~tt t
Locabon ..... , .................... ~ ............ :~ .............................................. ~ ...................
Da~e eompletedJ ....... ~.~..L.~..:..~.[ ......... ~ .............................................................
11 ~ ~
Depth of we ...........................................................................................................
Size of casmg...~ ............ - .......................................................... ~ .................................
' 11 ' ~
D~s~nce ~o ~e~ ................................................................... ~.Z..~Z ..........................
Dist~ce to war r while ~' ~-"' ~ ~ ~1~ nt rate
F~F ~ ..........................................................
of ................................................ gallons per. hour.
~ Formation
from j to
J~UNICIPALI'g/ OF A
J ~, r:rl::lV i:J)
I I
Driller
DELTA DRILLING COMPANY
Date t Date Date
Inspector i Inspector Inepector
Comments Conditional Approval
Date Sewer Install~ i P~lt NO. ~ptlc Tank Size
~ Holding Tank Size
~l]s Rating , Well To Absorption Area Well L~ R~elv~
' I Well to Tank
[ APPLICANT FILLS OUT LOWER HALF ONLY
Buyer
Address
Address /~ /
Address
Street L~atlon ~ ~
Typ~ Residence
~Slngle Family
,- ' ~ Multiple Family , No. of Bedr~ms
~ Other I
Wat~uppty
~ Individual~ A~ACH WELL LOG. A well log Is requlr~ for all wells drlll~ since June
~ ~mmunlty ~ 1975. For wells drilled pdor to that date, gfve well depth (attach log
If
~ Public Utility , available.)
Sewage Disposat
~ubllc Utility When ~nnected to Public Utltlty~
~ Ho/ding Tank
NOT~ THE INSPECTION FEE MUST ACCOMPANY ~CH REQUEST BEFORE PReCEdING CAN BE INITIATED.