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Example Water Well Diagram G.I.C. Well I.D ._______________

Example Water Well Diagram G.I.C. Well I.D ._______________ Current Owner ___________________________________ Well Type _____________________ Purpose/Number ________________________ Completed: (yyyy) ______ (mm) ______ (dd) ______

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Example Water Well Diagram G.I.C. Well I.D ._______________

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  1. Example Water Well Diagram G.I.C. Well I.D._______________ Current Owner___________________________________ Well Type _____________________ Purpose/Number ________________________ Completed: (yyyy) ______ (mm)______ (dd) ______ Land Location: 1/4 or LSD ______ Sec _____ Twp ______ Rge _____ West of _____ Mer Yield Tested at ______ igpm Recommended Pumping Rate _____ igpmRecommended Pump Intake ______feet Distance from known point: or GPS Coordinates 0000000 John Doe Drilled - Rotary Domestic House Well No. 1 1989 10 09 051 25 5 NW 06 100 12 6 60 feet West of SW Corner of House Formation Log - Lithology DescriptionWell Completion Details Ground level 0 Overburden 6.62” Steel Casing 10 12’ 15’ Bottom of Casing Driven Seal Prepared by: John Doe Date: Feb. 21,2007 20 Shale Depth in Feet 30 30’ NPWL 30’ 40 Gray Sandstone 48’ 50 60 4.5” Plastic Liner 70 Dark Gray Shale 80 Pump at 100’ 90 90’ 100 110’ Top of Perforations 110 Gray Sandstone Comments Starite ½ hp Submersible Pump installed at 100 ft. 120 12” Slots (Machine) 130 135’ Bottom of Perforations 140 140’ 150 160 170 180 190 200

  2. Water Well Diagram G.I.C. Well I.D._______________ Current Owner___________________________________ Well Type _____________________ Purpose/Number ________________________ Completed: (yyyy) ______ (mm)______ (dd) ______ Land Location: 1/4 or LSD ______ Sec _____ Twp ______ Rge _____ West of _____ Mer Yield Tested at ______ igpm Recommended Pumping Rate _____ igpmRecommended Pump Intake ______feet Distance from known point: or GPS Coordinates Formation Log - Lithology DescriptionWell Completion Details Ground level Prepared by: by: Date: Depth in Feet Comments 0 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85 90 95 100

  3. Water Well Diagram G.I.C. Well I.D._______________ Current Owner___________________________________ Well Type _____________________ Purpose/Number ________________________ Completed: (yyyy) ______ (mm)______ (dd) ______ Land Location: 1/4 or LSD ______ Sec _____ Twp ______ Rge _____ West of _____ Mer Yield Tested at ______ igpm Recommended Pumping Rate _____ igpmRecommended Pump Intake ______feet Distance from known point: or GPS Coordinates Formation Log - Lithology DescriptionWell Completion Details 0 Ground level 10 Prepared by: by: Date: 20 Depth in Feet 30 40 50 60 70 80 90 100 110 Comments 120 130 140 150 160 170 180 190 200

  4. Water Well Diagram G.I.C. Well I.D._______________ Current Owner___________________________________ Well Type _____________________ Purpose/Number ________________________ Completed: (yyyy) ______ (mm)______ (dd) ______ Land Location: 1/4 or LSD ______ Sec _____ Twp ______ Rge _____ West of _____ Mer Yield Tested at ______ igpm Recommended Pumping Rate _____ igpmRecommended Pump Intake ______feet Distance from known point: or GPS Coordinates Formation Log - Lithology DescriptionWell Completion Details 0 Ground level 20 Prepared by: by: Date: 40 Depth in Feet 60 80 100 120 140 160 180 200 220 Comments 240 260 280 300 320 340 360 380 400

  5. Water Well Diagram G.I.C. Well I.D._______________ Current Owner___________________________________ Well Type _____________________ Purpose/Number ________________________ Completed: (yyyy) ______ (mm)______ (dd) ______ Land Location: 1/4 or LSD ______ Sec _____ Twp ______ Rge _____ West of _____ Mer Yield Tested at ______ igpm Recommended Pumping Rate _____ igpmRecommended Pump Intake ______feet Distance from known point: or GPS Coordinates Formation Log - Lithology DescriptionWell Completion Details Ground level Prepared by: by: Date: Depth in Feet Comments 0 50 100 150 200 250 300 350 400 450 500 550 600 650 700 750 800 850 900 950 1000

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