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ATTACHMENT I — WELL INVESTIGATION FORM <br /> GENERAL PURPOSE FIELD INVESTIGATION FORM <br /> Reported By: Phone: <br /> Well Owner Name&Address : <br /> Phone : <br /> Well Location: <br /> GPS Position: <br /> (LanNde) (Longitude) <br /> GPS Datum (circle one) : NAD83 WGS84 Aquifer code (circle one): UC SC CF UNK <br /> Date of Inspection: Observed By: <br /> Cost Share Program discussed: <br /> Well Diameter: Well Depth: Taped/reported Blocked @ feet <br /> Well Status : (Check All That Apply) <br /> Accessible By: Well Head: Condition : Action: Loggability: <br /> _Foot _Visible _Capped _Left As Found _Loggable <br /> _Vehicle _Buried _Valved _Temp Plug _Site prep required <br /> _ATV _Discharge Visible Only _Plugged _Temp Repair Need: (prep work) <br /> _Boat _Under powerlines _Other _Flagged or Staked <br /> _Logging Van _Unable to locate Not Loggable <br /> _Not accessible Well use: _Open Reason: (unloggable) <br /> Flow upon arrival gpm <br /> Flow wide open gpm <br /> Flow as left gpm <br /> Recomendation: <br /> Owner Keep _ Owner Repair/Abandon _ Not Repairable _ SJRWMD Repair/Abandon <br /> Comments: <br /> Attach photos <br /> 8 of 9 <br />