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ATTACHMENT 1 <br /> WELL INVESTIGATION FORM <br /> Page 1 of 3 <br /> Reported By: Phone : <br /> Well Owner Name&Address : <br /> Phone : <br /> Well Location: <br /> GPS Position: <br /> (Latitude) (Longitude) <br /> GPS Type & Configuration: <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 Repair/Abandon SJRWMD Repair/Abandon <br /> Comments : FOR DISTRICT USE <br /> Project no . : <br /> Attach photos <br /> 8of10 <br />