GOVERNMENT OF THE VIRGIN ISLANDS OF THE UNITED STATES
GOVERNMENT OF THE VIRGIN ISLANDS OF THE UNITED STATES DEPARTMENT OF PLANNING AND NATURAL RESOURCES DIVISION OF ENVIRONMENTAL PROTECTION 45 MARS HILL FREDERIKSTED, ST. CROIX, VI 00840 PHONE: (340) 773-1082, FAX: (340) 773-9310 WELL DRILLER’S REPORT _____________________________________________________ (Well drilling Permit No.; Drillers License No.) ______________________________________________ (Name of Property Owner) ______________________________________________________________ (Mailing Address, Telephone) ____________________________________________________________ (Location; Latitude; Longitude) Type: Drilled ( ) Driven ( ) Other: ( ) Started: _______________________________ Finished: ______________________________ Total Depth: ________________ Casing Type: ( ) Galv. ( ) Black ( ) Other Depth: ________________ feet Diameter: ______________ inch Water Level: ______________ Flowing: ( ) yes ( ) no If not, how far down? _________ Feet Yield: Flow ____________ GPM Pump___________ GPM or ____________ GPH Drawdown from pumping: ___________ feet or ____________ vac. …
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GOVERNMENT OF THE VIRGIN ISLANDS OF THE UNITED STATES DEPARTMENT OF PLANNING AND NATURAL RESOURCES DIVISION OF ENVIRONMENTAL PROTECTION 45 MARS HILL FREDERIKSTED, ST. CROIX, VI 00840 PHONE: (340) 773-1082, FAX: (340) 773-9310 WELL DRILLER’S REPORT _____________________________________________________ (Well drilling Permit No.; Drillers License No.) ______________________________________________ (Name of Property Owner) ______________________________________________________________ (Mailing Address, Telephone) ____________________________________________________________ (Location; Latitude; Longitude) Type: Drilled ( ) Driven ( ) Other: ( ) Started: _______________________________ Finished: ______________________________ Total Depth: ________________ Casing Type: ( ) Galv. ( ) Black ( ) Other Depth: ________________ feet Diameter: ______________ inch Water Level: ______________ Flowing: ( ) yes ( ) no If not, how far down? _________ Feet Yield: Flow ____________ GPM Pump___________ GPM or ____________ GPH Drawdown from pumping: ___________ feet or ____________ vac. Use: ___________ Taste: ___________ Odor: ________ Hardness: ________ Iron: _________ Permanent Pump Installation: _________________ Manufacture: ____________________________ Type: __________ HP: __________ Capacity: ____________ GPM Installed by: ______________________ Date: _____________________ Person Filling Out Form: _______________________________________________________ Address: ____________________________________________________________________ DRILLE’S LOG From To Material Description Remark: Well log shall be completed and delivered to the Office of the Commissioner of Planning and Natural Resources within thirty (30) days after the completion of the well drilling operation, for each hole.