T _________ R _________

County _________

Montana Bureau of Mines and Geology

Butte, Montana

Water Well Log

Owner _________ Address _________

Driller _________ Address _________

Date started _________ Date completed _________

Location: Sec _________ T _________ R _________ ¼ sec _________

Type of well _________(dug, driven, bored, or drilled) Equipment used _________(churn drill, rotary, other)

Water use:

Perforated or screened: Ft. _________ to ft. _________ Ft. _________ to ft. _________

Type of screen or perforations: _________

Static water level, for nonflowing well: _________ feet

Shut-in pressure, for flowing well: _________ lb./sq. in. on: _________(date)

Pumping water level: _________ feet at _________ gal. per min. _________

How tested: _________

Length of test: _________

Remarks: (Gravel packing, cementing, packers, type of shutoff, depth of shutoff)

Log of Well