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EFTA00309073
diameter of well casing (inches): 6.63 Driller Name: Hydrogeologic Services, Inc. Driller License Number: WD 1472 If replacing the &enk vititti is dint dotardt!Zbil to be plugged? O Yes O No 0 Not Applicable If No. state for what use it is retained: '-vv`Arlette: r,:EY.13 FOR OSE INTERNAL USE Application fo
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