DRILLER'S CERTIFIED STATEMENT OF WELL COMPLETION
HGCD WELL NO.
DEPTH OF TDS READING
STATIC WATER LEVEL AFTER COMPLETION
WAS THE WELL SEALED OR CAPPED TO MEET TDLR REQUIREMENTS
I hereby certify that this well was drilled by me or under my supervision and that this well was drilled and completed in accordance with the District and State requirements and each and all of the statements herein are true
Should be Empty: