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<tbody>
<tr class="odd">
<td colspan="4"><h5 id="nrcs"><img src="media/image1.png"
style="width:0.58819in;height:0.34444in" />NRCS</h5>
<p><sup>Natural Resources Conservation Service</sup></p></td>
<td colspan="9"><h2 id="water-well">WATER WELL</h2>
<h1 id="conservation-practice-job-sheet-642">Conservation Practice Job
Sheet 642</h1></td>
</tr>
<tr class="even">
<td colspan="13"><h2 id="new-mexico-june-2005">New Mexico June
2005</h2></td>
</tr>
<tr class="odd">
<td>Client:</td>
<td colspan="5">     </td>
<td>Tract:</td>
<td>     </td>
<td>Farm No.</td>
<td>     </td>
<td colspan="2">Field No.:</td>
<td>     </td>
</tr>
<tr class="even">
<td colspan="3">Farm/Ranch Location:</td>
<td colspan="3">     </td>
<td>County:</td>
<td>     </td>
<td>Acre(s):</td>
<td>     </td>
<td>Date:</td>
<td colspan="2">     </td>
</tr>
<tr class="odd">
<td>Program:</td>
<td colspan="4">     </td>
<td colspan="2"><blockquote>
<p>Contract No:</p>
</blockquote></td>
<td>     </td>
<td colspan="3">Planned Installation Date:</td>
<td colspan="2">     </td>
</tr>
<tr class="even">
<td colspan="2">Drawing No.:</td>
<td colspan="3">     </td>
<td colspan="2">Item No.:</td>
<td>     </td>
<td colspan="3"></td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="13">Definition:</td>
</tr>
</tbody>
</table>

A hole drilled, dug, driven, bored, jetted, or otherwise constructed to
an aquifer.

**Purpose:**

To provide water for livestock, wildlife, irrigation, human, general
farming and ranching needs, and proper use on rangeland, pastures, and
wildlife areas.

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  Requirements:

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-   CONSTRUCTION SHALL NOT COMMENCE PRIOR TO THE ISSUANCE OF A DESIGN
    ACCEPTANCE LETTER ISSUED BY THE NRCS. (See §NM521.01 of the National
    Engineering Manual.)

-   It shall be the responsibility of the owner / lessee to obtain all
    necessary permits and/or rights, and to comply with all ordinances
    and laws pertaining to this installation.

-   On Federal, State, or Tribal lands, or when federal funding is
    involved on private land, the landowner / lessee must have
    archaeological clearance and approval / permit from the responsible
    permitting agency prior to any construction. If during installation,
    any cultural resources, historical resources, threatened or
    endangered species are found, the landowner / lessee must cease
    operations and obtain archaeological clearance and approval / permit
    from the responsible permitting agency prior to continuing
    construction.

-   Installation shall be in accordance with the drawings,
    specifications, and special requirements.

-   The following additional data is required: Well diameter and depth,
    casing material, diameter, and length, screen specifications, filter
    pack specifications, sealing and grouting specifications, flow rate,
    use of water, and water quality test results.

-   The signed Water Well Completion Report is to be attached to this
    job sheet prior to the on-site inspection.

-   NM-ENG-231 may be used to assist in system design.

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  **[Practice Classification and Approval (NEM Section 501):]{.mark}**

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The highest Job Class identified for all applicable practices shall be
used to identify the Job Class of the project.

  ------------------ ------- ---------- -------------- ----------- --------------
                                        **Job Class**              

  **Well Depth**             **Feet**                  **     **   
  ------------------ ------- ---------- -------------- ----------- --------------

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  Engineer Certification:

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The designer shall certify that the design has been prepared in
accordance with Practice Standard 642, the Statement of Work for
Practice Standard 642, and any other applicable practice standards
necessary to complete the design.

For designs prepared by NRCS personnel or non-NRCS personnel with
assigned NRCS job approval authority:

Designed by: Designer's Engineering Job Approval Limit: Date:

(signature) (for this practice)

For designs prepared by non-NRCS personnel with no NRCS job approval
authority assigned:

Designed by: New Mexico PE License No.: Date:

(signature)

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  **[Landowner/Operator Acknowledgement and Acceptance:]{.mark}**

  -----------------------------------------------------------------------

The landowner/operator acknowledges that:

-   They have received a copy of the construction drawings and
    specifications, and understands the contents and requirements and,

-   Maintenance of the installed work is necessary for proper
    performance for the life of the practice. All federal cost shared
    practices must be maintained to these specifications for the
    expected life of the practice.

Accepted by:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Date: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Landowner/Operator

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  **[Practice Completion:]{.mark}**

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I have made an on-site inspection (or I am accepting owner/contractor
documentation located in the case file), and have determined that the
job, as installed, conforms to the drawings and specifications.

Accepted by: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Job Title: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Date:
\_\_\_\_\_\_\_\_\_\_\_\_

Authorized NRCS Representative