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&PLICA.! WATER WELL DRILLERS REPORT DD Not Fill F0 (CIts
<br /> Rata'• this copy (Ser Funs 79,7060,701 t,7082,Water Cod.) N" 12490
<br /> THE RESOURCES AGENCY OF CALIFORNIA
<br /> DEPARTMENT OF WATER RESOURCES Sate Well No.--- I�-�
<br /> Other Well No._— _
<br /> (1) OWNER: (11) WELL LOG:
<br /> Name CalTia Luther enol drpth
<br /> Address P. 0. Box 828
<br /> Lodi Cat forma 98240a9 !t7 to f
<br /> (2) LOCATIONOF WELL: s1wrame dirt
<br /> Ceao,r e.n Joaquin Cie.,,, umbel If.
<br /> o Soft 222ft brodunt Al or
<br /> Town.h,p,Ran e,.ted e,c,.nn Y 6 Na. $eeten gars brawn n1lis
<br /> — 2 16
<br /> D;a,.nce from.„im,ra.d., n�lroad.,en.- :110 WNL of Looer sac 11a�_,hrittled bra= ^lrkr 18 is
<br /> of Aompa 1146 y _ 19 40
<br /> (3) TYPE OF WORK (check): ____ 40 AIX--
<br /> Ne,
<br /> ateNew Well 11 Deepening ❑ K"onditioning ❑ Destroying ❑ Siiiiiiiwy lixom c1V .______ $2 j6
<br /> If destruction,desi robe material and procedure in Itree 11. irlk.,reguea pw rtlow _ —_ _---------- __Ia—
<br /> (4) PROPOSED USE (check): (f) EQUIPMENT: 69 _6_
<br /> Domestic ❑ Industrial ❑ Municipal ❑ Rotary ❑ a aft jpW al of _ _ Al 9A
<br /> Irrigation [jo Test Well ❑ Other ❑ Cable EX Meadbana brmm clay _ __ ad — &A__
<br /> Other ❑
<br /> Brittle mandf brom cloy as fill
<br /> (6) CASING INSTALLED: —__ 81
<br /> STEEL: OTHER: If glove) packed b t -mm clay
<br /> 17
<br /> _ 11
<br /> SINGLE f2 DOUBLE ❑ Brittleendly 'Y<,-.-,�,,.-m� c�l�a-ywaa•a - 117 112% —
<br /> Gage Diameter 1Ti 6rar and,tow 1a,'A in
<br /> From Ib or of From Tu 188 1a&—
<br /> ft. 1t. Dia.. Wall Bore fL ft. C—A and
<br /> Baa-so-1 �1�..—.Ise I.n-
<br /> Sin of shat or..11 rin6: Sir,of.....1: --
<br /> Describe win, —_
<br /> (7) PERFORATIONS OR SCREEN:
<br /> Ty of anfo. of a
<br /> Pert. Rows
<br /> From To pec per Siu
<br /> it. ft. row it. in.x in.
<br /> (8) CONSTRUCTION:
<br /> We,a.urLu uo;ury.1 provided) Ye, ❑ No To what depth It.
<br /> Wer any aejin,ow....m< allor;oni Yes❑ Nn❑ If v<. a depth of n....
<br /> From f,to ft.
<br /> F,m, 1t.In it. Wo,k.....rd IY ,f-omplered u
<br /> Method of.vun WELL DRILLER'S STATEMENT:
<br /> This well d
<br /> was rille .. er
<br /> (9) WATER LEVELS: Thid d
<br /> my la•iadiceion a.J this report is trw to the best
<br /> 1
<br /> Depth at water .<,fin, found, if known ft.
<br /> Sdin. In.l bef
<br /> <.na.ernof my A..,Iedgr and belief.
<br /> p<.fon<;n . ;f known ft. NAME. 8” JOAQUIB PUMP (X)YPAffs IIN0.8 �
<br /> $.ad,o Inel .her rfnntin and dela It. �Permn,firm,or m.pera;na (T7t,d or Anand) '
<br /> (10) WELL TESTS: Address BCC No R0tt10aap Lmes
<br /> Vu knon,tair node? Yn ❑ No D n.b when) Cd trI•
<br /> Yield, RilJni..w:d It,d.ades after hv. SICNED _
<br /> Tens ninon.of were, Ou.damicd aod'am edd Yo ❑ Me (Well D,IU Q �+
<br /> fie.1.on:Its me ds of.d11 Ye. ❑ Na If fa,.ouchmr Licerue No. Dsted �7a mi 17
<br /> F SKETCH LOCATION OF WELL ON REVERSE SIDE
<br /> DWR 11301 ,ne,. y.ae n4ntaa m-n awe rnrG.D on
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