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I <br /> is. .. <br /> STATE OF CALIFORNIA <br /> QUADRUPLICATE THE RESOURCES AGENCY DO not fill in <br /> Use to comply with DEPARTMENT OF WATER RESOURCES <br /> local requirements WATER WELL DRILLERS REPORT No. 251133 <br /> Notice of Intent No. <br /> 87-2019/2020 State Well No. <br /> Local Permit No.or Date Other Well No. <br /> (I) OWNER: Name Moorman Is Water Systems (12) WELL LOG: Total depth 190 ft.Completed depth 185 ft. <br /> Address from ft to ft. Formation(Describe by color,character,size or material) <br /> City Stockton. Ca zip 95205 0 - 4 T <br /> op Soil <br /> (2) LOCATION OF WELL (See instructions): 4 — 10 Sand <br /> County San Joaquin Owner's Well Number 10 43 Clay <br /> — <br /> Well address if different from above 4 — 45 Sand <br /> Township Range Secti 45 — 52 Clay <br /> Distance from cities,roads,railroads,fences,etc. 52 — 80 Sand <br /> 80 - 118 Clav <br /> 121 - 126 C <br /> (3) TYPE OF WORK: 1 — - n <br /> New Well EXDeepening ❑ 138— 142 ' a <br /> Reconstruction ❑ 142— 6 $ <br /> Reconditioning ❑ 14 <br /> Horizontal Well ❑ 11 — <br /> Destruction ❑ (Describe — C I aO <br /> destruction materials and pro- <br /> cedures in Item 12) <br /> (4) PROPOSED U _ <br /> Domestic _ <br /> Irrigation <br /> Industrial El _ <br /> Test Well O El <br /> Munici ❑ O <br /> WELL LOCATION SKETCH er be) <br /> 01A <br /> (5) EQUIPMENT: CRA CK: <br /> Rotary IX Reverse ❑ No Si <br /> Cable ❑ Air ❑ ' met of bore. <br /> Other ❑ Buck ed from <br /> (7) CASING INSTALLED: (8) PERFOMAT <br /> Steel ❑ Plastic [ e ❑ Ty pe o(perfo2, ion or Sim _ <br /> From o D' Gage or Frowof <br /> ft. Wall ft.--� Alpsize — <br /> 0 160 16r, <br /> I <br /> (9) WELL SEAL: — <br /> Wassurfamsanitarysedprovided? Yes EX No ❑ Ifyes,todepth 55 ft — <br /> Were grata seakdagainst pollution? Yee ❑ No ❑ Interval ft. — <br /> Method ofsealmg Work started 19 Completed-19— <br /> (10) <br /> ompleted 19_(10) WATER LEVELS: WELL DRILLER'S STATEMENT: <br /> Depth of first water,if known ft <br /> This well was drilled under m jurisdiction and this report is true to the <br /> rn <br /> Standing level after well copktion 72 ft hest of my knowledge and helf¢fy. / <br /> (11) WELL TESTS: Signed -71 i <br /> Was well test made? Yes ❑ No 11 If yes,by whom? (WO]Driller), <br /> Type of test Pump ❑ Bailer ❑ Airlift ❑ NAME HENNiEiC K. RRtYS_ nRil I iN& f'(i_ _ TMC, <br /> Depth to water at start of test_ft At end of test f. (Person,firm,or mrporaticn)(Ty or printed) <br /> Discharge gal/min after hours Water temperature Address 35 Z J DCI A N DA I C A 11 r r� <br /> Chemical analysis made? Yes ❑ No If yes,by whom? City int 0 D E ST 0. Ci h ZIP.--�.r M 6 <br /> Was electric log made YB ❑ No If yes,attach copy to this report License No. 2 Sk 0&12 Date of this report JUNE P2 19871 <br /> DwR 188 IREV I2") IF MODITIONAL SPACE 15 NEEDED. USE NEXT CONSECUTIVELY NUMBERED FORM 86 96]55 <br />