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-- `� STATE OF CALIFORNIA Do Not Fill Ill <br /> THE RESOURCES AGENCY <br /> DUPLICATE DEPARTMENT OF WATER RESOURCES N© 7 6 5 2 1 <br /> Retain this copy WATER WELL DRILLERS REPORT State Well No.- - <br /> J <br /> U- 11) <br /> f 1 Other Well No.- <br /> (1) OWNER: / (11) WELL LOG: <br /> Name renj!y 3 Total depth 235 ft. Dep[h of completed welt 186 f[. <br /> Address Pnrmarion: D....ihr by robe,character,size of maltrial,a.d streefure <br /> Jacktia_nQ !Rd - <br /> it.to f[_ <br /> (2) LOCAT ON OF WELL: <br /> County San joaquin Owner's number,if anv ��„ t7- <br /> Township,Range,and Se"i.. t - Clay <br /> s — <br /> Uistance from cities,roads,railroads,etc. ce -v.t r <br /> AliciaS f r� <br /> (3) TYPE OF 'FORK (check):_ - -, <br /> New Well `-k Deepening ❑ Reconditioning ❑ Destroying ❑ ^ '7a "lay <br /> If destruction,describe material and procedure in Item 11. e <br /> (4) PROPOSED USE (check): (5) EQUIPMENT: 2andy Clay - <br /> DomesticIndustrial F] Municipal E-] Rotary [ ,-I <br /> Irrigation Test Well [7] Other ❑ Cable 17C r c, a <br /> Other ❑ c. <br /> (6) CASING INSTALLED: 108 c <br /> STEEL.^ OTHER: If gravel packed _ - - - " _ <br /> SINGLE Imo, DOUBLE <br /> `� <br /> Gage Diameter n n <br /> -125 Clay <br /> Froin I u or of From Tn 4;25-132 SLAIQ 44 Qi&Y <br /> ft. ti. Diam. Wall Bore ft. ft. 3 2-1 Go} s L8 C. <br /> 144-1 /i <br /> oarse Sand <br /> Srzr of shoe w well ring: Srz of era-d: -1J r d9159-1 'b3 Sand <br /> � T C <br /> 163 2, L O <br /> (7) PERFORATIONS OR SCREEN: <br /> Cype of perfuratiun or name of 1c`of 91a, C' <br /> Perf. Rows n <br /> From To per per Size i95 235 GI&Y <br /> ft. ft. row ft. in.x in. <br /> 7 <br /> (a) CONSTRUCTION: <br /> Wa, urfac-e s w,y seal p—ided? Yes ❑ No To what depth ft. <br /> Were .,.nua scaled against pollntiore Yes❑ No❑ If yes,no[e depth of s[rxta <br /> !•tom fl. ft. <br /> deo ft.to ft. W.rkstarted —22 f9 2,Completed 19 <br /> K"hod of sealing. WFLL DRILLER'S STATEMENT: <br /> (4) WATER LEVELS: This well was drdleut under my jurisdiction and this report is true to the hest <br /> of my knou,dedge and belief. <br /> Depth at which w.", was first found,if known <br /> Standing 1­1 hefure perforating, if known fe NAMF liennings _- osfell Lrilli*1 Coo I-lcr <br /> Standing legal after ptrfnrasing, and deyelo ing 15 ft, (Person,firm,or corporation) (Typrd or pri.ird) <br /> (10) WELL TESTS: Address ^ P Pliable d <br /> Was pomp test made? Yea No I❑ If yes,by whom? !'10apstoo -Calif. 9,5350 <br /> Yield: n eal.imin.with ft.drawdown after his. [S]a NED] !„/ 'rL-/_ei"#_ if � <br /> 7.5 (Well Drlllrr) <br /> Temperanne of water Was a chemical...lysis made? Yes E] No <br /> Was electric log made of well? Yes ❑ Nu If,yes,artach,copy I Liccnsc No- 116322 Dated 19--?2 <br /> SKETCH LOCATION OF WELL ON REVERSE SIDE <br /> DW R 188 I REV.9-691 25179-950 9-68 SCM TRIP AD OSP <br />