Laserfiche WebLink
QUADRUPLICATE STATE OF CALI FORN I A <br /> !.� Do not fill in <br /> Use of comply wuh THE RESOURCES AGENCY <br /> local requirements DEPARTMENT OF WATER RESOURCES No. 156310 <br /> N"tire of Intent N, WATER WELL DRILLERS REPORT slow Well N,,. <br /> I oa,al Permit No. or Dale Other Well No. <br /> 1,)lOtgWNER:+Name Bob &&an (12) WELL LOG: Total depth R. Depth of completed well ft. <br /> J1Q37�AtkSns �� from ft. to f. Fonnatfnn (Describe by .,In, cb.eter, .sim n material) <br /> ( it, Leekoford Ca >p 2 <br /> (2) LQCATION OF WELL (see instructions): hard Dan r di h b r9 <br /> Gamty ban Taagtl owners Well Number - tS t of reddish bra <br /> Well address if different form above sandsteir <br /> Tuwnship�iif Aange BE Se do34 9 - 19 brn searshq:�`sandsteno and <br /> Distance from cities, roads,railroads, fences,etc a Arse sa ala =ItV rocks <br /> 19 - 2Z5 esim ated Peck <br /> by gnaanh 23 - set 311tysaayclay—with <br /> ,small pea grave <br /> (3) TYPE OF WO 37 - 5 1 oonented roc <br /> New Well] Deepedng ❑ 51 - 74 Bra–bra gray e 7 W we <br /> Reelm truction ❑ - 1118 res e <br /> 1�—�� \N Reconditioning ❑ - 8rd 01ack SEn s ane sa111eC 8a <br /> Horizontal Well ❑ IVI - n Clay some Poexi <br /> l\ Destruction ❑ (Describe 156 - f <br /> destruction materials ad <br /> =_ <br /> bpnain Iwm 17) <br /> (4) PROPOSEDUSE: 206 b seb1pr-Ir <br /> L <br /> Domestic cemented roe <br /> Irrigation ❑ 21 - 225 Kreen'.sh black sm dstone <br /> C = Industrial ❑ 22 - 2 0 black sandstone with some <br /> Ail : l - Tett Well ❑ —silty xroyish Handy ala <br /> �' --- I stock ❑ C - 255 hard 11ray m d rreerMa gray <br /> Municipal ❑ - clay <br /> WELL LOCATION SKETCH I Other ❑ - <br /> (5) EQUIPMENT: (6) GRAVEL PACK: - <br /> ft clay <br /> Rotary ❑ Reverse ❑ Yen ❑ Nu Z Size r;. - <br /> cable I Air ❑ Diameter of hare_ — 280 - 297 Z"Si <br /> r <br /> Other ❑ Bucket ❑ Packed from ro k. - <br /> of ryraj sandy cley <br /> (7) CASING INSTALLED: (B) PERFORATIONS: 297 318 black srndstana <br /> - <br /> Swel 2 Plastic ❑ Concrete ❑ Type of perfrratnm ,,size of screen - <br /> From To Dia. Cage or From To Slot - <br /> ft, ft. in. I Wall ft. ft. size - <br /> (9) WELL SEAL: - <br /> Was surface sanitary seal provided? Yes f No ❑ If yes, to depth_!;()—f. <br /> Were strata sealed against pollution? Yes Cl No ❑ Interval R. - <br /> Method of sealiv Work stafte Comple[ 19 411 <br /> (10) WATER LEVELS: WELL DRILLER'S STATEMENT: <br /> Depth of first water, if know ft This well mac drilled under on, jurodictin and this ort fs true t the best at my <br /> Standing level after well completi R, knowledge and b e <br /> ZZ <br /> (11) WELL TESTS: <br /> Was well test made? Yes ❑ No * If yes, by whomDriller) <br /> Type of test Pump ❑ Hailer ❑ Air lift ❑ NAME Thaaor Well Drilling j <br /> Depth to water at start of test ft. At end of test-------ft (Person, Rrm or corporation) (Typed or printed) <br /> Duchmge oal/min after ra <br /> hums Water tempetureAddressPO bOA 301 <br /> r+7� <br /> Chemical analysis made? Yes ❑ No it If yes, by wham. city Lacka ford Ca Zip�7� <br /> Was electric log made? Yes ❑ NojF If ves, attach copy to this report License No. Data of this repart Oat 30 <br /> DWR 188 (REV.7-76) IF ADDITIONAL SPACE IS NEEDED. USE NEXT CONSECUTIVELY NUMBERED FORM <br />