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QUADRUPLICATE STATE OF CALIFORNIA DO not fill to
<br /> locall requirements THE
<br /> Use With RESOURCES AGENCY
<br /> ro. 22439
<br /> DEPARTMENT OF WATER RESOURCES N
<br /> tt tot Intent No. WATER WELL DRILLERS REPORT state Well No.
<br /> is�ud Permit No. or Da ''O.�trhe``r Well No.
<br /> I ) O"EER: Naou {f}� (12) WELL LOG: Total depth-y2;7_ft. Depth of completed.we1115ft.
<br /> sddress 168♦22� Austind rd, from ft. to ft. Formation (Describe by color, character, sae or material)
<br /> eta nteea J alit• -zip-
<br /> 3) LOGATIQN OF WELL (See instructions): 13--24 Clay
<br /> .,, 2,w1,3 Snndy sail
<br /> rip. II �$Cl Onmer's Well Number
<br /> A,41 address if different from above 2 � V Clay t& sand .el
<br /> (�f1 Gla
<br /> i .n'nshiP �s Ranpe �t� ♦��Sectino, _-T
<br /> Forane cities, �wd�s, railroads,fences ete.��iL{.aa Ilii sra
<br /> 1/8 ami. * 013 1 of a�0a ne • S70165 & shale
<br /> Sand
<br /> — 6 G
<br /> (3) TYPE OF WORK: �flj.."'$�6 �t,, y,,,�
<br /> '1 NeW Yv.RX Deepening ❑ Ot6+ Cla tL shale
<br /> fReatnstructiov ❑ s102 S'VI`.d
<br /> Reconditioning ❑ 102-1 G1�
<br /> Horizontal Well ❑ l" S LWnd
<br /> Destruction ❑ (Describe
<br /> destruction materials and Cl ny
<br /> procedures in Item 12)
<br /> (4) PROPOSED USE: -
<br /> Domestic =I -
<br /> Irrigati,m ❑
<br /> Industrial ❑ -
<br /> Test Well ❑ -
<br /> Stock ❑
<br /> Municipal ❑ -
<br /> WELL LOCATION SKETCH Other ❑ -
<br /> li) EQUIPMENT: (6) GRAVEL PACK: -
<br /> I4,tary 2 Reverse ❑ Yes$ No ❑ Sime -
<br /> Cable ❑ Air ❑ Diameter of bore
<br /> Other ❑ Bucket ❑ Fretted fmm��-
<br /> L CASING INSTALLED: (S) PERFORATIONS: a
<br /> rid wt
<br /> M'.0 ❑ Plastic Concrete ❑ 'PyI>e„1 perlmatum or at" of s num -
<br /> From TO Dia. Gage or From TO Slot
<br /> ft. ft. in. Wall ft. ft. size0 225 -
<br /> ( 6
<br /> OW 95 115 1
<br /> (9) WELL SEAL:
<br /> Was sudarr emit.c. seal nnrvid,d'? Yes 11 N„ F1 It .er, m depth_ 50 it. IWere strata sealed avainst no0ution., Yes ❑ No FInterval-ft. -
<br /> Methad of sealin' `
<br /> tont A \York Warted I 19 Conmlctra 1'J
<br /> f 10) WATER LEVELS: WELL DRILLERS STATEME\"r:
<br /> Depth nt first .water, it kno,.> It. Thi, wall me, rLi11rJ under ,nu i...edicF,u, cool 11... rr..... is our to the hest W our
<br /> Standing level after well armnlety,a- 99 ft. I knotcltdg, and belie/.
<br /> (11) WELL TESTS: Svm
<br /> i
<br /> Was o,ell test made] 5,. ".: ; It .��. b. .whom? � R: i1\ell Dnlh,;
<br /> TYPe of test 1"u,ip It.,�n, Air lift ❑ I yf*!E
<br /> Depth h tter at t rt 1 teat tr. At end of teat ft U61e{rs�( � cf-, nr �trp, .ti�{n� r n[e
<br /> ` Discharge v 1' A,- your. Witter temperature .1d lres_- _oaf-�µl1i{�4,P,--
<br /> x
<br /> • is Fd --
<br /> Chemtcd I h , a . .X, a .� h h sP Cit _1>� C4 4, t�
<br /> Was electric hn, mads _ _ „_ u , arc,..h my to this report � Li,e , n,�.��- ._ Dare m no, u,urt
<br /> DWR lee ,acv. 1.7c, IF ADDITIONAL SPACE IS NEEDED. USE NEXT CONSECUTIVELY NUMBERED FORM •3E,,..... ... so„oo•o:)r ose
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