Laserfiche WebLink
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. 284280 <br /> Notice of Intent No. State Well No. <br /> Local Permit No. or Date Elft—i A44 Other Well No. <br /> (1) OWNER: Name RnyrP 1101501AMP DPV. C01, (12) WELL LOG: Total depth—3M ft.Completed depth 988 ft. <br /> Address from ft. to ft. Formation(Describe by color,character,size or material) <br /> City Manteca, Ca ZIP — <br /> (2) LOCATION OF WELL (See instructions): 17 — —0 Clay <br /> County Son jowlin Owner's Well Number 20 - 24 Sanil <br /> Well address if different from above Airport Way PA — 99 r1ay <br /> Township Range Section <br /> Distance from cities,roads,railroads,fences,etc 4A — <br /> (3) TYPE OF WORK: — IA <br /> New Well [I Deepening ❑ <br /> Reconstruction ❑ <br /> Reconditioning ❑ 4 AA <br /> net X>— <br /> Horizontal Well ❑ <br /> Destruction ❑ (Describe <br /> destruction materials and pro- <br /> cedurm in Item 12) 226 <br /> (4) PROPOSED US _ <br /> Domestic _ <br /> 114 San�l <br /> Irrigation <br /> 'a Clay <br /> Industrial ❑ _ <br /> Test Well <br /> l O Li _ <br /> Municip@l� ❑ _ <br /> WELL LOCATION SKETCH be) <br /> (5) EQUIPMENT: GRAV CK <br /> Rotary ❑ Reverse Ij No S' - <br /> Cable ❑ Air ❑ et of here <br /> 'Other ❑ Buck ed mm <br /> (7) CASING INSTALLER (8) PE ATI _ <br /> Steel Plastic El Ty of 'on cesize of _ I . <br /> From D' Gage or of — <br /> ft. C11 IPWall t. size _ . <br /> C i <br /> WA I TV <br /> (9) WELL SEAL: <br /> Was surface sanitary sed provided? Yes 11 No ❑ If yes,to depth !20 _ft. — <br /> Werestratawaled against pollution? Yes ❑ No ❑ Interval ft — <br /> Methodofscaling PAN PFMFMTFB 10Work started- 19 CompletedOsr�19 <br /> (10) WATER LEVELS: WELL DRILL R'S STATEMENT: <br /> Depth of first water,if known ft. <br /> Sumdfn levelafterweI1. letloe ft This well suns drilled under rely jurisdiction and this report is true to the <br /> g P � hest of cop knowledge and 6eliel. <br /> (11) WELL TESTS: Signed <br /> Was well test made? Ya No ❑ If yes,by whom? {� (WeTI Driller]-�4. <br /> Typeof lest Pump yy�� Bailer ❑ �ttJ`� NAME <br /> Depth to water at start of lest SE E At end of test ft, ersoq Inn,or corporation yped or prin[e <br /> Discharge gal/min afterA HED Watertemperature Address 2525 FIFLANDA E AVE. <br /> Chemical analysis made? Yes ❑ No Qx If yes,by whom? City Mnn ESTnTf 4A PZIP ga7..-1rJ' r <br /> � <br /> Was electric tag made Yes ❑ No Ixx If yes,attach copy to this report License No 19AA040 Date of this report <br /> D" ISIT IREV 124861 IF ADDITIONAL SPACE 15 NEEDED, USE NEM CONSECUTI MBERED FORM 86 o6355i <br />