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STATE OF CALIFORNIA Do Not Fill In <br /> THE RESOURCES AGENCY <br /> Ol161NAL DEPARTMENT OF WATER RESOURCES N? 91215 <br /> File with DW! State Well No. 73 281W <br /> WATER WELL DRILLERS REPORT <br /> Other Well No. <br /> (1) OWNER: (11) WELL LOG: <br /> Name Mrs. Helen Cerr i Toml death 160 fm. Depth of completed wall is. <br /> Address 2737i S. Airport Way Formation: Describe by roto.,cbarnrter,size of material,and ss...I... <br /> Stockton 0 ff.. 3 Adobe Is. <br /> (2) LOCATION OF WELL: 3 45 clay <br /> Co9n1y S. J. owner's number,if any 45 51 <br /> , Sand <br /> Towmhip,Ranee.and session 1 l04 clay <br /> Distance from ci roads,railroads,me. 104 112 Sand & 'ravel <br /> 112 121 Blue clay <br /> (3) TYPE OF WORK (check): 121 134 Blue sand <br /> New Well ® Deepening ❑ Reconditioning ❑ Destroying ❑ 134 136 rile <br /> If destruction,describe material and procedure in Idem 11. 136 158 Sand <br /> (4) PROPOSED USE (check): (5) EQUIPMENT: 1 clay <br /> Domestic H)rIndustrial E] Municipal El Rotary <br /> fiy <br /> Irrigation ❑ Test Well ❑ Other ❑ Cable ❑ <br /> Other ❑ All matorial brown unless it is itemized above <br /> (6) CASING INSTALLED: <br /> STEEL: OTHER: If gravel packed <br /> SINGLE W DOUBLE ❑ <br /> Gage Diameter <br /> From '1'0 or of From To <br /> ft. ft. Diem. Wall Bore ft. ft. <br /> 0 6 n <br /> Site of shoe us well rine: 4 siz of peace]: <br /> Describe join. <br /> Welded <br /> (7) PERFORATIONS OR SCREEN: <br /> Type ofperforalinnuraameofscrten Factory cut <br /> Perf. Rows <br /> From To per per Size <br /> ft. ft. row ft. in..in. <br /> 160 by 1 <br /> (8) CONSTRUCTION: q/ <br /> Was a wdace sanitary teal provided? Yea CAI No ❑ To whas depth jT ft. <br /> Were any sl—s.ea led aRairnr pollution? Yes❑ No❑ If yet,nose depth of arra.. <br /> From is.m ft. <br /> From ft.so f[. Work inlsrZIMIS 13 t9 3 ,Completed JUnIS17 19 73 <br /> Method of aealin WELL DRILLER'S STATEMENT: <br /> This tuell wknoavledasa and belie drilled ursder my jurisdiction and this report is true to the best <br /> (9) WATER LEVELS: ' <br /> o m <br /> Depth at which water- as first found,if know' <br /> 68 Is. . <br /> Standing level before perforating, if "own f.. NAME J. A. Thalhamer Co. <br /> Standin level after p.rfor.amg and dmelopirsis. (Pers ,firm,ar eorp...Co.) (Typed o.printed) <br /> (10) WELL TESTS: Address 7523 Andrea <br /> Was pompe made? Ye." No El Ffyes,bywhom?Well driller Stockton <br /> Yield: 145 Ral.lmin.with 1 ft.drawdown after hn. ISIGNEDI <br /> Temperature of waste Was a chemical avaiyaia made? Yea ❑ No ❑ IWell D.ilirr) p <br /> Was electric <br /> log made of well? Yee [I No El If yea tach copy License No72 303. 2Dated June 18 9 1973 I9— <br /> SKETCH LOCATION OF WELL ON REVERSE SIDE <br /> DWR 188 (REV. 9-E8) .111..1.9-are In.TRIP A.Oze <br />