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ARCHIVED REPORTS XR0000003
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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A
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ACACIA
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3500 - Local Oversight Program
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PR0543359
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ARCHIVED REPORTS XR0000003
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Entry Properties
Last modified
10/22/2018 10:35:44 AM
Creation date
10/22/2018 9:54:37 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS XR0000003
FileName_PostFix
XR0000003
RECORD_ID
PR0543359
PE
3528
FACILITY_ID
FA0000733
FACILITY_NAME
RIPON USD-MAIN KITCHEN
STREET_NUMBER
304
Direction
N
STREET_NAME
ACACIA
STREET_TYPE
AVE
City
RIPON
Zip
95366
APN
25904005
CURRENT_STATUS
02
SITE_LOCATION
304 N ACACIA AVE
P_LOCATION
05
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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a <br />1I <br />ORIGINAL <br />File Original, Duplicate and Triplicate with the <br />REGIONAL WATER pOLLUTION <br />CONTROL BOARD No rJ <br />'�vrt e0pra¢rd4te ..wbrr) <br />WATER WELL DRILLERS REPORTDo Not FIJI In <br />(5eotrow 7076 7077 7079 Water Code) ')T I N° 48185 <br />(I) OWNER. <br />Name Burchell Nurser7 <br />Address <br />(2) LOCATION OF WELL <br />c..atr S t:ani s (I aus Owner s cumber If aae— <br />R F D or Street N. <br />Near N. W. Corner of <br />STATE OF CALIFORNIA StireWell No'_`- <br />�� Other Well No. <br />(3) TYPE OF WORK (check) <br />New well Q. Deepening ❑ Recondtnonartg ❑ Abandon ❑ <br />If abandonment, desenbe mote -nal and procedu" era Item 11 <br />(4) PROPOSED USE (check) (5) EQUIPMENT <br />Domestic ❑ IndustnaI ❑ Municipal ❑ Rotary ❑ <br />Imgation FM Test Weil [] Other ❑ Cable E <br />Dug Well ❑ <br />(6) CASING INSTALLED: <br />SINGLE ® DOUBLE 71 Gap <br />F or <br />rom it to it Dram W.11 <br />Joe 12 <br />Trye and .rse of r6oe or well ran; 12x5—SX4 <br />Ducnbe ,..tat We 1 de d <br />If gravel packed <br />Dumerer from to <br />of Bore it ft <br />Sue of xn.ei <br />(7) PERFORATIONS, <br />Tnw of perforator geed N <br />S= ofyarfaneso.. rn. leech br to. <br />From ft r ft Perf per row Row, per it <br />(8) CONSTRUCTION. <br />Waa a rarfac. --carr red pre tdad? ❑ Yu ❑ No To what dap.h it <br />Wen "T strap reeled ax.uraa poli.cma? ❑ Ya ❑ No If re, norm d.pth of ..rata <br />From fr to ft <br />Method of Sealing <br />(9) WATER LEVELS: <br />Depth ae w6seh w.ter was Ent toond 38 it <br />idmlr Irvel before pcforaerag it <br />...aad.n9 Ind after perferauax it <br />(10) WELL TESTS. <br />'Va. a pump rat made? Yes ❑ No If Tee by wham? <br />Ytdd xai /min wtrh 50 it draw down .fter bre <br />Temtxnture of '"or <br />Was . chemrt:ai eoairu. made? ❑ Ye. 0 No <br />Was riertne loft made of wail? Z)Yn ❑ No <br />(11) WELL LOG. <br />Total death 114 it DeptL of comvieted we11 114 <br />Format.on Der be 6,7 color choocdrr raise of.. terse! . d sw.. <br />yat.. <br />fe m 6 ft O Soil <br />Pan <br />8 <br />AB Sand <br />lio <br />8 4 <br />�r <br />d <br />107 a Clay <br />114 Sand 25 <br />Work started Jj 02 1lCrr Compiered jan 25 <br />WELL DULLER'S STATEMENT <br />This well wee dulled sander my lteradretron and tbu report as true to the best o <br />my knowledge and beluf <br />NAME 0..9 "1`ba_&'.=Ca.r=II- _ <br />(Person nrm o corporat..np pr..r.d) <br />Address Rt. 7 Boa 1524 <br />[SIGNED].-� { � <br />Well Drili <br />Laetnte Na.._._ 8745_ _ Dared_ <br />•sen a as som null. Q• n DWR FORM NO 246 4nev 3 74, <br />12 <br />
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