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RIGINAL ile Q[Igilial,Dajligle and Trlplicile with thi rn} s WATER R k AIYl1lON.OF ESOUR t,R0 p.0.aox'i o�s.. f SACRAMENTO S,CALIFORNIA 1 y� .�- l �' �"• '�- - :: - of W I WATER- rWELL =DRILLERS sREPORT state Well No T :.: ($ections`7076,7077,'7078�Water Gude) ? Other" Il No _ v __ - {7) Perforations: . - TY of perforator used = ----- --- - :---- — ; Perforated —ft."to —ft o iz —_— °l H le s `e No of -}, h es .> — -------------- --- ------- --- _- F ------------- 47 —- -- >: .. ----------------------------------- --------------------- >. = _ --_; �> --------- ------------ . -. ------— -— - — : ---- » -------------- ---------------=---=-------- --------------- - — -- - - _ — - -- ----- ----------—•---------- --------------------------------- -- - f. f, ---------------------•---------- ----- ------- -(.9)� Well pumping test: (8) Water levels: , . Depth at which water Date of test------------------By whom___-- —,- ----- — --------------- --------------------------------------------------------- first encountered-___—_____________..__—_______.-----___ft. Depth to water when test started.---_--------__—_.___—_______________---------------ft. Depth to water � � '., '- � G.P.M. at beginning oft t___ es before erforatin � � _________ft. Drawdown from standinglevel______—_________________________________---------.---- t. Depth to water G.P.M. at completion of test_------------------------------------------------------------------ 1 "after perforating______ -- == - ft. Drawdown at completion of test— ---------------------•---------------' ft. = Length of time"tested--_--______.__—________________—___._______-_-_________________________..-__ Note any change in-water level while drilling Temperature. ---- .of water-------- -----------•------------------------------ ----------- --- ---------------------------------------------- Was gas present in water?. ❑ Yes F400 (10) Getic al: Was wellgravel packed?------------- " -----Size of rock--------- -------------=-------------Thickness of pack----------------------------------------- Was asurface sanitary seal provided?.—----------=---------------------------------------------------=------------------ --------------------------------------------------- Were any strata sealed against pollution? ❑ Yes ❑ No If yes, attach detailed description. Stratasealed — — — -- �— - -------------------------------------------------------------•------------ Was analysis made of water? ❑ YesJX No If yes, attach copy. Was electric log made of well? El Yes' No If yes, attach copy. If well abandoned, was it plugged and sealed?__________________________ ---__ r' 1 l -r�--C I -- - 1 ��;~ ' ' F�G� � .�� Pi�y Method of plugging and scaling ---------------- ' (11) Location: (12) Time of work: North , Section No-_____/rte_________________ Work started dare_ __J----Coin date_tivc!:_ -_ Townshi 11 - Date of this report__----_-----_- �r ----------------------------- P---------- r _ Range---------^�~ ase&Meridian__��!_ _= WELL DRILLER'$ STATEMENT: _ how location of well in Sec- This well was drilled under my jurisdict o and this tion, thus (X} report_ is true to the best of m` knowledge and belief. Distances to sectio lines from 7 well, N or v——ft. [SIGNED]--------- — - ------------------------------ Wr11 Drilfri and E or Show location of nearest l;y ---_------ = ---- known well, :thus (0) - . 1kens, No&_�4141Classification------ 1 MILE Distance to nearest known well___ - --- — dV ft Dated 19 .27P72 2,50 401/CHlli iso... b-w,r3-FORM No. 248 . REGIONAL WATER POLLUTION'CONTROL BOARD COPY A r a :`:�k. � � _ ` >~.. •. � ,fir r�:. - -