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ORIGINAL WATER WELL DRILLERS REPORT Do Not Fill In <br /> Fila with DWR (Sact;ona 7019, N°THE RESOURCE'SY6AGENCY 60.7091, r 44906 <br /> OF CALIFORNIA <br /> DEPARTMENT OF WATER RESOURCES Beate Well No 7, 5-8-8 <br /> Other Well No <br /> (1) OWNER: (11) WELL LOG: <br /> Name Tout drr<b h. lk th of comvl«ed ren fl. <br /> Address Q,2 — /4R29 Formal... DV—,le k'rofw,rM•.rnr,Jv of nrlrrlal,<ad worbn <br /> (2) LO((�ATION OF WELL: `> �%7}��/✓ y� <br /> Coomy �!/)t/ "101-ia0/%N 0.n<r•numbr,lf.nr = ] '13A2} J/l CJAV <br /> Te.mh' R.......d$«I on �1 Zj (Z SRL/Ly1 —& rr D <br /> Onunce from a H—ieNs,r/o.d.,nilroad..«cI. 77 ` � <br /> (3) TYPE OF W RK (check): <br /> New Well'0' Deepening ❑ Reconditioning ❑ Destroying ❑ <br /> 11 desimclion,describe material and procedure in Item 11. ° 0A-.413=1- <br /> C' <br /> > t 111/ <br /> /C <br /> (4) PROPO ED USE (check): (S) EQUIPMENT: 1 � <br /> Domestic-Dd trial ❑ Municipal ❑ Rotary - ''� / <br /> Irrigation Test Well ❑ Other ❑ CableGW/41 <br /> Other <br /> (6) CASING INSTALLED: ✓c J/�✓ fid/ �7•�' / - <br /> 6TE L: OTHER: If gravel packed ,�- .9 1d ' > <br /> BINGLEDOUBLE [] /71— i 5? n 't <br /> Gage Di.meter <br /> From To or of From To <br /> ft. ft. Diam. Wall Bore fo ft. _ ✓ <br /> 7 - ! <br /> t ^7. <br /> Der«ibe mint ✓s7 f ,'�— _ <br /> (7) PERFORATIONS'OR SCREEN: <br /> T pe of perforation or name o(.cr«n — I A✓ I <br /> Perf. Rows <br /> From To per per Sim <br /> ft. it, row it. in.x in. } <br /> (8) CONSTRUCTION: G <br /> Wu a.urian unitary•«I provided? led No ❑ To.h«depth <br /> Wer my Itrau.«led a.aimt voll.uanie, ❑ No Fl I( .depth of.t — l <br /> From fe.m ft. 13e— <br /> From ft.to (•. Work.r n.d T v .C—P6" .i ' 9 <br /> Method of zraline WELL DRILLER'S STATEMENT: <br /> 9 WATER LEVELS: Tbi, .11 was drilled under my jurisdiction and ibis report it hue to the best <br /> ( ) - of my knoudedge and belie). <br /> D,mb•t .hlch . a.Sur (ound, :f knoan ft. <br /> Standing Inel beforer perforating, if known f. NAME Aelllt5l <br /> Standing level after rforzting and developing4. lF< on,firm,or<or rni ) (Typed or Prinlyd) <br /> (10) WELL TESTS: Add,eu <br /> W p..,r made? Y« ❑ No IF ym.by.boml 1 lrpe'7 7 <br /> Yield: ..1./min.vith ft,d«.darn rft<r hu. [SIGNED] <br /> TemDemm�of.•ter W...chemical and9•i•male! Y« [] No /'j (J ( ell Dn) <br /> W.elnrric <br /> ~ <br /> I.,made of well? Ye• ❑ No If yn,a..rh coy Lk." NCo�(��2SJ Gate 19_ <br /> SKETCH LOCATION OF WELL 0? REVERSE SIDE/ <br /> DWR 188 IREV.9.65) r<aalAC010......Title 0A... <br />