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RjGf <br /> leIMDIN DU e a <br /> Ie nrlgfnal DuplFcale and Trlplitate with ilia gx..I� 2 <br /> DIVISION OF WATER WOURCEi <br /> P O BO% 1079 77 W" !��✓ti <br /> AGRAMENTO 5 GAUFmRNiA �Pf� L <br /> F v <br /> 111 <br /> WATER WELL DRILLERS REPORT Do Nab Fill In <br /> State Well No <br /> - (Sections 7076,7077,7079,Water Code) Other Well No <br /> Region <br /> I <br />' (7) Perforations <br /> Type of perforator used__-FSCtAry <br /> -- -- ---- f --- - ----------- ------- -- - -- <br /> Perforated 232 __ - __---- ft ta_------ X32_-^_----____ft Hole size__----- _1_"___ -No of holes_-__ - _ _-CEn leis <br /> - ------ <br /> _r------ ---- ---- - -- <br /> - - - - - <br /> - - ---� -- --------^----------- -- <br /> „ or <br /> (8) Water levels (9) Well pumping test <br /> Depth at which water ,Us:d Date of tesZqR^4/5 By <br /> first encountered 01V--rp____ ft Depth to water when test started -_____ —_________________ ___________ft <br />' Depth to water ,�� 0,y-�g G P M at beginning of test--------1,12 - -t�----------------- ---- -- - <br /> before perforating__ , ft Drawdown from standing level________- Q -_ ' L e___ ___ ft <br /> Depth to water 40Iri & G P M at completion of test__.—_ <br /> after perforating_____. f___-_.___________ ___-__ft Drawdown at completion of test________-__ ___-ixlt�______________ t <br /> Note any change in water level while drilling Length of time tested_____._..._-----____-101*tea----------__------------------- <br /> ------ <br /> ________-_------------------ - — Temperature of water ------- - --- -- - --Was gas present in water? F1 Yes E3 No <br /> (1 U) General <br />' Was well gravel packed?-_-__ p8___ __-______Size of rock__ 1�__zc_]/ ___ __ _ _ _Thickness of pack -------------- <br /> Was a surface sanitary seal provided?_- —Yea_- .----------------- ------------_ --------------------------------------------- <br /> Were any strata sealed against pollution? ❑ Yes [?g No If yes, attach detailed description <br />' Strata sealed_ _-- —-- ---- -- - -- - -------_ - - -------- ----------- - ----- - - -- - - - <br /> Was analysis made of water? ❑ Yes (]F No If yes, attach copy. <br /> Was electric log made of well? ® Yes ❑ No if yes, attach copy <br /> if well abandoned, was it plugged and sealed?__ -------------------------------__---- -------- ----------------- <br />' -- <br /> cement <br /> forced from bQtto$ uMethod of lugging and sealing- -- wardg_ <br /> _ <br /> - <br /> (11) Location. (12) Time of work. <br />' N°rtb Section No__________ [________ _ Work started datc22/20/Wompleted date__J+/_bf.S], <br /> Township_________ ------- Date of this report-__-_.AiprU-19-,, <br /> Range__—_-_ _�3 __ r <br />' `Base &Meridian_.M_D---------__ _ WELL DRILLER'S STATEMENT <br /> to Show location of well in Sec- This well ki;as drilled under my Jurisdiction and this <br /> —1 A tion,thus (y,) report is true to the best of my knowledge and belief <br /> Distances to section lines from + r t�C� <br />' well, N or S----__-----____ft ISIGNEDI--WiSTM_i FJj,_DRIL NG <br /> � and)v or W__-------_----ft Well D,dler <br /> Show location of nearest eated <br /> — _ __ _ _______----------_ <br /> known well, thus (Q) <br /> Distance to nearest known No_�..__-_. _.__-Classification <br /> : >�z>rE Apr-;L-1 14------ _ 51 <br /> _.___-_ __ 19_ <br /> y <br /> ...��.._�•. r • ,.+w•. a•'a+ta>�ar.�! w/•a>�w.•�i n,'>F a>T hAY>aY <br />