ARCHIVED REPORTS XR0010116 - Laserfiche WebLink

Home Browse Search

ORIGINAL STATE OF CALIFORNIA Do not fill in THE RESOURCES AGENCY File with DWR DEPARTMENT OF WATER RESOURCES No. 065061 fIntent l.ri WATER WELL DRILLERS REPORT State sell No mit No or D ite__ 8.7-810 Other\5 ell N.6?— ��SEZZ ] ) OWNER \ire Century 21 Yeomans Realty (12) WELL LOG Total depthl 70 It Depth of completed ss elft +ddress 2 2 from ft to ft Formation (Descnhe bs color charteter s17e or material) it, Y, z,39J5376 0 - 7 Top Soil (2) LOCATION OF WELL (See instructions) X77 - 9 Sand C."unts n J a x n Oss ner s ',Nell NUmht r 9 64 C I aSan d ell address if different fr"m above 8197 11. Hwy 50 Tracy 64 - 66 Sand \ r,++reship 02—S Range Sec tro 66 - 105 Clay ` D stance frnm cities roads railroads fences etc (3) TYPE OF WORK - \e%t M ell LA Deepening ❑ - Reconstruction ❑Reconditioning G - Honzontal Well C1 - Destruction ❑ (Describe - destruction materials and procedures in Item 12) - (4) PROPOSED USE - Domestic - Irrigation ❑ - Industrial ❑ Test Well ❑ - Stock ❑ - Municipal ❑ — it LVELL LOCATION SKETCH Other ❑ - 5 r EQUIPMENT t 6) GRAVEL PACK SandGravel of — natan ] Re%cne ❑ 1 es \n ❑ Size G r a V e 1 _ C mble1 2 11 - ❑ Air ❑ Dr�meter of bore :7tbcr ❑ Bucket ❑ Packed frnm 7 0 to 1 2 5. fe - CASING INSTALLED 6) PERFORATIONS - Steel ❑ Plastic JX Concrete C1 T+pe of perforation or sne of semen — Froni To Dia Gageor From To Slot ft ft in I Wall ft ft size - 0 125 6 160 105 125 Scre4n - 9) WELL SEAL 7 - t\ tc surface samtin sell pro%ideO les �] No ❑ If yes to depth�_Z..O_-_ft - %Xere strati sctled m),unct pollution" les © No ` InterV,l it - \lethnd of sealin Mort, st irted 19 7. C rmtplcted 19 (10) WATER LEVELS 11 ELL DRILLERS STATEMENT Depth of first »ester if knossn ft This rncll maa drdred under nu/ wnsdichwi acid this rc)xrn It tort to rhe hist of core Standing lemel tfter cell completionit laimJedl,e and bbelict e+ li) WELL TESTSSIGNED 1 -� } s% Is xcll test pride+ les ❑ \u j It sys h+ -hums (\I ell Driller) SII r.Ik of test Pump o B„ler ❑ Air lift ❑ NAME H�PJ K I N G S BROS . D R I L L I I G CO . ,._.,INC . Depth t" ++It(r It st,n ul tctE ft 4t end of test ft (Person firm or corporation) (Typed or print Ml) i ' Via]/corn after hours Watcr temperahtn_ Address IS 2.5 PFI A N n A I F A V E _ in d)\i4 made� let ❑ No r If s es ht v atom� City Zip 95356 -- %\tu tlectnc log mad('' lcs ❑ No Ki If ses attach cops tie this report Lictuse No Date of this rtlxwrt 7 DWR 1813 {REV 7 76) IF ADDITIONAL SPACE IS NEEDED USE NEXT CONSECUTIVELY NUMBERED FORM