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Oct-26-99 05: 14P City of Lodi , MSC 209 333 6842 P.02 w 15MAt9 0j- CALIPORNI^ . ORIGINAL 'CITE RE50uptCf. AQENCY Do not Jilt in �ile With DWR DEPARTMENT OF WATER FtKSOLIRCES WATER WELL DRILLERS REPORT No. 256439 Notice of Intent No I Siatc Well Nn- Local permit No.sir Date Other Well No. (1) OWNER; N,sn,-. - CitY of Lodi (12) WELL LOG: Total depth N.Completed depth ft. Address 22� West Pine Street frurn ft. to ft. Formation(Describe by calor,character,size or material) City Lodi Calif onia zip 2 0 (2) LOCATION OF WELL (.fie instructions): to - 13 I County San joaul11 Owner's Well Nstrttlxr 1 — 13 — 40 Sq n tj Well address 041.fferent from above 0 E .Lodi Avenue Q — Township Range Section 55 66 Sand Dislarwe from cities,roads,railroads, fence.-,etc, 6o 22 r^v — 78 Sa�A 8 - 82 I 82 90 d (31 _ 2 — - 'TYPE OF WC71tK: � �. New well xx , r� f3eefxnmR U 2 and _ Hrtrrarstructian ❑ 138 — 4.8Qlay I Reronditirmiep ❑ 14816o ZAnd Ifori%nniul Well ❑ 1 - Destruction ❑ ([)cscrilx d dntructinn utaterials and Pro- ",20- 224r,\\\ / Za I ceth+rca in[tern IY) 112,51-11 M (4) PROPOSED US Sarxd and Pan l�ntttts tic 2 Irrigation _ d, Indtutrial ❑ 2 (:�` d Ttrsl weu Q ❑ a Cla Muniri ❑ — 4 Sand +rr — Clay WELL LOCATION SKETCH it'^y � - sandy Hard Pan w F3trea (5) terltnvlfENT. CnAv Cly — Clay I la«aty ❑ Rever;r. 4] Na SI 39 t3,nd _Hard Pan C.161'. ❑ Air ❑ trek. <dhnrc � Sandy Hard Pan & Clay other Cl Suek ert from 400 — I (7) CASINOlNtiTALLED (ti) PF, 40RATI — Steel 09 Pwlic ❑ y 7 rrf��• ' an r+r aisR.Of From D' Gage err t I ft. f t Wall * Oo r 250 10 full' a 1: 6 ,�2• Std#' o - -- - 2 tt Fulf Io 3 L 0 -395 Stdflo (9) WELL SEAL: Was surfam;unitary seal providev)? Yca.1E] No U if yet,m depili 50 ,•—IL — Wcrq strata scaled upimtt pollutiostf Yn 0 Nn ❑ Interval rl. Method of,atling CP-rr e CL=U-t— - NVoik darted (10) WATER JAWELS: WELL MULLER'S STATEMENT: lh,rrhof fiat water,irkewwn ft. Thfa weld uralill in erre 'urisdv,liort and this report it trt.c to the Srandie�invrl 8110F well cuaipintinn Fr• diem of my due r• rte die . (11) WELL t ^ si ntzl wnll test male? Yea IX No l,1 if yea•by-hum? 1t5.Id Y Wrl l P,ilk r) of test rump C-1Railerr] Airlift I] NAME Clark W0.11 & (Eu 1 meat Co. , Inc. I .� 2 )� pth to water at star)of test ft. At end al'test �—f, �(17rrso+r4 finn,oreOrpararinn)(r pedor,)rinted) Diwl6rktr sal/alis)after hoar; Water trrnper,turo Address �+0 �._il'r S ��V hemieaianslr,f.nsaslr? Ya ❑ Na ❑ llye�Lywlom? (;i,y il ockton,__ rat lfa ni a (JP Was eWtrir! made Ye; [X, No If yes attach r my to Ihis r-l-rt Lice..s..e Na I nate of 1 his report. oNlR tee(RLV. U-") IF AOOITIONAL SPACE 11 NEEDED, USE NEXT CONSECUTIVELY NUMSCAED FORM :]