Laserfiche WebLink
ORIGINAL STATE OF CALIFORNIA DO not it <br /> THE RESOURCES AGENCY r� c <br />'File with DWR fiu <br /> DEPARTMENT OF WATER RESOURCES No. 21616 6 <br /> kf <br /> ItNn WATER WELL DRILLERS REPORTstate Well Norout No or Date Other Well No D <br /> (1) OWNER Nan, M c C o r m 1 c k $ Baxter (12) WELL LOG ToW aeptb14 3 k Depth of completed we pt <br /> addm P 0 Box 1728 from ft to ft Formation (Describe by color character sae or material) <br />'city Stockton CA 7lp95201 - 32 Dark Br D Clay <br /> (2) LOCATION OF WELL (See tnstmettons) 3-2— 7 5 B C/1 <br /> C'"'aty S Owner s Well Number - 75- 90 S and Clay <br />'W ell address if defferenttfrom above S StocktQn & Church ' 9 0_ 140 Coarse S�, d - Some C1 a <br /> N <br /> Twvriship 11 Range 6 E _ Cectio <br /> Distance from cities roads, rmlmads fences, etc - \ •� <br /> r <br />' (3) TYPE OF WORK <br /> Yew Well�] Deepening ❑ v \� <br /> Reconstruction ❑ - �`4 <br /> Reconditioning ❑ <br />' Horizontal Well ❑ <br /> Destruction ❑ (Desenbe <br /> destruction materials and, <br /> Procedures m Item 12,)'- <br />' (4) PROPOSED USE" <br /> See Map Attached Domestic q <br /> Irrigation ' ❑ y <br /> Industrial \ ` ❑ �- <br /> ` - <br /> Test Well ❑ <br /> Stock .\ G \ <br /> r Municipal ❑ <br /> WELL. LOCATION SKETCH Other MW - (� <br />'(S) EQUIPMENT (8) GRAVEL PACK <br /> Rotary $] Reverse ❑ Yes M No Q' Size 3 , - <br />'Cable Q Air Q Dof bore 10 8 <br /> Other Q Bucket ❑ Paekad from 123 <br /> ro 14 3 fr r <br /> (7) CASING INSTALLED (8) PERFORATIONS, - <br /> tee] ❑ Plastic Concretrk q Type of perforation or site of screen - -- <br /> From To - -Dia Gage.dr From .�To Slot - - <br /> ft ft in Wall ft � ft ze ' <br /> VC 0 140 4 h40 130 - <br /> (9) WELL SEAL <br />'Was surface sanitary seal pmvidecP Yes 93 No C] If yes to depth- 2 3 <br /> enM strata sealed agauut pollution? Yes C3 No ❑ Interval r* <br /> Method of seahn Grout Cement Work start - 19 Complet - 19 <br /> 1Q) WATER LEVELS WELL DRILL RS STATEMENT <br /> epth of lint water, if know Thu well DY <br /> d d my N diction ani! thv r <br /> tandmg level after well completion knowledge art It eriort w true Co the ben my <br /> (11) WELL TESTS SxcvExr <br /> A-- <br /> 'Vas well test made? Yes C No (N If yes by whom' Ve Driller) <br /> of test Pump ❑ Bailer ❑ Air ]ift © CAVI 0 <br /> th to water at start of testh_ At end of test ft (Person, firm or corporation) (TypecT or printed) <br /> Add.,—10556 Petuni a L,N, <br /> „c sal/rain after_. - - hears Water remperiture �� Palo C!'-d r m - C Ate_ Z,p9 6 0 7 3 <br /> analysis made? Yes Q No ® It yes by whom d - - - 7 3 <br /> electric log made? Yes ❑ No 9 If yes attach copy tv Oils report License NO 5.12 4 0 6_- FS&te of this repot* 4- L 9-8 7 <br /> PWR 166 tR;v 7 >ar IF ADDITIONAL SPACE IS NEEDED USE NEXT CONSECUTIVELY NUMBERED FORM - <br />