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• I dui of ttc s <br /> t^ .4F-1-*'I-ITTAL LO(' Do Not Fill In <br /> i,dt"i. criae See. 1✓7S2 STATE OF CALIFORNIA <br /> THE RESOURCES AGENCY NO 95114 <br /> ORIGINAL DEPARTMENT OF WATER RESOURCES <br /> •File with DWq <br /> 'CATER WELL DRILLERS REPORT stare Well Not 4r=-437- <br /> Other Well <br /> (1) OWNER (it) WELL LOLG- <br /> iN3111L Cit of „C.tock-on Tuui Jeuth s02 ft P ;,eh f, enplet d wrll 26 it <br /> Address C ity hall Furmatton Drur,be by tofor rbara'lrr u_e of maleruf and slruclurr <br /> Stockton Californai 95202 0 5 ft to Soil ft <br /> (2) LOCATION OF WELL 5 15 C lav <br /> L—niv San Joaouin number f..y 15 21 San <br /> To—ho Range andSectton Victory Park 21 51 Blue Clay <br /> t m3rce(rum cities road, raslraads etc Stockton Ca 51 56 .Sand <br /> 0 70 Blue -Clay <br /> (3) TYPE OF WORK (check) 70 78 Sand & Gravel <br /> New Well [Z Deepening ❑ Reconditioning ❑ Destroying ❑ 8 112 Blue Clay <br /> if destructlou describe material and procedure in Item I 1 112 1 Sand <br /> (4) PROPOSED USE (check)• (S) EQUIPMENT 1 2 Blue Clav <br /> Domestic ❑ Industrial ❑ Municipal ❑ Rotary ❑ 1 2 154 Sand <br /> Irrigation ) Test Well ❑ Other ❑ Cable ❑ 1�4 169 Blue Clay <br /> Other ® 1 9 <br /> 175 Sand <br /> (6) CASING INSTALLED 175 204 Blue Clay <br /> STEEL OTHER If gravel packed 204 223 Sand &[ Gravel <br /> SINGLE Q DOUBLE © 22 2 Clay <br /> a <br /> Gage Diameter <br /> 2 244 Sand & Gravel <br /> 244 2 0 Blue a <br /> Fromt u or of From To <br /> ft It Dtam Wall Bore ft ft 250 258 Sand <br /> 0 60 4" 0" 0 60 258 266 Blue Clay <br /> 60 262 266 270 Sand <br /> T 0 290 <br /> Blue ClayN <br /> ]lze ui .hoe..r well Fink one Sir os znvel 290 02 Sand <br /> Uexnbr iomt Welded <br /> 02 Blue Clay <br /> (7) PERFORATIONS OR SCREEN <br /> Type of o.rturzuun.r name of screen <br /> Perf Rows <br /> Frum To per per Size <br /> t! ft row ft in C in <br /> (8) CONSTRUCTION <br /> W,. urtacr.anlrarr seal pronded, Yes Q No❑ To wh,t J.Prh R <br /> lY.rr my i-tj Yr+E] `u If res nate depth of.[rata <br /> r ram <br /> It to It �rt p <br /> Q <br /> Krum ft to fe Work.t ar trJ 0 Lylair) completed 1 rP9 8 <br /> ttethud at seskait WELL DRILLERS STATEMENT <br /> (9) WATER LEVELS-1Tbls cell uis drilled Finder my jurlsdlrtrnn and Air report rr frue to the best <br /> i of my knou.ledge and belief <br /> Depth At wh—h .eater was first fuu• 1( knuwn Q ft <br /> It—Jsn% Ir cl brfure perfuratinsF kna !r NAME Clark t ell & 7ul nm <br /> et,rsslrsr le.r! ,re r aer Foraen. sad develapine F[ 1 Perwn firm oe eorparauon, tTsprd ur pr,nrrd <br /> 10) WELL TESTS T+�s Address 2024 Tifny <br /> pump[est made, Yes X No ❑ If vis by whom, PQ & E f <br /> 1 •4 .,I'm- with it drawdorn,trer hn [${C%rP1 <br /> 1 rWrll Dnllrrl <br /> L u1V.r.[ur of w.[ r Was a h.m.al an44su made, Yes 0 Na 0 76602 April 78 20 <br /> a! v <br /> Wv eles en, idK ma¢e of wr112 Yn Q \u.M it ra ar[xh caVv Llt.en]C No. I9- <br /> SKETCH LOCATION OF WELL ON REVERSE SIDE t _ <br /> i <br /> DWR 188 eREV y do, 3179*so e•low TRr•Ao O&P <br />