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PR0544594
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Last modified
6/21/2019 4:10:42 PM
Creation date
6/21/2019 2:47:08 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0544594
PE
3528
FACILITY_ID
FA0006298
FACILITY_NAME
DANIELS PROPERTIES
STREET_NUMBER
2210
Direction
W
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
12330040
CURRENT_STATUS
02
SITE_LOCATION
2210 W COUNTRY CLUB BLVD
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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ORIGINAL J STATE OF CALIFORNIA Do not fill in <br /> THE RESOURCES AGENCY <br /> File with DWR DEPARTMENT OF WATER RESOURCES No. 137329 <br /> of Intent No. WATER WELL DRILLERS REPORT <br /> 78-1432 State Well No. <br /> .'ermit No. or Date Other Well No.O <br /> (1) OWNER: Name Robert Rishwain (12) WELL LOG: Total depth ft. Depth of completed well ft. <br /> Address 45 Hunter Square Plaza from ft. to ft. Formation (Describe by color, character, size or material) <br /> Cit. Stockton, Calif Zip 0 - 2 adobe <br /> (2) LOCATION OF WELL (See instructions): 2 - 20 brown -clay <br /> County San Joaquin Owner's Well Number 78-1432 20 - 37 brown & lew clay w san s real <br /> Well address if different from above 2350 Moreing Rd. 37 - 45 blue ela <br /> Township Range Section- 45 - 54 eta & sa <br /> Distance from cities, roads, railroads, fences, etc. 54 - 58 San <br /> 58 - 67 sand ay <br /> 67 - 69 e wo6,q Chips and clay <br /> - 73 w light sand <br /> (3) TYPE OF WORK: 73 75 Sri <br /> New Well ESC Deepening ❑ 7 5 0 clay <br /> Reconstnrction ❑ $0 -1 cours nd <br /> Reconditioning ❑ 12 0 b lu <br /> Horizontal Well ❑ 124 s <br /> Destruction ❑ (Describe 1 - 130 b clay <br /> destruction materials <br /> procedures in Item — <br /> (4) PROPOSED - <br /> Domestic El _ <br /> Irrigation <br /> Industrial \O p — <br /> T Well \\\\ �/ ❑ u — <br /> Stoc — <br /> Monicipa <br /> WELL LOCATION SKETCH >Other ❑ — <br /> (5) EQUIPMENT: (6) GRAV ACK: <br /> Rotary [ Reverse ❑ [}K No Y Size.'J42�L <br /> Cable ❑ Air ❑ r of bore 1 — <br /> Other ❑ Bucket ❑ oro 5 t 13 0 — <br /> (7) CASING INSTALLED: (A) ERFORA — <br /> Steel Plastic ❑ Cn e Type of pe a or' .e of scree — <br /> Froin To Dia. Ga Fr To - <br /> ft. ft. in. Wall > ft. i - <br /> 0 80 OD 12 80 120 <br /> (9) WELL SEAL: <br /> Was surface sanitan- seal provided? Yes J�C No ❑ If yes, to depth 55 <br /> Were strata sealed against pollution? Yes ❑ No ❑ Interval ft. — <br /> Method of sealing Work started 11J-16 19 Completed — 19 <br /> (10) WATER LEVELS: \'TELL DRILLER'S STATEMENT: <br /> Depth of first water, if known ft. This well was drilled under my jurisdiction and this report is torr to the bes7 of my <br /> Standing level after .yell completion 14 ft. kna¢ledge and belief. <br /> (11) WELL TESTS: SIGNED <br /> Was well test made? Yes ❑ No ❑ If yes, by hnm? (Well Driller) <br /> Type of test Pump ❑ Bailer ❑ Air lift ❑ Noack Pump <br /> Depth to water at start of test ft. At end of test ft 1 •-(Person, fine, or corporation) (Typed or printed) <br /> - _ <br /> Discharge gal/min after hours Water temperature AddressP c b Box 908 <br /> C'ty Stockton, Calif Zip 9 5 2 01 <br /> al analysis made? Yes E] No C1 If yes, by whom. <br /> Bras electric log made? Yes ❑ No ❑ If yes, attach copy to this report License No. 355213 Date of this report <br /> DWR 188 (REV. 7.76) IF ADDITIONAL SPACE IS NEEDED. USE NEXT CONSECUTIVELY NUMBERED FORM <br />
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