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LUI:AFION NOT CHECK <br /> �'41G1""`' WATER WELL DRILLERS REPORT Do Not Fin In <br /> File Origiflal,Duplicate and irfpllcaie with the* Co �� 34964 <br /> t.r d.) <br /> � <br /> REGIONAL WATER POLLUTION (section[7076,7077,7078,Va <br /> CONTROL BOARD No. STATE OF CALIFORNIA State Well No.------__, <br /> r <br /> Other Well No. <br /> rfn+srs rpproprl,str Raasrbrr) -"' <br /> t I) OWNER: - - - <br /> Name t I I) WELT, LOG: <br /> A <br /> �' , + Total dept- ']. (} <br /> ,rrl�l�r1T• r1Tr�':'T.F' ft. 'Depth of completed well 1400 <br /> ddress 2707 Country r ClUb ssr <br /> Blvd. <br /> 46-11 Formation- Deerrl it by color,ebar.cter,: r of snrlrrlrf, d etrartnn, �� <br /> Stockton Calm'. ft-to Et. Ton <br /> ; <br /> (2) LOCATION OF WELL: r <br /> y CaantySaTi ,:� Owner's number,if any— .`�52 �7 •' <br /> .`1x8.88.,{Ili rl aT <br /> R.F.D.or Street No. <br /> i,a 40n n <br /> is <br /> and <br /> _ b 73 --` Gra y sa nd <br /> (3) TYPE OF WORK (cbeck): 75 "1 uo cla <br /> w.. •� sand <br /> New Well Deepening El Reconditioning - <br /> ra <br /> & ❑ Abandon ❑ 4s t_93 ll� Blue C�c+' <br /> 1 f abandonneent,descrihe material and proerdure in Item 11. 120 OrY'�1 Salm — <br /> �. (4) PROPOSED USE (checlz): (s) EQUIPYiENT: .-1.20 3.35Biue cla <br /> Domestic [N Industrial ❑ Municipal ❑ Rotary - Gra. Sand <br /> Irrigation E] Test Well ❑ Other ❑ Cade ❑ <br /> DDg Well [� - <br /> (G) CASING INSTALLED: I If gravel packed <br /> SINGLE ❑ DOUB11i G." <br /> From or Diameter from to <br /> ft.to ft, llDi.m. 12&aOVall of Sore ft. ft, <br /> Type and rix.of shoe or well rind Size of gravel: <br /> Describe joint - <br /> (7) PERFORATIONS: <br /> Type of perforate-used •• .. __ <br /> �ws SIZ,e of Perfo..tiooa n.,lana th,by ➢a. •` <br /> From fr.m ft. Perf.per row -Rex•. „ ” <br /> .. .. .. ,. .. Par E[. .. .. <br /> +— (a) CONSTRUCTION: <br /> Was a surface sanitary seal provided? El Yes ❑No To what depth ft. •• " `•� - <br /> Were any strata ttaled against polIution? ❑ Yrs ❑ No If yet,note drp[h of araza •' „ <br /> rr.r From fr.to <br /> fr. <br /> Method of Sealing <br /> rt ± Is[cured <br /> 1-2419 Completed y <br /> r9 'j7 <br /> (9) WATER LEVELS: WELL DRILLER'S STATEMENT: <br /> Depth at which water was first found L ;7i :�• T <br /> r r�i This well was drilled under my iurirdietion and ibis report it true to the hest of <br /> my knowledge and belief. <br /> level before prrfontina ft. tt,r-�r� <br /> a ,din ford afar •,mac .s�..,�_-• ., :-n N1ts.[� -`- ' . QQ <br /> R perforarinR _ rr.. i/ <br /> "} •�Y" i�V`. .-, (Person,Ston,or teri r ryDed or Dtiated) <br /> (I o) WELL TESTS: 64,6 South Ca lifornii St. <br /> y Vya•+pimp test made! ❑ Yes ❑ No If yn,by whom? r <br /> Yield: xai./rnio. with fr.draw down after hra. <br /> Temperature of warm 67850 <br /> W u a ehemi�]ana]yris made? LlYea ❑ Ne <br /> - <br /> License No.—----------- -——sp.O Dated------------- - 19 <br /> as a eecric lea male of wdF? [] Yea <br /> 0 NO 91682 1-3,311 wt Oull1 R DV1+R FORM NO. 2443 (Rt:y- 3.$q) <br />