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STATE OF CALIFORNIA Do Not Fill In <br /> THE RESOURCES AGENCY_ <br /> "" ORIGINAL DEPARTMENT OF WATE"• RESOURCES 1 ,N0 9 4 5 5 3 <br /> Mu with DWR <br /> WATER WELL DRILLERS REPORT Sute Wcf1 NJ <br /> Ocher WeiI No <br /> (I I) WELL LOG: <br /> Name Mate Of Califar.nia Tutaldr :h <br /> ---- _— n ft- 1,PA of ramplcted well 31.5 It. <br /> Formation: Dnrribe by color,rbrrxrler,rise of mntrri•1,end st—l—e <br /> (2) LOCATION OF WELL .n ft <br /> • � c <br /> —_"_�•2__ Yell n wt G 1 a y- <br /> y Coun-y 5�j7_`_M_ �.(''; ga•nrr's number,if arty J �`r <br /> - 2 5 a <br /> Tounsh ip,Rxngr,and Scctnon <br /> � <br /> Distance from cine.,road,nllroads,etc. [� <br /> __. PIv t o ,th &,,_Cauntry_C1ut� _. r:. f <br /> (3) TYPE OF WORK (c{�eck): 1. D 147 Qj Q_u_� <br /> New'Wfell 57J Deepening [-jReconditioningQ Destroying © �� C U�_.�.�f�1C <br /> I/dost ruelion,rlrscriGe ntaleriai nerd pror edurr ire hent]1. 16 2? Qand <br /> — �! <br /> „ (4) PROPOSED USE (djeck): (5) EQUIPMENT: <br /> Domestic ❑ Industrial ❑ Municipal ❑ Rotary ® tu_ <br /> Irrigation ® Test \yell ❑ Other [] Cable <br /> ❑ �' -.—� IISL Czv e l <br /> ...t.a. <br /> Other _ , ., _❑ <br /> (6) CASING INSTALLED: .2 222 <br /> STEEL: OTHER: If gravel packed <br /> SINGLE DOUI3LE ❑ ,L< <br /> Gage Diameter aii <br /> From Cu or of From To <br /> ft. ft. Dim. ��:'all Bore ft. ft. <br /> 22 25 28 <br /> -3-3- JL 0 18 0 315 <br /> � Sir-e of shoe�r wc31 rinr�l�(i t>1� p Sirc of era vel: - <br /> .-%i6/ Ur:tribe aloe d--- <br /> (7) PERFORATIONS OR SCREEN: <br /> rYpr u(oerfontiunu tnc of scrcen Lou VgrCU 42, f- ul—f10 <br /> r Per f. Rows <br /> From To per per Size _ <br /> ft. VOW ft. in.x in. <br /> io — 2 35 - <br /> _2cLZ . <br /> (8) CONSTRUCTION: <br /> Lf'a vrfacr sanitary sell pro,idcd? YesyY'4 Nn �� To whit dcprh <br /> iu•a Ve 11 any snzs..st-ticd rcainst poll,rc ion? Yc. [f Nn , If `- <br /> � yet otr doth of ttra;a <br /> f.- to Is <br /> ._ V"ark t[ar[cd 19 ,Camplered 19 <br /> }lrtieuJ�^ `f sexlin¢ <br /> Lr WELL DRILLER'S STATEMI"NT: <br /> "—" <br /> (9) WATERLEVELS: This well teas drilled under My jurildicliorr and This report is True to Me best <br /> Depth <br /> of my kno?aedge and belief. <br /> a[ which wx.er was first f--d, if Anawn !t. <br /> standinG level before perforat=nR, if knoxn ft. NAME Clark Well & Equipment Co. <br /> 1•w inndin¢ level after ytrforatin¢ and devdupin¢ fc '(Pen n,ftm,or corporation} (Typed or prvrrrd) <br /> (10) WELL TESTS:- v Address c2024 East: -Charter Way <br /> Wta hump test made? h'ei I No [� •7f yet,9)y whom? ?_,G & E J ©c On5 <br /> !`A 206 <br /> d' <br /> 82 eal.lmi�.with 4 p ft.drawdown atter het. ISIGNTD] L J G <br /> rrmpernurr of wa.er WC i chemical analysis male? Yes f-X No [] (1�r!!Urilln) <br /> YVas electric log made a(well? Yes�J`• <br /> N.Z] [f yes,--h copy <br /> License No.—.7-6602Drted , 197 <br /> ++ SKETCH LOCATION OF WELL ON REVERSE SIDE <br /> DWR }88 IRE, 9.1a) <br /> 25.19-950 I—SON TRIP AD asp <br />