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Fife Original Duplicate and Upficate with the SHEET 2 DIM10k 11%," "ft RESOUREES SACRAMENTO a CALfFORN1A WATER WELL DRILLERS REPORT Do Not Fi In p (Sections 7076,7077,7078,Water Code) State Well Na.,_-5• _E 7,R1 Other Well No _ _----- Region -- - (7) Perforations Type of perforator used-----/ Q � _ G _ Perforated ______-_ __ ft to---/ B-v_--____-_______ft Hole size_________ _ _____ No of holes - -------- - ---- - - -------- -- -------- ------ --------- --- --- - ------ -- ------------ -- - ---------------- ,. ,. ,. ., ,. „ _ ., ,. „ ., ---------- ----- -------------- ------------------ ------------ - --------- ---- ----------- -- ------------ --- ----------- --- - - ' (8) Water levels- (9) Well m purnp 8 test: Depth at which water ` Date of test:7:,'._Z__4 By whom_-__!L�__ first encountered ____ ______________ft Depth to water when test started_____ __ .-� _ _ ft Depth to water G P M at beginning of test before perforating____—____ __ ---------___________ft Drawdown from standing level-----------__--711 -----_____________ _._- --ft. Depth to water G P M at completion of test__________—_. a ________________________ after perforating__-___-___w_ _ ft Drawdown at completion of test______ ______ ___ ___________ _ ft Note any change in water level while drilling Length of time tested—______ __________-_____ -------_-----------_------ -- _____--------------------- -- Temperature of water- - ----- ------------------------ -- - Was gas present in water? ❑ Yes (10) General- 'Was well gravel packed____ _+Q_____________Size of rock________ ____________________Thickness of pack____-_____________________-____ Was a surface sanitary seal provided—-------_- ____ _______________ _____ ____ _ _ / r k ' -- - -- --------------- -------------- - - - ' Were any strata sealedains_t o un ? a No if yes, attach detailed Description Strata sealed----------- — '�'S'"` - - - - — s• - Was analysis made of water?4❑-Yes If yes, attach copy Was electric log made of well) ❑ Yes o If yes, attach copy , If well abandoned, was it plugged and sealed)-_ Method of plugging and sealin r (11) Lo � �� 4 (12) Tune of work rt Section No --Y Work started date_— ---Completed d�ate�Zf=l_ �-_—_`__*5_ Township- Date of this report Range------- P---- Base _ l &Meridian AVS- WELL DRILLER'S STATEMENT ' i Show location of well in Sec- This well was drilled under my jurisdiction and this ;ton,thus (x) report is true to the best of -iny knowledge and belief Distances to section lines from well,v*ft or S_3-0-C_ __ft SIGNED) ! __(J----- _----__ ------ andE�_v',a>C ft &:1111+ �� tiibrrur. Show locatp4,P „"a�xe.st„ 0 � known well, thus (O} License Na� _► slassification C 1 I MILE Distance to nearestUK�jiwn f`s�'� ft Dated_ /M � k: fF n lira ' b W R FORM No 246 REGIONAL WATER POLLUTION CONTROL BOARD COPY 23072 3 50 40M QUIN sro