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RIGINAL H Fria 0rlgilial Duplicate and Tnolrtate wlih the (;H L BIYIi�ON 4F VATK HE's-SURCES 31 , +SHEET 2 P O BOX`7079 .-- SACRAMENTO S CALIFORNIA / - F A i I • WATER WELL DRILLERS REPORT Do Not F:11 In �.. (Sections 7076,7077, State Well No,zoos,Water case) Other Well No UV A e� -�_W__ Region _ (7) Perforations Type of perforator used ____�MI44!2-0 Perforated --- - - --- - -- - - -- -- ------------ _ it to _ _ '_--- -___--f t Hole size----------- -------------- -No of holes - ----- -- - -- „ ,. --- - --- ------- - -------------------- --- ----- --------- ---------- ------- ---- -------------- --- -- - -- - --- ,. -- „ ,f ,. ,. ,. ,. ------- ------------------- ------------ --- „ ., _-------------- --- - --- - - - --- - — ,. (8) Water levels (9) Well pumping test Depth at which water Dare of test----- -_- ----By whom__ --- rst encountered_----------------_________ _ 3-3__ft Depth to water when test started Depth to water G P M at beginning of test ------ --------- - - -- ---------- before perforating______________ _ _ _ -it Drawdown from standing level _____ft ---- --- ------- Depthto water G P M at completion of test after perforating______ _ _-------_------------------- it Drawdown at completion of - ..........._it • Note any change in water level while drilling Length of time tested___________________-------------- -------- ------- ---- ---- --- ----- ---------------------- ------- --------------------- Temperature of water-- --- Was gas present in water) ❑ Yes ❑ No (10) General Was well gravel packed>_-_____ __ ______ ________ Size of rock____ _Thickness of pack Was a surface sanitary seal provided) --- ----- --- ------------------ -- --- ---- - Were any strata sealed against pollution> ❑ Yes ❑ No If yes, artach detailed description _ - Strata sealed----------_ ---------------------------------------- -- --- --------- ----------- --- ---- --- - --Was analysis made of water) ❑ Yes ❑ No If yes, attach copy Was electric log made of well) ❑ Yes [] No If yes, artach copy If well abandoned, was it plugged and sealeda__-_____------ _ r- n i_F i D E N T I A L Method of plugging and sealin - — '7Q'7 b. , P gg g g-- ---- -- ------— - e _�---------------------- I Location• ��ti u.� _ �., �,r r 7� 0..✓ (12) Time of work. North Section No--______________ Work started date_2-12'51 Completed datel2=27-3-_'_ Townshi ____ _ Date of this report_____-!-2Q7n51 - - - ------ ------------ Range------ ----------- ----------- Base&Meridian--------- -------- _- WELL ]DRILLER'S STATEMENT c I Show location of well in Sec- This uell was drilled under my jurisdiction and this lion, thus (X) report is Irtie to the best of my knoxhdge and belief Distances co section lines from well, N or S________ __ ft JSirNEDj SOC-Mi. ��: TiT�u, & 1',u0T0R_7T0R_{S and E or W _____ __f r irru n„rr, I Show location of nearest By _ i I known well, thus (0) I RILE Distance to nearest known License No 67850 Classification C-57 well fr D-ired 19 DWR FORM No aas REGIONAL WATER POLLUTION CONTROL BOARD COPY x59Tx,5V wM VfN