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STATE OF CAUFORNIA <br /> N THE RESOURCES AGENCY DO not fill fit <br /> r ORIGINAL DEPARTMENT OF WATER RESOURCES <br /> File with DWR <br /> dVATER WELL DRILLERS REPORT No. <br /> dice of Intent s,— Slate \\'ell No. <br /> - <br /> �.ucal Permit No. or Date 88-31 60 Other P ell No. �— <br /> (1) OWNER: Name Pick RaB11er1Z (12) WELL LOG: Total depth 15.8_ ft. Completer) depth 160 IL <br /> Address 38499 Botany Green from ft. to ft. Formation (Describe be color. character. size or material) <br /> F-1 Cut Fremont, Ca. ZIP 0 - 7 Clay <br /> (2) LOC:ATION OF WELL (See instructions): 7 - 17 Sand <br /> County San Joaguln Owner's Well Number 17 - 25 Clay <br /> Well address if different from above 3531 Turn Ike 25 - 35 Sand <br /> Township StOCktAn Range 61'' kk Section f 35 - 40 Blue clay <br /> Distance from cities. roads, railroads, fences, etc. - 40 - 50 Blue sand <br /> F 50 - 55 Bluecla <br /> 55 - 59 Blue sand <br /> 59 - 63 Blue Clay <br /> (s) TYPE OF WORK: 63 - 68 Blue sand <br /> -J New Well N Deepening ❑ 68 - 109 Blue Clay <br /> Reconstruction ❑ 109 - 119 Blue sand <br /> Reconditioning ❑ 119 - 145 Blue clay <br /> Horizontal Well ❑ 145 - I M Blue sand <br /> IJ Destruction ❑ (Describe 151 - 154 Blue clay <br /> destruction materials and pro- 154 - 158 Blue sand <br /> ced6res in Item 12) _ <br /> (4) PROPOSED USE: _ <br /> Domestic Pr'1V. — <br /> Irrigation - ❑ _ - <br /> - Industrial ❑ _ <br /> rr Test Well ❑ <br /> Municipal ❑ _ <br /> Other ❑ <br /> WELL LOCATION SKETCH (Describe) — <br /> (5) EQUIPhIENT: (6) GRAVEL PACK: <br /> -� Antary 11.verse ❑ Yes M No. ❑ Size RGOft <br /> rt — <br /> Cable ❑ Air ❑ Diameter of bore li <br /> Other ❑ - Bucket ❑ Packed from 100 1. 160 _ R. <br /> (7) CASING INSTSLLEU. (A) PERFORATIONS. <br /> I' steel ❑ Plastic)[$ Concrete ❑ Type of perforation or size of screen _ <br /> From To Dia. Gage or From - To Slot — <br /> ft. ft. it. Wall ft. ft. size <br /> 0 160 6 160 140 160 <br /> PVC - <br /> r _ <br /> (9) WELL SEAL: - <br /> 'J R'assurR,,.nihan, sealprovided? Yes 1A No ❑ Ifye;todeplh 100 ft. — <br /> \here strata sealed against pollution? Yes ❑ N, hdrnzl (t. — <br /> I Medmdofsea(i., \5`ork started 19 Completed 11 --f9-88- <br /> (lO) WATER LEVELS: WFLL DRILLERS STATEMENT: <br /> Depth of first water,if known ft. <br /> This well ¢ns'drilled under rift ju risdicl ion and this report is Inrr to Ihr• <br /> [ Standing lerd a(ln-well rnmpletinn ft lsreofm knoul,doeand hclfe{ <br /> 11) `FELL TESTS: Sicnc..l G� Q�/1 � i7Z e { Bkkpr. <br /> \l'as well test marl"° Yes ❑ No ❑ If yes,is x hom? - \1 ell Dnllerl <br /> 'vpe of test Romp ❑ Bader ❑ Airlift ❑ NAM! _CEtlwater Dri n—U L). ,-_]_nL• <br /> rpth to water at start of test _—ft, At end of test ft t PrsonIm, orcorporobnn)ITypedor printed) <br /> Diuharge galnnin after— hours Water temperature .Addeg 300 S. Kir:rCy <br /> Chemical analysis made' yes ❑ No [Ilives.be w hom' Cih Turlock, Ca 7.IP 95380 <br /> Wasel,etnelogmade Yes [I No El If yes,attach cop,to this report License No. 321252 Date of this report 12—S-8R <br /> IF ADDITIONAL SPACE IS NEEDED, USE NEXT CONSECUTIVELY NUMBERED FORM 86 96355 <br /> owR 166 (Rev. 12-861 <br /> i.,l <br />