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Customer cbtainermit <br /> f.: <br /> ORIGINAL STATE OF CALIFORNIA Do not fill in <br /> THE RESOURCES AGENCY <br /> Dile with DWR DEPARTMENT OF WATER RESOURCES No . 168959 <br /> •f_ Intent No. WATER WELL DRILLERS REPORT state Well No. <br /> IL. rail No. or Date Other NN ell Na <br /> j <br /> - '( 1 ) OWNER : NAuo. Delta Pum ( 12 ) WELL LOG : Total depth-1 I 5ft. Depth of completed aeB-7Lft. <br />� Address 646 S . California St - <br /> from ftto ft Formation ( Describe by color, character, s materiall <br /> cit% Stockton , Calif . 95208 - 22 Clay <br /> ---1(' 2 ) LOCATT 2 OF. WELL ( See instructions )- 45 B Sand <br /> jc�mnn �J1 4 o,.•net's Well Number Blue ela <br /> 4 <br /> j\% ell address if different from above Downing & Turnpike 6 Blue sand <br /> aT,nvnship Stockton Range _ .- section 73 - 110 Blue clay <br /> -Distance from cities, roads, railroads, fences, etc. 110 _ 11 Blue sand <br /> 113 115 Blue clay <br /> ( 3 ) TYPE OF WORK : - <br /> -- ) New K'ell)t Deepening ❑ — <br /> '- -I Reconstruction ❑ _ <br /> Reconditioning ❑ <br /> - - Horizontal Wall ❑ — <br /> L. Destruction r, (Describe — <br /> destruction materials and <br /> procedures in Item 12 ) — <br /> ( 4 ) PROPOSED USE : - <br /> Domestic priv xl - <br /> Irrtgation — <br /> Industrial ❑ — <br /> Test Well ❑ — <br /> - Stock ❑ — <br /> Municipal ❑ — <br /> WELL LOCATION SKETCH Other ❑ — <br /> �, ji31 EQUIPMENT: ( 8 ) GRAVEL PACK: — - <br /> Rotary X) Reverse ❑ Yes Vg No ❑ Size Roofing _ <br /> - Gthlc C Air ❑ Diameter of bore 1Z . <br /> -IO[her ❑ Bucket Packed from 50 - <br /> - : CASING INSTALLED: ( 8 ) PERFORATIONS: - <br /> - ,Steel ❑ Plastic Mfr Concrete ❑ Type of perforation or .size of screen — <br /> i From To Dia. Gage or From. To Slot <br /> -- - ft. ft. in. Mall ft, ft. size — <br /> 0 1 0 0 75 - <br /> PSI - <br /> ( 9 ) NYELL SEAL: 50 - <br /> \tAs surface saniL n seal provided? Yes ® No L] If ves, to depth 50 - <br /> - \l"ere strata sealed against pollution. YesNo Interval ft. — <br /> Method of sealin, Bentonite E:e ]York started 19 Complet <br /> ( 10 ) WATER LEVELS : WELL DRILLER'S STATEMENT: <br /> Depth of fiat water, if knower ft This well uers drilled under mu jurisdiction and this report is true to the best of mu <br /> Standing level after well completion ft, knowledge and, belief. / ) <br /> ( ll ) WELL TESTS : SloaBkkpr . <br /> \t"as well test made? Yes ❑ No ❑ If ves, by whom? ( Well Driller ) <br /> Type of teat Pump ❑ Railer ❑ Air lift E] NAME Calwat er Drilling Co . , Inc . <br /> Depth to water at start of test k. At end of test Et Parson Arm, rpomRnn ) ( Typed or printed) <br /> D,--s.arge gallmfn after hours Water temperature Address 3b0 $ . KilroV <br /> ul analysis made? Yes ❑ No ❑ If yes, by whom? city Turlock , Calif . Zip p5380 <br /> 321252 nate of this re 2— J 88 <br /> elecMc log made? Yes ❑ No ❑ If ves, attach copy to this report License No. po t <br /> DWR 188 [ REV. 7.761 IF ADDITIONAL SPACE IS NEEDED, USE NEXT CONSECUTIVELY NUMBERED FORM <br />