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customer obtainelrmi t f.: ORIGINAL STATE OF CALIFORNIA Do not fill in THE RESOURCES AGENCY File with DWR DEPARTMENT OF WATER RESOURCES No. 168959 f_I.tent No. WATER WELL DRILLERS REPORT state Well No. n _Il. rmit Sa+. ar Date Other \\'e!I NoC i 1 ) OWNER: Na,,,e Delta Fum ( 12) WELL LOG: Total depth 11-5-fe. Depth of completed aenlZft. I� Addrer 646 S. Californi St - from ft. to ft. Formation (Describe by color, character, size (it material): a it, Stockton, Calif . zip 95208 - 22 Clay ---'(2 ) LQanTT 2 OE WELL (See instructions): B Sand CounR rJ1 Q ' O.ener's Well Number Blue clay { f �\\'ell address if different from above Downing & Turnpike ( - Blue sand T,,,,.n,,,;p StocktonRangc _ section 73 - 110 Blue clay jDistance fmm cities, roads, railroads, fences, etc. 110 _ 11 Blue sand 113 115 Blue clay (3) TYPE OF WORK: - j New Well`/] Deepening ❑ - Reconstruction ❑ _ Reconditioning ❑ Had,n ud Well ❑ - L. Destruction ❑ (Describe - destruction materials and procedures in Item 12) - (4) PROPOSED USE: - Domestic pr i V X7 - Irrigation ❑ - Industrial ❑ - Test Well ❑ - _ Stock ❑ - Municipal ❑ - i WELL LOCATION SKETCH Other ❑ - _ ji31 EQUIPMENT: (8) GRAVEL PACK: - - Rotan X) )fevers, ❑ Yes Vg No ❑ Size Roof in _ 12rr -- G.thle C Air ❑ Diameter of -(Other ❑ Bracket E' Packed from 50 - T: CASING INSTALLED: (8) PERFORATIONS: - - ,Steel ❑ Plastic N Concrete Type of perforation or size of screen - i From To Dia. Gage or From. To Slot --- ft. ft. in. Mall ft. ft. size — _ 0 75 6 160 60 75 - PSI - (9) WELL SEAL: CCInS - %Cas surface sanilan seal provided? Yes ® Na ❑ If yes, to depth50t. - - \l"ere strata sealed against pollution. Yes p No ❑ Interval ft,Method of of srahrI Bentonite Work started 19 COmPIet _=19091 (10) WATER LEVELS: WELL DRILLER'S STATEMENT: Depth of fiat water, if know This well uVer drilled under my jurisdiction and this report ft true to the best of mV Standing level after well eompletion R. knowledge And, belief. / ) ( 11) WELL TESTS: SIGNET) "�-'. C!�-^-2C . . Bkkpr . \Cas well test made? Yes E: No ❑ If as, by whmn? (Well Driller) 'Type of test Rump C Bailer ❑ Air life ❑ NAME Calwat er Drilling Co . , Inc . Depth to seater at start of test k. At end of test EL /(�Parsonrr44 Arm, nr corporation) (Typed or printed) D;--`mrge galimfn after hours Rater temperature Address 3b0 J • Kilroy C.h. Turlock , Calif . zip95380 sal anaksis made? Yes ❑ No ❑ If yes, by whom, r C q U\w electric log made? Yes ❑ To ❑ If )-as, arlach copy to this report License No. 321 252 Date of this repot 2-. 1-88 DWR 188 [REV. 7.7e1 IF ADDITIONAL SPACE IS NEEDED. USE NEXT CONSECUTIVELY NUMBERED FORM