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„46A6WPLlCAT2 STATE OF CALIFORNIA .. _ - Ea not fill in..
<br /> f Wso compl]►wHh _ - THE RESOURCES AGENCY
<br /> local regnlrnsnts DEPARTMENT OF WATER RESOURCES No. 173122
<br /> tl•o of Intent>, ± ` WATER-WELL DRILLERS REPORT st,,\sell No..
<br /> ..•[ural PermitVN8: D
<br /> ur nie �,0.�
<br /> ..,,. - w T. - - Other Well Nc”.
<br /> ( )OWNkR Y Assured Packing Plant (12) NVELL LOG:_,Total depth (t.Depth of„Inpietnl Wei> '
<br /> q\ddrear, r n'i-F"-'�Arsle t A= R��; - In.- ft. 'to ft. Fnrmatirm (Describe by color: character�size or materl'al l-
<br /> ..r,-St6ckton��-'C.A' zip 2.3.1 - Cls , :+ r ,y-r
<br /> *`'"f`'"' y.x` '��_"��•. `w AY""r15 - 30 --Sand
<br /> (2).LOCATIONsO�ttWELI,�(see fa5tructiUn9);
<br /> t"Gwety�' �,1e�aet -'� Owner's Wel]Numhrr -
<br /> WeA address[f dilfr�rr�en�tq(ym�.n above _ A r, - - San +ter.• '4� "' i_ r rye'.``3` ". '
<br /> '..yJi 7n,pR.,,!",�,�y ,'�f'Y.'"t<• '�',� '` - 17 .'hr... �S� .s
<br /> 1 Tnivpshl '+ nite Sectio ' !. .✓ y Lu'=`+1T�
<br /> C Disttnccee(rrcm�l '�� '' v c 3 4 y riT!;.' •,$Sr
<br /> p clfa roada"mlimac...'fencrs etc
<br /> - _ t o'^.
<br /> (g5�'ILF J '✓(i45� i - SV1 ". ,,. -
<br /> (3).TYPE'OF WORK, ''sr _fiAM ,t- hF"•u°^*' ..rxs '
<br /> New AVell 1-..Deepening❑ r
<br /> Recamtn,ctinn - ❑ - - >t '"'"',^P�w�""+gid"-
<br /> Aecandltianinl, [� .J:g.
<br /> I Ic� � �� t � s �r� ;`v �'" � � Hnrizontxl'Well, ., � "Cf ' 1 �A::i�.T'"�"' `, :.°"+�'•,F-�,�,;..
<br /> Destruction'
<br /> ❑ (Descn'bec
<br /> • .t.�-�� �, '� _
<br /> destruction materials a,rtd _ l gy
<br /> i y v 'i.*' i{i. ,°"' a+ .✓ I� ;. promdures in Item 1$ a,.u _ �I §+
<br /> (4).PROPOSED- ill) -
<br /> ?v *1ir �y} r f Domestic
<br /> �?��,b�'' � � „� L" Irrianh n�. � ��-❑ :F -V '+8fi at � .?:" �'?�' '�u44P
<br /> ?'t I�;p i
<br /> T Li
<br /> tx} r cb t {`tr� 1 a}fia a s `
<br /> F 4f3'','rr?g n-}.y�•,•�,}-,r.T.h?iK.�r NF,,-..' Municip .3 ..: _ &A ft
<br /> �• .. il�'i .f;LOCATION:SI[Ltl'Cfi;-,;,y�: Other ''`" '',j❑i.. � ' -
<br /> ti
<br /> (If)M$Q�FIPfrt$SVTI �Yafi " �"T?'F-r• (8)ICRAY�SL ACKi t a "'§„4n,"' .!rt.°' +n`.ny ,°TS;h.°�w#Y .�'�,° `
<br /> -a;
<br /> CIA
<br /> Size a . ,br * ♦ e«: f'a`d^'• %.d'.A "'F
<br /> i 1 t{` ,ati.tifiys,'-c. f• y,rq.s. �7..::�e,F-:' y.: •v_w y' ^at
<br /> d tF Q' `"Air 4y,k❑'ta, r of bare
<br /> .. r Q �'�d„-,r. �'Ybuckeit�0�3 ,t _ - •: SFhc a7.�"-;3-° _t. f 'f' ti
<br /> 7J`CA9WC'INSTArJ D r ; (8I ERFORA I {' A4�z� ' ti! r�rp ti� :^ ag.
<br /> " *F s
<br /> b4ra1; PLutic,❑ TYDe of or ze aF scma rb - fr: "'.it«iw v, M At
<br /> y' t f
<br /> %386 � t3t5 ............+ 5 " "i�-� 4 i
<br /> Fy".r
<br /> ;u` '�,�°�:aw2ykx" "� '�{sr ,may,. �:,,r... ��� � �,.. .�• -r r•sk '?K- `P� �
<br /> . �•�rFa''`.'.h.Li �' ``Wr Cv'g1' fs r4: t t•.m 't 3,'' t« �a.�_V _ry,R - _ "r- �. y.:1
<br /> 1(0j,0VELt' EALr r f S bt f lf.Wf{s4.
<br /> �ilvai�Yt'nrr(mee saultary rcn1 Pro+dded7Yw 6 tNa Q yes,entdeptt ►�-1t t raWr� r_ rasa ?y�
<br /> . r1 °�P•fia5grs„lX;4r'R 'c+a... rF:1; �,,w a.r] -
<br /> Were.•rtrsta 'aealed3ayltioit Dolfutlan? , .❑:� No io' Interna] �wft.� 't '. ,-�3r!% ]t"k;f'- .',•,,;•a .,.rt;+ce JC`t.'y'-".'b.11 '.}'i5h�-,b ¢',+a
<br /> iMath'L';ol •,NIng
<br /> ` -?+'"ri `'` r•t:r;s. .Work•! 'r F `'19'' .rt; ComPlee•a - i. :,Ig;irw#.-L'•.
<br /> (10) WATE t 1LEVELS � e to rt v .,s v 3;; WELL DRIL R'S. TA-'EMENT::7
<br /> 'to- "4 r •:••six-
<br /> . 4,d x ThFr reeA was dnAed under y furbdfctian and thio report k�e'to ih of
<br /> �Soiaading•leve]yter.,Weu c aiDktlos�s ft krom7cdye and 6etFr/ h } ;"r 4 h , A74xt-ylm�,� d
<br /> ME }�'WEI.Lj,TFSTS: a 'c}' t'+'*, w.'�'•x+�e- -{; 2 +: SicN� r - '1' d 'y;+'�A {�2".µ ` � '(�t3'z"°biy'csa�q•
<br /> Was.,; tesbtriode? tf;Yes[]7--r Nn If'yea 6 homk�}'y(WeADriller
<br /> :y� .�. ~
<br /> `lypc:nf{Cost $7 Pump ❑ -+ Sager❑ '�4 -
<br /> 'NAME
<br /> Air.lift❑ ,gyp as i�+. sA-. a'. •5-
<br /> �y,cF aa, ,a�.,'sw `h` "^`T,ry�; `''; ,� _", f,,, .-. •'F .
<br /> aDepth to-water,aSt+start-•o( tat k .n +1 At-e d of lest 'it- F-. ts." _ ;Be
<br /> ' rson:: rm.Pr corpontiwr ar printed .a '
<br /> g {'at1+ 1 t�4 4 a"�§�`a c � i y r r.r L� Add fd4hti (tlY -,
<br /> -- VLAia titer hoop Water tempera _
<br /> ., # City
<br /> �Chemieal aaabal�made?. Yea[] �Sho �(y IF.�ya by whom?f. - �
<br /> W tlectrlclog•made? ,lia b -•No. If yes.attach
<br /> "cop in this report� i'--'- 'L[cense No �- ' atn'o!Sh4 repo =0�4• .t
<br /> a DwR tee tPe¢v.y res^y CIFrAbDITfOM1IAL 5isACE IS NEEDED. USE NEXT,COIVSECUTIVE:!Y NJ MBERED FORIM r'
<br /> s(,41 I? �F1'�+`,ur, �+
<br /> .t� a''fd c^ 1"=F _',} ..n�S,SeU. `++ 'y -•' 4 `'^
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<br /> ,'�� nd, -+yt s ry g.W tr _ r �... '� { t.♦ ti- r',t "`. '';�. r
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