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&. ORIGINAL STATE OF CALIFORNIA Do not fill in THE RESOURCES AGENCY He with DWR DEPARTMENT OF WATER RESOURCES No. 145680 of Intent No. WATER WELL DRILLERS REPORT state Well No, :ermit No. or Date 8- 0 5 - _ 7��;r� OtherWell No ''(1 ) OWNER; m,, Gonzales Transit sMix (12) Wi WELL LOG: Total depth 1 42ft. Depth of completed well 11+2 ft. Address 8181 1 W• Business Loo 205 from ft. to ft. Formation (Describe by color, character, size or material) ;;n. TracyCa. Zip 95376 0 - I Fill '72) LOCATION OF WELL (See instructions): - i5 Sandy cls County San JOaq.ul n _Owner's Well Number 1 - 19 Sand Cell address if different from above 19 - 21 Cilay,:�, t..inu•nship Range Sectio - an \\,,5> Distance from cines, roads,railroads, fences, etc. H 20 - -mile - ay �san s res s west of Chrisman Rd . south side '7 ,7 - � a.y e. na e 2 - 1M. Clay (3) TYPE OF WORK: 107 f 11 Gravel New Well X- Deepening Q 1 1 ,1-7\.tip\ 1 1 Clay RecOnstrrction ❑ 114 - \�l 21;-Gravel Reconditioning ❑ 1.2 1'31 =01a Horizontal Well ❑ `131 - 1 9. . -Gravel �{ Destruction ❑ (Describe - 142 -C _a y !{l destruction materials and procedures in Item 12)' (4) PROPOSED USE. - Domestic Irrigation - �• - �� - lrrfgation �;��`. ❑ Industrial `.� '-•� ❑ - Test Well ❑ - - Stock •i❑ Municipal Q - ' WELL LOCATION SKETCH �,' Other ❑ -`� 5)-EQUIPMENT: (6) GRAVEL PACK: - Rotary EX Reverse ❑ yes X No 0 Size 1' ,able Ll Air ❑ �iameter of born = it..Other ❑ Bucket ❑ `P�c]ced,Smm - r (7) CASING INSTALLED--, (8)`PERFOAA,TIONS: - iteel E3 Plastic OE C[ cipc*ems, Type of per(erarfan ur`s¢e of screen•,-; _ i... Froin To. Dia. 6ik�r From\ To ` ,Slot ft. ft ` in. Wal! ftp\\ ft. `ti size' - 0 142.. 8` 160 102' 1 n (9) WELL SEAL.: \1� - k'as surface sanitary- seal provided? Yes ($[ No ❑ If yes, to depth 50 ft. Fere strata sealed against pollution? Yes ❑ No ❑ Interval R, Method of sealing Work started 1$ Completed 19 `10) WATER LEVELS: WELL DRILLER'S STATEMENT: Depth of first water, if known -K- This well was drilled under my jurisdiction and this report is tyre to the best of my "Standing level after well completion 1 0 g, knowledge and belief. (11) WELL TESTS: SIGNEu � -LC1 L✓� ( C C`��l � C a Alas well test made? Yes ❑ No QX If yes, by whom? (Well Driller) / Type of test Pump C] Bailer C] Air lift 0,, �;NA --Henn s n Bros. Drilling Coa Inc. #. n-nth to water at start of test ft. At end of test-------ft "' Z rL a n, 7 n co rot' ) (Typed or printed) r;eai/min after hours Water temperature Address 3 5G E�enaye4e o Modesto, a o ip 0 analysis made? Yes Q No TM If yes, by whom? .•� p a r r^ 2 081 ate of this report Was electric lag made. Yes ❑ No � if yes, attach copy to this report - Lichtse 1\To. DWR 188 (REV.7.78) 1F ADDITIONAL SPACE 1S NEEDED. USE NEXT CONSECUTIVELY NUMBERED FORM 6..