- + � ,}-,t' i- _l � _-- - - •.. s<-r;n� - -sx...•tii r';+u4�t..,:;�fac;yyt tL ti0u:"rg'sr.�'
<br /> a
<br /> .'.i. _ -i�•K•yr•3y�r�."rvw•�'wrt r.^rr'r��wara.A'RTaia�y.,.,�•.•„�T...,,�w•�lrwS�Fplt r- 4I - �v.
<br /> ••.-: "+!n�vr'�n "a..s.wmw�W':,xafr,�rb;'y,I:' .r rc.
<br /> }l01-1 ti��`;�'r,.Ja7i r-Fh�•trf,�,Y_ qq9�++rp'x'�Y"'�r rr�Y,c
<br /> h
<br /> r,:�QDADltOPi.ICATE 1tk - fi' -•s N` .-.STA SE OF CAWFORN1A y'r: - r'x k a4"
<br /> r �>W+tO'COg7 i✓'Ta�,t I�• - ,+y t k .. - (i'�""� t ,��1,3r:<yr.tCDO'1i0>t!/ws:
<br /> ?s a " THE RESOURCES'AGEIYCYhl�'S V t 4" �y
<br /> �.iocal regvlrerrlenta r � �-°` � � �- � ,F1 e• g
<br /> ENT'OF WATER RESOURCE - t" "OGAJ]0 4Q�'.7i�'
<br /> r`r><rre�/rntent N '13Y348 V�'ATER WELL DRILLERS RF; Isn; 5rr�
<br /> i ! Y2:�..Ya 4 4r
<br /> i--'.LrKal Permit No nr Date- 1 c tt`+ r� r. • -- s 4 E •ls...tr•_
<br /> .-. r .� �
<br /> 1 ,. +�r � ,., - ��.sw .z.. r-..•i4a v-+•tiers
<br /> r _1) "0 WNEjji h; ? `JOhsssn �lx#h]mann ,� r I2 wEL.I,`LOG'
<br /> dd 239191 l.aru�a#^ !� $0llE� r ` `: 4 .a yTotal dep11► _!r Devth M camDleO-red`
<br /> � fmm [!.• to -:ft Formation+ y,. w+"�
<br /> s f- �S fDeierihs•t»''�o��r chttructer,�*'rtlse�ots'mals�r�)�a
<br /> f[xti?" F r.-,:L.:i.•' •..,cswNy't- - ',c-.3" 21p - :`'. /��sp .y, K+ ti"7.�Y)y�Fy%�'rs��`+i r•
<br /> �" { � {See ftlstriJotlons) ,. �'•n,. �r. .
<br /> • -,i CL CoPRtY s>F. thvtJers\yell Tuml+er „,+=f5•rtr>daiFi�S',i-„r
<br /> 7-1 Nett oddreu If ailfQe:eN fmm abmr , '19
<br /> f`jumwhip n? -]tanJ ”i�'�`-'' Econn�G"
<br /> Y�
<br /> aF DWanne tlrom altks,roads railroads fences,-etc �� address
<br /> 4LI AI
<br /> h
<br /> (.r)'TYPE OF'. �VOHIC:
<br /> Ne, Ivail: Dn•PrninC �7. -r.:. i _ ..4+ -r. ri-'�sa"•.e t'+,.�'�`�
<br /> G T"�. -V RrnmstruMlon ❑
<br /> 'F _ rr-•r r r ,'�- 7_ liesneniitr minC .Q - -.r ;� � y
<br /> • F � 1 r ._ ._ 1sa �;r C.
<br /> llrlriYnnitil Well -, .� f V•
<br /> y..r ...
<br /> Unln+Mian L"I (t)escn'Fx•:_
<br /> .. dretnrrtion nmtrrials� � ' 4`•*" +�'�$'
<br /> {
<br /> I,rM'ednr[S In Item
<br /> s (A) PROPOSEDw , iii c�`Sfr S.
<br /> c .; 4,F _ f Dnn;rstia• O �►�e7++.Wks• $::.a +'
<br /> y } 1rriJ:atinn� th �iwsye� =.an no :re#pans
<br /> f t Ire lrrrtrial ❑ y'1 ��7 :•� �.er I7r. rI1av o
<br /> ell &in
<br /> or
<br /> ti
<br /> t
<br /> . «ELI, LgCAT[UN ShiSTCII Other /`, ❑ r:"�'V _.•,r,,, r- ? �•z '•
<br /> _,1:SI liOUTA?!F\T
<br /> 00) CRAI'l�ACII V"\�� <<`.--, �/ . : -- •. z«+t1.-•kz.cy, �.t y
<br /> RiN�ry � 1 rhe.❑ V 1� Nr' ��V l' � ♦ Vr• -rt-.fJJ rr�,��_
<br /> Crble- ❑v AIr. .. ❑ � r of]xn�-1(\.gin ,-•� ,"\�,)� - .. : p w' C
<br /> nJh r ,©, Rµt-Let , _
<br /> ',r>Sk�-frnnr1 hr,
<br /> I'
<br /> E .r CASUNC INSTALLED ixY PF:K1•'(1RA `�` - p �,.1� �
<br /> VA�w1�• ut
<br /> Frecl ❑- ,1'lµsler.l Ci r K Tvlrr rd t+r+ ktn r•Ire !urcra'.-fit - Y-�z'
<br /> Front, 1 Dia. C w-�r Feria&, 1 ToWall. w
<br /> SIMV
<br /> - 7--
<br /> R � .
<br /> (9) WELL SFALe'
<br /> 1: -
<br /> 1Pxs nurfatr yauaaq srI1 Prnridrd? S"r. N,r _^ 1F •., r,.drJ.Ih-SO .-Wit.
<br /> \5 - stmia -+eAlrrt_a�,rin*1 IvM,Akmss Sr+ ❑ Nn -jXr,;,� 'J _.-_ h' - -- .
<br /> -\Itth.d of sr:din>;� Cffi'16nr. U••r► .IarlrcS
<br /> f]t1) \VATF.Ii i L\ELS WE'LL DRILLER'S STATF.M:N•T:I n
<br /> ':?rpth nF Get wµtr+, if Inn+,Jr --• .--Ir- '77rir re'rf! r + rlrillr•ri r+rrrlrr R1,/ P 1 l:rrir.+ urf Nrlr-r1+ 1 k her"'1
<br /> 11Jr! I+nf mp i�
<br /> Standint• 1,s1 afire+calf enny,Jrti•r1_�. _. _jt knnulydr;.• ern! hrlir/• _
<br /> 111) «'I;LL TESTS: Sir.xru�-.��_�_
<br /> 55;,• w-.-0I Ir.t made? 1'e� \n S 11 rr., 1,. '01.... ------ -- P8ne pefi i) 11 r7 _
<br /> v'.rr r.t ir.t rem( a h,,il.'r❑ A" Ut is \.l\tE.-._� ro Well ��r.8, SLC. JJ
<br /> DJ 1Jh b, +.etre -nt-st n al eire1e. At cud I trq �_FJ -
<br /> j 1 3I4�0
<br /> :I)i,edlarcr___y 1/min aft, _fu.rv.
<br /> 1 -(7rrrnisal anuli•rs mode:' Ter `; \'n •, 1 ly uh••.__---.._T�--� Ca:v....__ u-rR�ru�.? -_—!p 7,.��J-��]//./L��y S__ r
<br /> t 55'r•riniri; L• ,.adr 1'r• {� \'. _ 1 :nt.0 1. •.p, I•.11.1 rb r%I•�lar \� �J _11.0r,4 Ihi ��i • - {
<br /> •rrlYlrt_ �
<br /> i
<br /> SWR 199 :Rev.1 7e, IF ADDITIONAL SPACE 1S NEEDED. USE NEXT CONSECUTIVELY NUMVERED FORM
<br /> IIB-6
<br />
|