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f <br /> f <br /> 7 <br /> QUADRUPUCAII STAT[OF CALIFORNIA -' <br /> US*to comply with DO not r711 1'A <br /> Irements THE RESOURCES AGENCY Q i c <br /> _ DEPARTMENT OF WATER RESOURCES ' N0. 129431 a . <br /> irhotica of Intent N 810 <br /> L� WATER.I WELL DRILLERS REPORT State Well xa <br /> •.Loral Permit No:isr <br /> . <br /> /L+` Other Well No., <br /> r O-)-OWN Cehatal <br /> "1e 12 WELL LOG: <br /> Add <br /> '27% • Totil depth rt.Depth of completed wrel�ft._y y i <br /> Y fn+m ft. to it. �rmnti6n (Dear y minr, character, size nr mahHall <br /> City •- <br /> 5 <br /> `} <br /> LL (See instructions): L <br /> H'r Cw.urdy Owner's Stell Number - �'- �;'• <br /> bb •*+*.- W_ell addre_ss If 4 <br /> .Lj Ttromav .r.r <br /> R ' <br /> 1k .T.rmbip - --ty� pnp�nR�e7tjs - Section' <br /> V. <br /> -��- <br /> � 1 � {a) TYPE OF WORK: :y <br /> `' 'l New Wen SS { <br /> LT'Deepening <br /> T , y�' RR'nnrtnretlnn - '❑ _. p2 <br /> s ,y i 1' - Reconditioning <br /> y' "� I f ❑ ck 7kµ <br /> Hnrizmttnl 1Ye11 <br /> 0 - •.t tb1'i " '. <br /> r <br /> Dnlnretian[:]',(Der <br /> �• :� - - _ <br /> • � ° � L f V,Y' dMructirm maws <br /> procedures in Item <br /> f4)'.PROPOSED_U s:.w.. - , <br /> Nt y x :�et#.h. <br /> DIrrEmltaetrioc <br /> � <br /> sn, nanlIndurt .. <br /> :O _❑ _ <br /> •`,�v?.+ 2•r$K'k.v'+:�m+ <br /> n+� <br /> '3 �� + r_ , � ��_ f T Welt ❑ 'f: v t�>"�"S;'ihy,;.t+� � <br /> } ti r't✓ 1 i +� J i�rl tY� it <br /> SIM 24 <br /> WELL LOCATIOWSIMTCH. . Other ❑ ` <br /> = C <br /> t (b) EQUIPM$NTI (6) 11 <br /> 7. <br /> CAAYBL\PACK <br /> s � - ';::�".� ,.t?,`,.'. •,h{r�<'.,++3;�n;r� _ <br /> 't RMary ❑:: Aevene t] ❑ No .51 �'' <br /> s L <br /> a ffi :Air ❑ r of box <br /> b1 <br /> urs.Ot6er <br /> _0 Bucket ❑.:.� yam- -rr--t'- , .-�., Q�1�' �1/'. - f, <br /> ,�`{7) CABINC INSTALLEOt -(8).PERPORATIt/18 � an � as. .�!M <br /> K, 'Steel `'?Istria{] Co a Tyne n(pe <br /> or <br /> �fze of scteetL' �' Or..-..�' <br /> F1' •To D{a C.a r e <br /> F V To � Q �. �t3/ • . si/ r r w ..tic ti �,w �?}S. <br /> ft. ��• '> a a, �:,�. ..r' �Gk�k'�� <br /> G ° 77 WMIM <br /> k s (9) WELL SEALS <br /> ;� War 1pteaee'aa9afla real rovlded? Yea No r ��� � • <br /> b v ❑ �'�1f yes,to drptl�:.�t. <br /> ' fWeni'L Strata`'.roafed arainst-pollution? -Yes❑ No 9 Interval. IL' <br /> r1'kt1'Melhod'af'. ,: wnrlc started_ _19 Cemplet 19 - �," <br /> (IQ):WATER•LEVELSr _WELL DRILLERS STATEMENT:`f / = �° <br /> .:.me.•irk ft. _ !. F <br /> This lecli uwe drilled under mV IurfrdlaNprt and thin. rrue to 9he'6safso/m +f <br /> :Stfndiaa level after well camPlrlia �F, kuou'lydite and-bellaJ. ft r� y� t, �,:�Fx� 1 <br /> WELL'TESTSI Slcsv '.;ftf(' '.'' y' �� fr y -Y�rl,r, <br /> f, {Vu vreR test made? Ya-❑ Nn '.H yes. by.whom? a•��iW ,. z�l' <br /> 'Type of tese-. .,.Pump ❑ .. --'Bailer❑ Air lift Ej <br /> NAM -, r <br /> S SDepth to water`at stair of t.•t _ft. At end of int -fl 3143W Zom �'Zti�6�L(�O°`�adrtea) <br /> Dlrehar/e�„_ltal/min L <br /> after_ sours Water tempera Addrn i7�. <br /> yT Chendcal analysis madr? Yes ❑ f'-No❑ If Yes. by-=-I i(�tY --- [i e. ` - •�'� <� _ <br /> Zr.. <br /> 6. <br /> 'Wog eloctrlc Ing made? ^Yes -No Elrs,If aaltah err } <br /> } GWR tea (aev s se!' IF ADDITIONAL$PAC NEEDED. US T ECUTIVELY NUMBERED <br /> J�1N 2X98. 4 r <br /> r ^ <br /> hf SAN JOAQUIN LOCAL R''" <br /> 14EALTH DISTRICT <br />