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i ¢ FQOADRUPLICATE�' 1� _
<br /> jS •u�:+0 OORIp'y/ I 1 �-�j OF CAUFORN14
<br /> ' f �UN 7 RESOURCES AGENCY `� ,DO flOj �i
<br /> local rsqulrem4,ts
<br /> DEPARTME �t 4 c!�
<br /> TATER RESOURCES
<br /> No. 100
<br /> Netloe or Infect Ao ` - . .
<br /> _�-r �K�T I�LLRRS REPORT tiTr�
<br /> 'I.otial P�mtit NIP, or bete 7� -��Q- ���L' - Statr Weil N
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<br /> 7 _ Other Wdl No. ¢ ��
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<br /> 's (1) OWNER xonee j /X E.s� R A)u V S. I2 ;
<br /> Addy IUE/l1 A ) WELL
<br /> LOG: Trtal depta�`i 3 It.Dep'et of cmiplrted
<br /> �.`. _"... - fn,m It. to k. FnrmaHnn (Dercritx
<br /> City �'iC RL �L1... f}LJr- r' hr mlor, rhaiattte. riu r tnater4f)
<br /> ,'sit
<br /> (2) A' ION:.OF,WELL'-
<br /> ins#ruMiotts): ir.;r? f�,/,..r.r ! r
<br /> 1`ht..Crwn ! {t.rN - Ownrrr,-�tY�e.II Number
<br /> {Sec -." _ �:C f i�y11r/r r,• '' a' {J
<br /> r We111s addms'Ff dieerent!rom aboNr�{�I.?1 t� lw� r.- C.yl.•;rh„� _ %,� 7 , .J t
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<br /> Rr TotrrtsltiP - ISr• �Y rr` /°jr:L eJ "h JY L/CG 7- `
<br /> Sectio
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<br /> 1-k At
<br /> .,fs'rv��rv- 5. !': //f. •+� .�.hY. ^r-r. t'•�..%1l rrr.G..-.- �f r..,.�t�Y
<br /> :a .Ptd }r'• ) a �{
<br /> OF WORK:
<br /> _t `Y�, ;•ate." - t '/�l, Neu• Wel1,g
<br /> s
<br /> AemeutnrrHnn Q }-
<br /> 5'. L: _ - Recatimiitt, -`s-
<br /> y Y zu ndlr x
<br /> 1 15 a'r -n...,: -Hnnzuntal.Well ❑• ��� t"t '+F'ti'C
<br /> DctttuWon [I (Deacnbe e _
<br /> r s derttueti(m materiels
<br /> prnenm aiuin
<br /> (4) PROPOSED
<br /> -
<br /> z LX} .Nr`I �r I it r�r a AfJf r a 1+4 i r:
<br /> 4 �.., .y- -, , frrittaHrm
<br /> - er E
<br /> ` k ludmtrinl 13
<br /> �x
<br /> ti ti� al 5 r Well Murdv >, .❑ � -- .-�'•I -::Yr, rl.lt-: l.'l//t -. .-Sti v:1
<br /> 17
<br /> i
<br /> WFLL LOCATION SYETCII Other ❑ j 1 - .rJi(i lX/':tr�„7t %.K•I:r.•.ri�:ilrG y f "' !,
<br /> t{S) EQifIPMTiNTs (8)'.CRA PACK:sh—
<br /> SC,
<br /> _ .-S�'•_�xtr.�rC�t.�..•` - 'r' -`�"jtl�-"a,��e t
<br /> 't„ ;,( �- Q ` Alt - ❑. r of bore
<br /> TOlMer,Y p '.-.: - •biic),et -❑.-. rom,
<br /> t.r 'fir ,G
<br /> 4 6fea 91 Pltutic❑ Type of
<br /> R.
<br /> (9J WQ.L SErLLt t = i
<br /> i„V,Wat w�faw aaaitarY aeal P'aridea7 Yn ❑{ Nfl'L7.:If Yn.M deM�- [t. _ ...r
<br /> r q,r til
<br /> a �Wtrta strata .salad aYainst
<br /> pol Yea �• erval�,_,�t, - -' '�
<br /> Y ( ll utinaQ
<br /> 5$
<br /> Work ttartrd..
<br /> {lo> Ws1>�R:LEvLst x :` r
<br /> Depthi'd"er.t-.rater ir'mo�a- s WELL DRILLERSSTATEMENT .: r st yh�""crd i
<br /> .7K Thin well.u�as drilled under mi,'her6dlcHr•n and t7rk n 6 r7ft,the belt
<br /> ,yta�'Stwbdintr-Istel aper waU�anletMr: - ft. rnntcledrrr end bdirl• .. r. , vj;jv - 7
<br /> -
<br /> 1°{11),WELL TESTSI �` SrcN(ta
<br /> St Wu weU-tett'madeP -"Yer�li - ]vn❑ !f;.er whom' liGi� �Vrll griller)
<br /> �iType of lett -Fnmp{_rr, -9eilei [..)r _ All lift❑ 1{ -V"4'
<br /> i;..
<br /> NA111E'��/ . ! Y :�c'.. lig. 4Cr'�rr r�:�l/• •.�� r
<br /> .y Depth frowNer at start of ir% �'*_,�N At rod of tett ,k (Fm. lirm rco
<br /> t
<br /> v •3,. 1 rpnnttion) (7�'Pt'd err print
<br /> ad) u - t'�t.• ■.;,
<br /> I/rola att,r r' hnun NVatrr tmpem Add,, :1 �l 2
<br /> - t Cheroloa)-aealYtbirtudei 'Yet No',,..tr--'if yes. by whom._ City
<br /> `
<br /> ❑ - LJ' ...
<br /> etaiKr lnit madeP Ya N. If yvs,-attach ropy to this re rt LEeetue No
<br /> ata of this -
<br /> awA taa ctav sn 1R ADDITIONAL.SPACE IS NEEDED. USE NEXT CONSECUTIVELY NUMBERED FORM
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