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SYAtE OF CALIFORNIA - DO piOBy in
<br /> ~ THE RESOURCES AGENCYxF 4
<br /> is DEPARTMENT OF WATER RESOURCES No. 1 "V0a�,"y'
<br /> �.. _ WATER WELL DRILLERS REPORT ,tH:e.•e11�:,. �
<br /> .,+.or Date .J_G.�.3-- Other l\'cll\o.—�„_•_,. ,.
<br /> \une-T.> S � fifi MtI1._ (12). WELL .LUG: 'r.�,:ri s1eS�th3.3..�FL. Depth 111 C—Plrtr l wellJ.
<br /> 7Ri
<br /> _1 ax f form.ft. t.. ft. F•.:mutism !I]c.rriLe by wlof, ch�mvf r. size hr radcHdll �.
<br /> 4 -25 Clay
<br /> OF,WELL (5 a instnlctiarls): - (t..t Air w 3
<br /> rt- Dwnees\vr31 Number It el -34
<br /> 6�� i
<br /> )runs above
<br /> lianue'.'. sectio,. - - �,
<br /> -
<br /> rends raiironds,fences, t,._t,t,.c h tltp�q _ -Al
<br /> } I
<br /> .� Art
<br /> -1),_TYPE OF'WORK.:
<br /> how:Weil X] DeePenmP❑ . r
<br /> pr 7y r
<br /> Rrmrnditioning
<br /> - e -
<br /> ltar{Yantal We[I': ❑ •. 'ter - :�./!- -'� :.
<br /> Destrucdan❑ (Descnf a YSI{f Rs� - --
<br /> destruction
<br /> penoedutes in
<br /> i4-.P4[OPOSED US_ii: 7,
<br /> Domestic t..1`.'• , �" y<,
<br />! Terfltatinn� ❑
<br /> Well
<br /> r, Mupklpltl� -
<br /> ... LQCATTC+N SKETCH - - Other". . `f.'•• Q -
<br /> , Nevrrse ❑
<br /> i Air ❑ tstbter cf bore - rr
<br /> - i !�. • -: y�-.,�{r{J� �-� Vie.� / - - -.. �";.:
<br /> kuckbt ❑ td�t�-(som ��-r"-:--F'V-` ' � .;
<br /> 1-;gTALT.EI] :[B) FEPJ•'ORA`Fl` r r
<br /> ...i:c Co' 'T}'t�of ~ n or of scree X. \: " t a
<br /> "- $dk r
<br /> o Dia. Ca.�r gratrl~ "." J
<br /> ^� i 1.e •-
<br /> .
<br /> e
<br /> s�
<br /> Wall' ft: .f... - —
<br /> t
<br /> •1
<br /> C
<br /> N Lt�lV1 t'rr
<br /> ,1.5..E 3$.E4ti
<br /> ..•. � L�?
<br /> ,.,:nry xal Pmvtde2' Yeas' _ NO ❑ Tf yes;M
<br /> �ralcd a4ainat pollution?
<br /> Ya- 0 No
<br /> 'Work stamdi+
<br /> WELL DRILLER'S STATEMENTa
<br /> i know •••ft• This cacti uva4 driiie&fndrr ml turf-diction and this report is-cto iha beet r¢miI ,.�
<br /> `' r - ft• knowledge and belief.
<br /> (Well Driller)
<br /> .Yes ❑ No .If Ser. by
<br /> Pump❑ Railer(] - A r lift❑ ]tiAME:•.
<br /> i (Ponon,ffmr,or rPnrntienn) (T or Printed)
<br /> „ft, at an't f-test_. —ft. At and of test—ft - . . "
<br /> Address
<br /> mal rola:"alter ours WateT tempera s
<br /> If Yes. bY «Itorrtd Zi
<br /> a made? 'Ybs ❑ Nob
<br /> Yn IJ N If ycs.uttneh rnPY to this reMrrt ` License No y;Data of this mpa
<br /> 'ns iF ADDITIONAL SPACE.IS NE£l]EG. USE .y EXT CONSECUTIVELY NUMBERED FORM
<br /> ,x
<br /> ' 'i,..."'_'_'^ rT•�"c"'" y�� �-y,.. ` }E-.. _{�"}' Yfi' �`Y ��7i��,�` �_.�)3".i£�"x ''�e '�J r� sy�,�s:,,'f f _, �.f� ['
<br /> h c _ �' x4� .s�r' .. K��4eti _- $;� n- r,. ��e� '` f � r �' rz_'�•�� �y,•x �
<br /> sK '-..c Y K y r`ti.y,:-. ,.ted, .� � r s�i,ti�k '"�•,st v�..r„-„
<br /> -f. u.--e, 2': -i.v”_._ ••:;7.�'. .�,, „t,,•
<br /> .rc... � � r .;� 4�.f`:C �ti •.�..i': ,r � �.. t+,.: .Srf,.,e'Y k.-, ��x -fi-t - � �
<br /> ���, ..• 1' �..' � ( �. S �+e. ;h y '�1' _4 �:.L ��'3`'"`'�`` �b A T F�"� ���� .-..t"�.e -r�#k �s,t.��a k_ � .� '
<br /> .'.�'r Y-ii�. �'�x w._ .. ,� �., ax�'�.•'...2r,.�5�;.{"r..d`..:v„x,,�_`�S��fA mgr :�_'.-�?f.'t:•ri'd r,£'rl��y xa� '''lc. s�..:
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