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JUit 1 4 1666 _ <br />'ORIGINAL ®PATER WELL (DRILLERS REPORT l Do Not Fill la <br /> File with OWB (Sect3om 7079,7040,7081,7062,Water Cade) <br /> THE RESOURCES AGENCY OF CALIFORNIA w 'A �" 44663 <br /> State well No 6�^f l Q 7E <br /> DEPARTMENT OF WATER RESOURCES , ` f <br /> Other Well No .::% 7 / <br /> aL1) OWNER "'` (11) WELL LOG: <br /> me Fred 1 arc e so TOW depth 220 ft Depth of completed well PPO it <br /> Address Rt. 3 BOX b25 Fortnanon Describe by rotor,character raze of material,acrd tirectere <br /> Stockton Calif® it to fl <br /> (z OCATION OF WELL: 160 — 1781 sand <br /> Coaety S ar_ <br /> Joaquin Owner s number A any 178 — 188 Erey c l E <br /> awarhlp R—ae and SecttaaT_ 7 ,.t 1 (92 brown e 1 a <br /> istanee n <br /> from etea roads railroads etc rl '+r 192 — 193 coarse wand <br /> r. 4_ 93 204 Frey Clay <br /> (3) TYPE OF WORK (check):,i 20 «- 216 b rc wn clay <br /> el{ ❑ Deepening M Reconditioning [3 Destroying ❑ `�� t' 220 loose br oVrn stand <br /> feole.'Iru,loon, <br /> describe material and procedure on Item 11 <br /> (4) PROPOSED USE (check). (S) EQUIPMENT: ' <br /> omestic ❑ Industrial ❑ Municipal ❑ Rot2ry ❑ <br /> rriganon [a Test Well ❑ Other ❑ Cable El <br /> Other ❑ <br /> kINGLE:Q <br /> 6) CASING INSTALLED <br /> EL <br /> STEOTHER If gravel packed <br /> DOUBLE ❑ <br />' Gage Diameter <br /> From To or of From To <br /> ft it Diem Wall Bore ft. ft <br /> n <br /> Sas of rhos or re!!nae • Size of Rra vel <br /> nerrbe cotnc put <br /> t7) PERFORATIONS OR SCREEN: <br /> ype of mfontsan or acme of screen <br /> Perf Rows <br /> From To per per Size <br /> ft ft row ft in x in <br /> VZ)-- <br /> ES) CONSTRUCTION <br /> ar a surface samary cal provided? Yes ❑ No ❑ To what depth ft <br /> Were any strata sealed against pollution? Yes 0 No❑ !f yea note depth of strata <br /> rom fr to it ('] <br /> tom ft to ft Work started 27 AIeM• plated J 29 <br /> Fm 6U- <br /> Method of sesltnot WELL DRILLER'S STATEMENT <br /> 9) WATER LEVELS, This well was drilled under my Iarrsdtctson and this report is true to the best <br /> of my knowledge and belief <br /> epth at which water was firs, found Lf known 61F frMik �,.,.,,,, T <br /> L <br /> candrag level before perforating +f known ft NAME J o m e Pare ro Jr e <br /> Standen level after r(oratinp and derdopen [s (Perron,firm or corpormoe) (T d or prretrd) <br /> Lmade <br /> WELLTESTS: Addres,Rt. 3 Box 805_? Yea ���❑ No ❑ If pia 67 whom? � <br /> :al)mti+ with it drswdora after bn rsIGNED] <br /> lemptrawrt of weer Waa a chemical•nalyus ma (Well Drifter)de? Yar El © ' /r14 <br /> 1a electric[Ott made of well? yes License No 120724 --Dated - --- T <br /> ❑ Ne ❑ Ir re+ aruch co 7 April-2,-_a_. , 19 {C]6 <br /> SKETCH LOCATION OF WELL.ONE REVERSE SIDE 1 <br />�4WR 1 fie a Rev o est 08291 000 10 05 0011 Tate V ZSoa► <br />