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IRIGINAL STATE OF CALIFORNIA Do not fill in <br /> THE RESOURCES AGENCY <br /> le withDWR DEPARTMENT OF WATER RESOURCES No. 120344 <br /> Intent No WATER WELL DRILLERS REPORT state Wen No <br />... rmu No or Date Other Well No <br /> OWNER Name (12) WELL LOG Total depth 265 ft Depth of completed wen 2C 56 ft <br /> I-ddres from ft. to ft Formation (Describe by color, character sue or material) <br /> ty— ,e,eke f-GV d,--Ga�• -€� z(p 0 - 1 T o Soil <br /> Iay <br /> 1) LOCATION OF WELL (See mstmctlons) - 15 Sand Brr1. c <br />:onnty $a4} joaquin Owners Well Number 15 - 55 Med. bro • clay <br /> ell address if different from above 55 - 70 Small\roc C ay <br /> iwnship T4N Y Rang echo 36 76 = 83 Me r v�C a <br /> 90 Sistance from cities roads railroads fences etc Approx. mi ' $3 aI1 y <br /> ntersection,/ Approx. 90 - Q w <br /> - brit. cial <br /> clue Rd. ig 5 - e <br /> cietY <br /> (3) TYPE OF WORK bri ' <br /> J/ �\� <br /> New Well X Deepening ❑ 11 U <br /> Reconstruchon ❑ .\� <br /> Reconditioning ❑ - <br /> - <br /> Horizontal Wel! ❑ 2 <br /> :r58 Sandy brn. eIaY <br /> 158 t63 E)qse <br /> Destrucuon ❑ (Describe = - - <br /> destruction materials and <br /> 473 elay <br /> procedures in Item 12) - <br /> (4) PROPOSED USE - <br /> Domesnc 'jEK 100 1:19 i soft britt. brn- clay <br /> - <br /> Irrigation ❑ - - ' <br /> Industrial ❑ - <br /> Test Well ❑ 20 3 _ , <br /> Stock ❑ <br /> Municipal ❑ - <br /> WELL LOCATION SKETCH Other - ❑ I <br /> S) EQUIPMENT (6) GRAVEL PACK w 1 <br /> Rotary ❑ Reverse ❑ Yes ❑ No ❑ Size 256 - dark b n• sand <br /> ihle x Air ❑ Di.uaeter of bore 297 - clay Sum <br /> Itier ❑ Bucket ❑ Packed from Mit - <br /> ,) CASING INSTALLED (S) PERFORATIONS - - <br /> Steel Qr Plague ❑ Concrete ❑ Type of perforation or size of screen - <br /> Froin TODta Gage-or From To Slot <br /> ft ft - In Wall ft - ft. Sze - <br /> tt 1 C a a <br /> a <br />(9) WELL SEAL - <br /> CI <br /> as surface sanitary seal provideda Yes No ElIf yes to depth —ftere strata seated against polluhon" I es No X Interval _ ft <br /> eth,A of seaLn 2 t0 1 ran Work start - 19 Completed 19 <br /> (10) WATER LEVELS WELL DRILLER'S STATEME T <br /> epth of first water, if known 90 -ft Thrs well �F'11!ea ander my pt action d this report is true to the best of my <br /> randing level after well completion a4 _ft knau.lede ler <br /> (11) WELL TESTS SIG\ED <br /> �Ivqs well test m ides Yes ❑ No ❑ If yes by whom° (Well Driller i <br />[Dev-ptliofto,ype testPump CDBailer C3Air lift ❑ N-kM i •� Irri Inc • <br /> water tt start of test ft At end of test—ft (Person4 firm or corporation) (TypeJ or printed) <br /> Ie. �al/min afte -hours Water tempera M l <br /> Tr— p CD 2 37 <br /> City <br /> 1, analysis made? Yes C No ❑ If yes, by whom <br /> ?? Apr• 20 r 1987/ <br /> W s electric log madea y� ❑ No ❑ if.es lttach copy to this report License No. 777491 _ nate of this report <br /> DWR 188 (REV 7 7e) IF ADDITIONAL SPACE IS NEEDED USE NEXT CONSECUTIVELY NUMBERED FORM <br />