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<br /> QUADRUPLICATE
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<br /> STATE OF CALI TORNIA Do not(Q in
<br /> loco(YCilulrementE THE RESOURCES AGENCY {M�• 20 1 "�
<br /> iDEPARTMENT OF WATER RESOURCES 8
<br /> <L<d Inlenl N,.._ 135313 NATER WELL DRILLERS REPORT
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<br /> I 1 1) OWNER: sn.„< Geer.- r.,_- .. •T... (1°) WELL LOG: Tnbu d<n, Cn u.Depth m e m,akled 1 rt.
<br /> 4. Zvi- Nett ;eerCiz�ai'.:£ tm ' Yw-
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<br /> r ny_ a6B£1i8Eir L - �'r�'P33 r
<br /> ^ i (3) LOCATION' OF WELL (See inanrdiolLS): Be- 92
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<br /> Son a9oaquin-0......W<n Sa,nmrr __ = 2 E2IL� 4 S QC1 V, 3 4iits dies
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<br /> (3) TYPE OF WORK: -
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<br /> � I (4) PROPOSED USE: -
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<br /> .� F IDJu.Wnl =' • - inatstllottl nn thin cYell and
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<br /> WELL LOCATION SKCT(:11 Olher C I -
<br /> (S) EQUIPMENT, (6) GRAVEL PACK: _�
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<br /> ' 1:1 CASING IKSTALLED:. lal PENF'OAATIORS:
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<br /> Fmm TD Dia. Gihe Dr From T. Slot
<br /> It It. size -
<br /> (9) WELL SEAL: -
<br /> W., auda<r cannon '-d r n•ij-le Sr•rl S..)r II
<br /> \1'rrt ,Nam ara Lel A,mme rv.liun.m. Sr. $.,{�� let•T:.I________n_ I __ -
<br /> "• t101 WATER LEVELS! I U'ELL DRIL.LER'S 5'f.ATEmL.N-r
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<br /> .r (11) WELL TF.S'La: ,. „•r.. .....
<br /> 'r.�l.r�a rr`r r�,,,.,, �':• � - .-” _. ��76�,51b'_£.6.•;•„P3.S.r,SeR�+.rL�J.oTai_ISIG%._ .
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<br /> NSECUTIVELY NUMDEHED FORM
<br /> IF ADDITIONAL SPACE IS NEEDED, U-51� NEXT CO
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