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`" - Do Not.v:,In <br /> STATE OF CALIFORNIA �7 q C� Q Q p C <br /> E THE RESOURCES AGENCY <br /> Retain tDUPLIChis copy DEPARTMENT OF WATER RESOURCES 1\O 1 5 v 8-8 5 <br /> WATER WELL DRILLERS REPORT State Well No. <br /> Other Well No76-567W <br /> (1) OWNER: (11) WELL LOG: •`r <br /> Name <br /> Haven Acres River Club TnuldrDth 155 fr. Depth f DI ed.<n 135- <br /> Address 1691 W. Srewert Rd. - <br /> Lathrop, Calif. . 0-7 Sand soil ft. <br /> (2) LOCATION OF WELL: . cit{>s.: Blue sand <br /> OClay <br /> eSan Joaquin whO_ <br /> - <br /> T..n<hw.Kan-,.end Secdor, not available Sand <br /> Din a frome;,m<.mad,,railrmds. 1 1 W. Frewert Rd. Clay i - <br /> lIlbst of 1 5 .—near river 92-95 X1XX Sand <br /> (3) TYPE OF WORK (check): Clay <br /> New Well X] Deepening ❑ Reconditioning ❑ Destroying ❑ Fine ne Sand <br /> if destruction,describe material and procedure in Item 11. Blue Cita <br /> (4) PROPOSED USE (check): (f) EQUIPMENT: <br /> Domestic ® Industrial ❑ Municipal ❑ Rotary P' ps <br /> Irrigation ❑ Test Well ❑ Other ❑ Cable ❑ " <br /> Other ❑ <br /> (6) CASING INSTALLED: <br /> STEEL- OTHER: <br /> If gravel packed <br /> SINGLE E) DOLIBLE0 PIRSMID <br /> Guge Diameter <br /> From '1'0 or of From To <br /> fs. it. Diam. Wall Bore ft. ft. <br /> 1 OV 12 1 100 1 135 <br /> Sue of,hos or.ell dna: Size of aurel: pea <br /> Drrcribr ioint <br /> ill tied <br /> (7) PERFORATIONS OR SCREEN: <br /> TYD<.f,crt....i...r..menf.r«. D a ic screen <br /> Nrf. Rows <br /> From To per per Size <br /> L. ft. row. ft. in.z in. <br /> 12n 135 <br /> (8) CONSTRUCTION: <br /> V.,a.udace unhaq..I provided? Ye, EX k. (3 To h.,d.D,h 51& ft. <br /> Were,rte suata scaled aaainar pollution? Ye:❑ No D 1f yes.note depth of strata <br /> From ft.to R. <br /> From ft.to L. work... , 76 <br /> tapkud 19 <br /> hl<.hod or V.Pmpnt, WELL DRILLER'S STATEMENT: <br /> (9) WATER LEWLS: This will furs drilled under my pfirdiction and tbis report is true to the best <br /> of my 4w(wdrdge and belief. <br /> Depth at which i.a¢i Las�ii� fauad,it hnnwn a. <br /> gundins level ``el h f rl:a �.i:;f knn.e ft. - xAME s Bros DrillingCo. Inc. <br /> Sundin d .(vleneT-' rforutoa and devdo in ft, (Person,Sr.,or mre.attoo) (Typed or panted) , <br /> (10) WELL TESTS- Address Rumble Rd. <br /> Wa,pump t.[made? Yu o N i ` If r .b;.Isom? - - Calif.. 0 <br /> Yield: Kiri Ital.lorin.with ft.dra:do. f.r hrs 'ISlesaw]- 9!. - <br /> Tem '�i,achemieal a nal d0 Ya ❑ No <br /> paruure of.,E<r if'":.e . ;..� . r,ia m, <br /> Vu <br /> Its. wdl? Yeo p., Nn " If>n,much coDY License No 29083 Dated- 9-17 11976 <br /> SKETCH LOCATION OF WELL ON REVERSE SIDE <br /> DwR 188 (n[v. 9.66, •ass wR•.o ,Or ba. <br />