Laserfiche WebLink
.� <br /> STATE OF CALIFORNIA <br /> QUADRUPLICATE THE RESOURCES AGENCY 00 nol fill in <br /> Use to comply With DEPARTMENT OF WATER RESOURCES <br /> local requirements WATER WELL DRILLERS REPORT No. 270831 <br /> Notice of Intent No State Well No. <br /> Local Permit Na or Date Other Well No. <br /> (1) OWNER: Name &XIM I16im (12) WELL LOG: Total depth_715 ft.Completed depth ft. <br /> Address 24900 Sowlep Rd from ft to ft. Formation(Describe by color,character,size or material) <br /> City Acampo ZIP <br /> (2) LOCATION OF WELL (See instructions): r . <br /> County San 10—a}tdn Owner's Well Number <br /> Well address if different from above As — <br /> Township—4N Range ZE Section 77 — ` r G <br /> Distance from cities,roads•railroads,fences,etc. — w w RarA sitphtly -Qgt: of hogo 35 ft and about 150 - 156 1— w <br /> m <br /> n — <br /> P'xz z d ive . il o site underwocle 172 - 175 <br /> ltr (3) TYPE OF WORK: 17C. — <br /> N New Well I$ Deepening ❑ IA3 _ R ]tv rla3E <br /> Reconstruction El I RA AM hritlla tiny <br /> Reconditioning ❑ R <br /> Horizontal Well ❑ _ <br /> Destruction ❑ (Describe <br /> destruction materials and pro- <br /> cedures in Item 12) <br /> (4) PROPOSED U -JV�gcla� With Same <br /> V Domestic _ <br /> r <br /> Irrigation <br /> a Industrial ❑ _ <br /> Test Well O ❑ <br /> Municl ❑ _ 0 <br /> I er <br /> Oil,' WELL LOCATION SKETCH 16e) — <br /> (5) EQUIPMENT: CRA CK: <br /> Rotary ❑ Reverse E] No S <br /> Cable Air E] ' met of bore <br /> Other ❑ Buck a ed from <br /> (7) CASING INSTALLED: (8) PE AT <br /> Steel ❑ Plastic ❑ e ❑ Ty d ion oss ze — <br /> From o D' Gage or of <br /> ft. Wall size — <br /> (9) WELL SEAL: — <br /> Was surface sanitaryseal provided? Yes fk No ❑ If yes,to depth ft — <br /> Werestratasealedagairutpollution? Ya 4 No ❑ Interval ft <br /> Method of sealing Workstarted 19_ Completed 17 19117— <br /> (10) WATER LEVELS: WELL DRILLER'S STATEMENT: <br /> Depth of first water,if known ft. <br /> Standing level after well completion ft This well uws 7d under m /urisdict{on and this report is true to the <br /> B P I: Gest of my M dge and belie <br /> (11) WELL TESTS: S;gn� �rt�h •< --�(1//' <br /> Was well test made? Yes ❑ No Ej If yes,by whom? (Well Driller) <br /> Type of test Pomp ❑ Bailer ❑ Airlift ❑ NA E =Soar MW Ttri]]i <br /> Depth to water at start of tea_ft At end of tea ft ����s (Pearson,firm,or mrpomtion)(7"yped or Printed) <br /> Discharge gal/min after hours Water temperature Address /.s A7 F. TAya Oak nr1 <br /> Chemical analyte made? Yes ❑ No ❑ If yes,by whom? City I;U��?4IR ZIP 95249 <br /> Was electric Mg made Yes ❑ No ❑ If yes,attach copy to this report License No. 1Q1 5 AP Date of this report <br /> DWR 1851REV. 12HMI IF ADDITIONAL SPACE IS NEEDED. USE NE)rr CONSECUTIVELY NUMBERED FORM 86 M55 <br />