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7GkIADRU-PLICATE �—GCO'
<br /> 1� til b 198 Do not fill in
<br /> locall r comply with i j1y .�ESOU ROES AGENCY
<br /> local rogl.irements l jt4FF.TTJJT OF WATER RESOURCES
<br /> ped I
<br /> No. 128667
<br /> 5 NEp VATER WELL DRILLERS REPORT
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<br /> Lcd 14nnit Sn.m Dme
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<br /> (]) OWNER: X.mr Frank Machado (12) WELL LOC: nxni dr /��
<br /> P,h • /n.Drum of nm.vlrr.a
<br /> 22 331 S. U on Ave* mm, ft. I. ft. Fnnn.Hnn In me by ml.n, rha u,er. ar n mrt"'o'
<br /> Add.r_. - Sandy s
<br /> (:h), n eCaS a• •iP_- 2 C7�7
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<br /> 2)o LO�Ae'hIO OF�V LL (Stt•�MtniCtiaHS): _ - 6 $ nd
<br /> 9 wrR.nmh.. I 2 Cla
<br /> Wrll uddn++if dinvmnt fnm+alxrce Sa
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<br /> Ui>U.x'e Inm+ritie>.nmda,
<br /> Perrin roiln..Jx, e
<br /> south of Ave. ens s •
<br /> SO
<br /> I (3) TYPE OF WORK
<br /> Sex Hell= Ihmentne❑
<br /> 14a.•nrtmNmn CO3
<br /> dnaNainn frltanl1 ord _ .;.\ �.t.
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<br /> (4) PROPOSED OSE: `•1
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<br /> WEU. LOCATION SKETCII `% (kher ❑
<br /> IS) EQUIPSIE]T. B) GRAVEL`Y'ACK. b 0
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<br /> I• C.h4 ❑ At, ❑ \e�,er nl lio,
<br /> Other ❑ Rnrket ❑ Pu\WYrvm+ n,- ... •,i
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<br /> 101 CASING 1]SCALLED:/(\''._ (X) PERF`OR`IO\S:
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<br /> Fmnt To Dia. Qw0 Fto�� ✓ Tfo \��Y2)
<br /> ft. f iin. Wall Ft: t.
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<br /> (g) WELL SEAL:
<br /> \C.r n.d.ce aann.ry and PmridN? I'm[�• Au G If yrr,h.
<br /> \Tem >erot. ceded .a.ml txdh;linn? 1'e.❑ Xn u In4rva1 \Ynh amnm � IB Cn•nnlmd IB_
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<br /> WELL De1LSTATEMENT:
<br /> (10) PATER LEVELS: 11hit II ca dirdW AM,, At, indaJini .
<br /> nd ,h4 rcm.rt i• In•e In tAr Mn of my
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<br /> i xuWine hvd doer ,,II I,00,o r� // f .1IPJ.
<br /> Smstn__ (yell Drilled r'
<br /> j W., :I jiA TESTS. 1
<br /> ,,. B y . by .+ m,? Heaainaa Bros DllllinR Co..IIIc.
<br /> Ti aril ,t mMr? Pont,C tlader❑ Air lilt ❑ \A\iF
<br /> T)re ni le.t mp G d ..1 1.1 H '4tr I%V&
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<br /> • .d ,a 7 ���da 16 Ate•
<br /> Ih'J+ar,:e a.l/min .ler hnnn Wm
<br /> ait ,rPrmnR Add. -4525
<br /> Ira• T.n 9n5U
<br /> n, by nh:m,? CHy' Modesto
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<br /> L..m•AAI avly'n made? Yea G ]n 11 y Liren'No��)I Date.d Chi.ntn
<br /> R'a.rkatdr 4a male? )'m G No[Z 11•n,aH.,cM1.v.ry In Ihi• .rlx.rt
<br /> DWR tee tPrv.+rl, IF ADDITIONAL SPA CE IS NEEDED. USE NEXT CONSECUTIVELY NUMBERED FORM
<br /> E®ROD UST 101'
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