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Do Not Fill Ix <br /> STATE OF CALIFORNIA <br /> LL THE RESOURCES AGENCY <br /> OlfO1NAL <br /> File with DWR DEPARTMENT OF WATER RESOURCES N� 115166 <br /> WATER WELL DRILLERS REPORT Stafe Well No <br /> ClAer Wee No.-7-4----9-8-7--W— <br /> (1) <br /> o.74"5x7W(I) OWNER: (11) WELL LOG: <br /> Name John Dem i c hel i s Toul dwh 92 h. D1PIh of enm I...d rdl <br /> Address 17306 E. Avena Fo.m.don: Dnrribr by rotor,rbererfrr,8171 of Rdrr,d,.981 tN11et9rr <br /> Eecalon Calif. 95320 <br /> 4 <br /> (2) aLOCATION OF WELL: 2 121 sand <br /> Count an Joaquin if.ny 123 - 1 sand & Eravel <br /> Tar.hip )tante . ds«.ipn y-1-S R-8 Sec. 21 1361 0 brown clay <br /> Distance from cities,mis,rsilro.dl,.tcS0Uth tide. o a 1 0 - 152 brittle clay <br /> mile East of 1111m)hx 1 2 - 164 brown clay <br /> (3) TYPE OF WORK (check); 164 — coarse sand <br /> New Well ❑ Deepening $) Re:onditioning [l Destroying [] <br /> 172 brown clay ' <br /> `g ff dtils,,letfon,describe material and rocrdure in Item 11. 72 — 176 sand k <br /> (4) PROPOSED USE (check): (f) EQUIPMENT: 176 180 brown clay <br /> 0 1 brittle clay <br /> Domestics E3 Industrial ❑ Municipal E] Rotary El180 <br /> 283 br04m clayc <br /> Irrigation:E Test Well❑ Other ❑ Cable KI <br /> Other ❑ 2 296 brittle clay <br /> (6) CASING INSTALLED: 2 00 sand & ravel <br /> STEEL: oTtfex: If gravel packed 00 30 bro,,rn Cay <br /> +- �22 <br /> _ a2 brittle clay <br /> SINGLE DOUBLE❑ c <br /> — brown cla <br /> Gage Diameter — 3 .brittle els From 'Ib or of From To <br /> ft. k. Diem. Wall Bore ft, ft. 3 — 37'2 Pray:rsand . <br /> ]NtO <br /> 2 10 <br /> •a 10 12 <br /> e f� s <br /> sn of.hoe ur sell rinxs 1 2X X 8 Q 6DY .`�R <br /> 104—ibe win[ b'uttweld n <br /> (7) PERFORATIONS OR SCREED': 3 <br /> f <br /> Type of oerfoe:iun or name of screen <br /> A proper well seal was installed on is <br /> pelf. Rows i- <br /> From To per per Size well and I am not responsible for any <br /> rt. ft. rote ft. in.xin. -alterinp, or removing of the seal or. <br /> 12 FF 1 2 1-60 1/8x 1• casln <br /> " 10Tr 30 268 16x ? • <br /> 1 <br /> (8) CONSTRUCTION: y <br /> Wa.a_,face.Rimy u.!provided) Yes❑ �Io❑ To rh.t depth is. 1 <br /> Wnr any sl esu.riled.Rrir.rt pollution) Ye No❑ If yrs nou depth of rtnu <br /> from ft.to h. <br /> From ft.to ft. Work meted If "' ,Corpletrd 1 2—12 19 74 <br /> i WELL DRILLER'S STATEMENT: <br /> ftethod of.eGn <br /> 'i This we!l war drilled under my jatrisdiction and This report is trate to the best <br /> s (7) WATER LEVELS: o of my knowledge and belief. <br /> Up.h w which rner ear Ent fo—d,i(known 6o fs. <br /> Sundina Ir�s'd before ferfontfn(I <br /> NAME <br /> if known _ N. T ;�r�e 6r <br /> (Paw-n,, ro,or rorpornion) (TYNE or[1)47181) <br /> itandin level dsar r(ontin and developing ft. <br /> (10)-WELL TESTS: Address 11 V, <br /> F-0 <br /> Waspump.n[m.&? <br /> r <br /> $,. 1'iddt isldmie.with' ft,dnrdorn due hn. SIGNED f -. e% (�C� A <br /> (01-11 DrU1r) pr <br /> Tempeuturr of warr We'a chemic"analysis made? Yes❑ No❑ r a <br /> We'11...ric lot made o(.vdli�Yn _N.C1 - _- If Y. a.uch copy License No._._LG'.J 24 Dat a s 1974 Iri <br /> SKETCH LOCATION OF WELL ON REVERSE SIDE <br /> Y" <br /> 117199.7110 9.71 Was TRIP(Dr COP <br /> •y DWR 199 (Rrtv.9.461 <br /> ,rk ��,,,..:w.+---•_...�._... _... •- .. -r:.:.,.;ar:'itw:w.!.'.�15Gtd.�cYlyd'AaS1" <br />