Laserfiche WebLink
®PRCIN A� STATE OF CALIFORNIA Do not fill in' <br /> N THE RESOURCES AGENCY p' <br /> File with DWR DEPARTMENT OF WATER' RESOURCES No. 178135 <br /> r -of Intent No, WATER WELL DRILLERS REPORT State Well No, <br /> 1 'emit No.or Date_$5=5 3 8 other Well,,0.02504�23�3 <br /> (12) WELL LOG: Tom depth—4 0 Cft. Depth of completed well 3 3 0 ft. <br /> from ft. to ft. Formation (Describe by color, character, size or material) <br /> o -.1 Ton Sol 1 <br /> (2) LOCATION OF WELL (See instructions): 3 -7 C 1 d <br /> County San j()a Q 61 ice_ Owner's Well Number 7 -12 Sand <br /> t� <br /> Well address if different from above 15 5 2 9 R F 1)F N D 0 D R- Xe <br /> Township T R A C Y Range Sectio +� <br /> Distance from cities,roads, railroads,fences,etc. I 39 -65 C I a `\�+ <br /> n d \'>,��, <br /> south side 70 - -a-V N� <br /> �NLJ-p Cl <br /> (3) TYPE OF WORK: 205/212 BNu� Sand <br /> New Well EX Deepening ❑ 1 ~[1n Rliip r.-�at <br /> Reconstruction ❑ 240 -2�--�KFinp 40P Sand <br /> Reconditioning ❑ 5 8 <br /> _2 7 0 1 U <br /> �y <br /> Horizontal Well ❑ �,� — jj.�� �,O) <br /> DCAMCllen p (Describe `ti 4 -2 9 8 C <br /> destruction mntertuls �{ r� { / <br /> procedures in Ttem )� 2,y —2 7��\,S e l Sand C� >� <br /> (4) PROPOSED Tjk) ? 2 9 9 2 M,$ i n e S e t/A)S fikbb <br /> Domestic °T 31,940,Q��'Iay n <br /> Irrigation ❑� <br /> Industrial j ❑ <br /> T 't�Well ❑ <br /> -Bloc �L :�:• \�.`�� — /! ,:�.�1 <br /> Municipal,; <br /> WELL LOCATION SKETCII Other ❑ <br /> (5) EQUIPMENT: �(6) GRAV Ir L`,ACK: S(r?n�� R <br /> Rotary nJ Reverse ❑ r ley. l No Size h 1` �`, 41 <br /> Cable ❑ Air ❑ Dtniniter of bore �— <br /> Other ❑ Bucket ❑ <br /> (7) CASING INSTALLED-{( (8),PERFORA I �� <br /> Steel ❑ Plastic pl Coaq bte U'�, Type of pe erf"iaZ'an or size of acreen�!^t� <br /> From <br /> ft To \ ia. &jeLpFro1'>\ To o <br /> Wall ft. ft. aize <br /> 40 <br /> 200 <br /> �� <br /> ' — <br /> ti _ <br /> (9) <br /> WasqxcL rLea prov9a9:$ Yes�I No ❑ If yes, to depth 1 D <br /> . - <br /> Were strata scaled against pollution? Yes ❑ No ❑ Interval— ft. — <br /> Method of sealing "44—� Work started 2111 n P 5 19-8.-5-_ Completed-19— <br /> (10) <br /> ompleted19(10) WATER LEVELS- WELL DRILLER'S STATEMENT: <br /> Depth of first water, if known ft- This well was drilled under m1 i rI di-tion and this report is true to th est of ruy <br /> Standing ICveI after Well completion S 6 k, knowledge and belief. <br /> (11) WELL TESTS- SIGNY--]D- <br /> Was <br /> Type well <br /> test made? Pump Q No,[� if yes, by whom? Air ITEC❑ (Well Driller) <br /> }( NAME HENNINGS BROS . DRILLING CAI INC . <br /> Ip, e 'I Person,firm,or corporation) (Typed or ria <br /> Depth to water at start of test ,Y� At test ft ( rP ) ( YP printed) <br /> UAddress, 352.5 PELANDALF AVE <br /> Discharga�al/min after hours Water tern rahtre' <br /> cal analysis made? Yes ❑ NoR,IE.yes, by whom? City H Q n F-�T n CA <br /> .electric lop'made? Yes ❑ No If yes, attach copy to this report I License No 2g 0 813 Date of this report 5 <br /> • DWR 188 (REv.7.76) IF ADDITIONAL.SPACE IS NEEDED. USE NEXT CONSECUTIVELY NUMBERED FORM <br />