Laserfiche WebLink
9 <br /> I+1 <br /> 3rATtt Ore CALIpapp A <br /> ORIGINAL TME "NSOURCEs AWNCY <br /> He with DWR DEPARTMENT OF WATER RESOURCES Do 1101 fill to <br /> iV�xicr of intWATER WELL DRILLERS REPORT No. 29060 <br /> ff ent Nm <br /> i t oCal Parmit Na or Date State Well Na <br /> (l) OWNER: Name - Other Wel!Na <br /> h Address 02) WELL LOC; i'etal depth 202 ft.Completed de h <br /> 1j <br /> City ZIP from ft. Pt —�_ft. <br /> 1 to Ft Formalino(f rihr by calor,character,size or material) <br /> (2) LOCATION OF WELL(See instructions): <br /> r County wlk s7Qa �l] <br /> Well address If different from abevn r Owner'sto Well Number <br /> tt <br /> Towmhip I3ante ✓ Ran e <br />[ g <br /> 06tanlY festa"cities,roads,railroa11,315111 <br /> Section _ <br /> ds,fences,etc. = <br /> (9) TYPE OF WORK: <br /> New Well M Deepening ❑ _ { <br /> Recorutruction <br /> Reconditioning ❑ <br /> Horizonw well ❑ <br /> Destruction ❑ (f)ftcribe — \ <br /> destruction materials and pro. <br /> cedures in item 12) <br /> (4) PROPOSED US i <br /> Domestic P r I,V. <br /> Irrigation _ V <br /> Industrial ❑ <br /> Test Wail 13 <br /> Munici 1 Q <br /> O r — <br /> WELL t.00ATiON SCETCH be) <br /> (S) eQUiFMFN1 RAY C K. <br /> Rotary ReC]ne til^ No <br /> Cable ❑ Air ❑ bore .W 1� <br /> Other ❑ Buck c rom <br /> I7)CASING]NSALLED ` r\ _ <br /> Steel C) Platte (A) PER <br /> a Ty of f of Sim of <br /> From �' I f cage <br /> r <br /> ft. — <br /> F a _ } <br /> t• size _ <br /> (g) WELL SEAL: i <br /> Warsurfsce — J <br /> mnihry seal txovided? Yes Na❑ If yea,to depth _ft _ J <br /> Waestralas"kdagaimtpoilutiona Yes❑ No❑ Interval—.ft <br /> MONA of anling onite <br /> (10) WATER LEVELS; Warkstarted L9� Com leted= <br /> ITepib of first wares.#known <br /> WELL DRILLER'S STATEMENT; <br /> 1. <br />` Standinglerelafterwell rnmpktiots it Thts well uM drilled under m /urisdkiton and this report fs true to the <br /> (I1) WELL TESTS Imstof r nowlad andi l- <br /> was We4 <br /> test mule? Yea❑ 5i F <br /> No© If ye%by wbo n? <br />' TyikuFtr,t Pnmp [3 Sailer ❑ <br /> kPthtowater ats4,1oftep Alt Uft ❑ NAME CeilWedteX Dril } <br /> it At end of tat__ it ll tip. Inc- <br /> b.., <br /> nc- <br /> bO"n iscluerye tl�lmin aFrer {Poraoa,firati ur cprpoatlanl Ciyped or pdotedl <br /> ChemiraianJ Warertemperotuse Addrr�es <br /> Ya ❑ Na❑ if yes;by Whom? r <br /> Wasrlectrklo made City <br /> Yes© NZIP o ❑ .. ss;atlaob to this re License Na <br /> E OWR urtl IRtrv, leap IB AIMMONAL SPACE IS NBtdOHD, Vt3f Nt:1tT CVNSrCUTiIrtLY NtlJAltitiRRD p teofthis report —_q-22.&3-- <br />[, <br />�--- ---._�Cy' rl flifl' Oltl (�f1: cr . nn 7r. _ vJu <br />