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i l 7 <br /> OR1GiNAl STATE OF CALIFORNIA Do not fill IR <br /> File With DWR THE RESOURCES AGENCY �# <br /> DEPARTMENT OF WATER RESOURCES NO. 129428 <br /> of stent No, I��°�? NATER WELT, DRILLERS REPORT <br /> 1 <br /> emtit No-or Date R�� State '4re:! tio.02N07EJr Q05t J <br /> 1- Other Well No t } <br /> ' I) OWNER: lame AJ <br /> o T4113 T1 la—bile CITI DSC 12 �j <br /> CN17 1; wE' Z+�G: Total de l <br /> E grldress �.�• w. �i e:itOli� p�- � ,_ft. ;Depth of completed wcitl 7� ft. <br /> from ft. to ft, Formation (Describe by color, charact <br /> city er, size or material) <br /> SLacxton Cali£ , -Zip_952 o e <br /> (2) <br /> LQCAT1S)N OFoacu,WELLunoi, San (See instructions): 3 sy <br /> Owner's Well Number iG3 an <br /> «'ell address if dillerent from above ay1 San ayerS <br /> T:,wnship Range an `� n <br /> Sectio <br /> Distance from cities, roads, railroads, fences, etc are a, ress y _ <br /> r 8` 01 No . ;f road9 X ,e Y <br /> P <br /> j (3) TYPE OF WORK: <br /> New Well [}X Deepening ❑ ol <br /> •IY�✓ Reconstruction ❑ \ f <br /> t J_ Reconditioning <br /> Horizontal 'Well ❑ _ <br /> n <br /> Destruction ❑ (Describe <br /> destruction materials and <br /> �y procedures in Item 1A _ <br /> y� (4) PROPOSED\ �-7 _ <br /> Domestic <br /> Irrigation._'!"`\ _ ' X) ,r <br /> Industrial ❑ <br /> Tyr Well \" ❑ -`� roper,_W e Lover was fns a e <br /> n� <br /> Stock v 7 Qn vF14 = anC am no <br /> ^ Municipl\ ��. BSO or any a er�ng or <br /> WELL LOCATION SKETCH \.��- Other n`\ ❑ '� \ a or eauing. <br /> (5) EQUIPMENT: (8) GR b,PACK: � <br /> Rotary Reverse ❑ No Size <br /> Cable ❑ Air ❑ ��ter of bore A �) � <br /> `\ <br /> Other ❑ 5� 190 \ <br /> D Bucket <br /> (7) CASINAINSTALLED, <br /> (8) E1Isrt. <br /> Steel ❑ C c Type of pe n or a of sereeFromDia. F To <br /> in. Wall f ft. S-rc 150- _ <br /> X - <br /> (9) WELL. SEAL: Ilk <br /> � <br /> Was surface sanitary seal provided? Yes EZ No Li If yes, to <br /> Were strata sealed against pollution? Yes ❑ No Interva �k. _ <br /> Method of sealing <br /> s 1 1g <br /> Dept Work Complet <br /> WATER LEVELS; WELL DRILLER'S STATEMENT.- <br /> Depth of first water, if ,no <br /> Standing level after wen compled This wele l r my sdictlon <br /> knowledfnd repo is eta the beat of mW rtd <br /> (II) WELL TESTS: <br /> Was well test made? Yes ❑ No ? SxC\rte <br /> Type of test B yea, by whom. ( !Driller) <br /> Pump ❑ Bailer 0 Air lift ❑ NAME panero Well Dr1111n nc . <br /> Depth to water at start of test, At end of testlt (pay g <br /> tris; rm, or corpnmtior t) ,—ped r printed) <br /> Discharpa. �gal�� Aker_ _ tiour,s Water temperature Address 7+ <br /> analysis made? Yes Q No ❑ If yes, by whom? Ciry Dakdal e• Calif• ------------ <br /> NO <br /> zi <br /> rfktrir log made? Yes ❑ No ❑ If yes, attach c 11i� . . - ') /p /2 <br /> opy to this nepart License Ila of: report !�- <br /> DWR'la8 (REV.7.76) IF ADDITIONAL SPACE 15 NEEDED, USE NEXT CONS' ECliT1VELYI,IU BERE[l F tMj' <br />