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ORIGINAL WATER WELL DRILLERS REPORT Do Not Fill Ix <br /> File Original,Duplicate and Triplicate with the (S■ctiow 7076,7077P,ion,Wat■r coda) N? 6,6342 <br /> REGIONAL WATER POLLUTION te <br /> STATE OF CALIFORNIA State Wen No._ <br /> � INTROL $OARD No- r r- -- <br /> �.. t.�Irraprlete■amt&rJ ()Aer Well?Vo- -_---_..._..,- <br /> z) OWNER: ----••--•--•-------�--- <br /> {11) WELL LOG: ..., <br /> nMA <br /> ►; <br /> Name G2"QtiJlnl T :R' „ sa <br /> -%nap <br /> t .tv 7l Too]depeh ft. Depth of completed :ell ft. <br /> Address Q]{ `, 7! Formation: Drstfibt by color,c6erseter,size of a■atrrial,awd ahrcium <br /> it,m fr.5113d" '-O s0ii <br /> p to firm br ci <br /> of "firm br cl to T br cl, <br /> (Z) LOCATION OF WELL: (61 6 ; sof} SS .R Cem.S <br /> County T.., 0.ner'.number,if any-- 6 •� ` al t: br SS & br c <br /> R.F.I)-or Seen 10. T n r; tr... } • r ' ..br SS Ce-j, S t��5..1 f'rVl <br /> , . r,,,, , 8 05 alt: S5 & slltyr br cl <br /> i ;1 V _FF �.qIr 5 1G "br Ci D SS uo em 7 <br /> 1 "T br e # <br /> T .T6 sen 64 <br /> y , <br /> (3) TYPE OF WORK (check): 1 h 1 <br /> 6 , <br /> New swell it] Deepening El Reconditioning [3 Abandon © ^ _ <br /> If abandonment,dricribe material and Procedure in Item 11. 75 <br /> l <br /> rr <br /> I (4) PROPOSED USE (check): {5) EQUIPMENT: plr ' <br /> �'• n <br /> Domestic E] Industrial ❑ MunicipaI ❑ Aatary 'i3 ct fir- <br /> Irrigation g] ❑ Cable <br /> TestWell Other ❑ -216 <br /> r-t•.�r ac' ,, <br /> Dug Well ❑ 22 " 22.5 <br /> (b) CASING INSTALLED: If gravel packed q� <br /> SINGLE 1� DOUBLE l Gage LQ _ czw 13 - <br /> tt��V r� oDiameter from to 240 <br /> i C <br /> From le.ec 1Q0 f?0 Diam. 10 Wall of Bore it. ft. 245 `.7 T r C�'cr'�eui �+� R. ter; ^ryl_ <br /> „ 245 " 2rpr4 "illi hr 94 <br /> br <br /> " Sept. 1959: went back 2-'deei)ened & rf a�?�,e <br /> Type and size of shoe or Well rang 8 x b Size of gr.eel: — ._. r? <br /> Describe coins weld <br /> 276 2171 "br silt— cZ <br /> (7) PERFORATIONS: 273 280 ..br c? & SS <br /> Type of perforate-used 41• •' <br /> S17@ of perforationsia.,lena:th,by 1 in1' <br /> . <br /> FrCJgI1 fr.M ft. Perf.per row Rows ' <br /> 1 <br /> 175 10 rcr ft. .. <br /> (8) CONSTRUCTION: <br /> Was a.urface sanitary seal prorided? ❑ Ya ❑ No To whit depth ft• - - "t.nr �p,[! 1f <br /> Were nay strata sealed against pollution? ❑ Yee ❑ No If yea,note depth of strata <br /> From ft.to <br /> ft. .. .. <br /> Method of Sealing <br /> Work stared 39 Completed <br /> 19 <br /> (9) WATER LEVELS: WELL DRILLERS STATEMENT: <br /> Depth at which crater wan first found b3f[ rhit well was =Ydrilled under y jurisdiction send ibis report ft true to the bat of <br /> MY knowledge and belief. <br /> Aftg level Wart perforating f[' NAME ' <br /> 1 •ng Irvid after perforating f[ pl,l�"SC+anf•_P T)-H 1,.1 nr�z <br /> Acrron,farm,or eorpontion 1 ' <br /> Adder.:: P 0 Box bra (Typedorpri■ted) <br /> (I0) WELL TESTS: Linden, Cali <br /> W1460 pump unmade? ❑ Yat ❑ No If yw,by whom? ' ' <br /> Yields gal./rain.with ft, draw down afterhey, <br /> Temperature et rater1 Wen Dr111rr t <br /> Wu a ehemiul aa■lysis made? � YetQ Q,.Q No Q'i' f <br /> Ucense N0._ .-._.___.�_............... DztC4—,,�_--�........_ <br /> ''ss electric Ing made of well? <br /> ❑ Yes ❑ No <br />