Laserfiche WebLink
' + STATE OF CALIFORNIA <br /> ORIGINAL THE RESOURCES AGENCY Do not fill in <br /> File with DWR DEPARTMENT OF WATER RESOURCES <br /> ' WATER WELL DRILLERS REPORT NO. 2157339 <br /> V of latent No. State Well No. <br /> Permit No. or Date _ g$ ' 2 9s� Other Well No.61 <br /> f.I d <br /> i!('u1ao1WNER; Name C#lF ON 25 l ivG (12) WELL LOC: Total depth 43 ft. Completed depth 40 ft. <br /> Address V4 ja )K!N O R L from it. to ft. Formation(Describe by color, character, size or material) <br /> 'City 54 0,AM oAj C4 'LIP �s 1 O - 4 AL21rr3 <br /> (2) LOCATION OF WELL (See instructions): -- 4-- 4- <br /> County �WC�u1H Owners Well Number Mw 7s- a FLl <br /> Well address if different from above ITC- 919AWQ Wy. N 6 - 10 ✓ <br /> Township— IN Range 6 Section 2 0 <br /> Distance from cities, roads, railroads, fences, etc. - <br /> t'7 .&oAk e W a oil 20 <br /> ' f, 0Vj7;4 af h&L&y 41~' Al - 19 14111`114 <br /> dGPrIt-0joeo-Ty <br /> N (3) TYPE OF WORK: <br /> {ryk New Well 14 Deepening ❑ - <br /> r <br /> r Reconstruction ❑ <br /> F� Reconditioning El - \ <br /> MW 7 S Horizontal Well El - <br /> 1 o Destruction 0 (Describe ^ <br /> �. t'o >!T J destruction materials and pro- <br /> •^► cedures in Item 12) V ) <br /> 1 (4) PROPOSED US N <br /> ` Domestic <br /> Irrigation <br /> Industrial ❑ ^��J <br /> q Ar Test Well ❑ \0_) <br /> Ivtunici <br /> er <br /> WELL LOCATION SKETCH ( be) <br /> R7-) EQUIPMENT: GRAVELlj GK: <br /> Rotary [l Reverse ❑ No` sizie� <br /> © ❑ ho- <br /> Other <br /> s > <br /> Cable Air et, of hove <br /> Other 5t $uck ed f m \tv � -J, <br /> 1 - <br /> (7) CASING INSTALLED: (8) PE ATICI�S: _ <br /> tee[ El Plastic n e Tyf"f fo 'on or size of Q _ <br /> From D' Gage or of <br /> ft. f Wall t. size - <br /> 9) WELL SEAL: - <br /> as surface sanitary seal provided? Yes 51 No ❑ If yes,to depth 22 ft. <br /> Were strata sealed against pollution? Yes ❑ No J4 Interval--ft. - <br /> Method of sealing eRtt t! a Work started f 19 Completed Z 19 <br /> Uepth10', WATER LEVELS: WELL DRILLER'S STATEMENT: <br /> of first water,if known ft. t <br /> This well was drilled and +tt jt indiction nd this re ort i.tlrue4 to lhg, <� <br /> Standing level after welleompletion it. best of my knowledge and'be r f ✓ ���'�/� <br /> 1I) WELL TESTS: Signed T ^ <br /> r <br /> as we]I test made? Yes ❑ No If yes,by whom? ( ll Driller) <br /> rf test Pump ❑ Bailer ❑ Air lift ❑ NAME J?gwrdy*A P f*_ f tic- <br /> water <br /> � <br /> n water at start of test ft. AI end of test ft. '6Z (Pe rs�p,firm,or ro3t'op}(Typed or printed) <br /> t"las,jectric <br /> arge gal/min after }awns Water temperature <br /> Address !-� tt /N W <br /> lemical analysis made? Yes% No ❑ if yes,by whom? � City ��c.�"vr.► - --- 7_IP 's•�`sr <br /> log made Yes ❑ No ❑ ]f yes,attach copy Io this report License No. Sf 68 Date of this report <br /> IF ADDITIONAL SPACE IS NEEDED, USE NEXT CONSECUTIVELY NUMBERED FORM <br /> 1114R 013(REV- 12-n61 86 96335 <br /> �5 <br />