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ORIGINAL WATER WELL DRILLERS REPORT Do Not FsU Zx <br /> IFile With DWR (Sections 7071,7010,7091,7092,Wsur Code) <br /> THE RESOURCES AGENCY OF CALIFORNIA o PIN A 44 <br /> DEPARTMENT OF WATER RESOURCES State Well No—JS ~ // <br /> Ocher Well No <br /> (i) OWNER, (11) WELL LOG: ' 4 <br /> acne M R. EARL �ROBERTS <br /> 7 O B E R T S Total depth ft Depth of completed well it <br /> Address P 60X __241 0X al Formation Describe by color cberarter sue of lesional,sed ttraetare <br /> F C CAMP CALIFORNIA ft to ft <br /> (2) LOCATION OF WELL: <br /> countySo 1Q i n Owner.number if any 4 �„�f3 Z• P <br /> Townsh.p Range and Section L C �7 2 <br /> Distance from clue, road. railrosda act Ea s t O ]. 1 Fw 50 G� GG!!6L Hl a <br /> O6 Band <br /> Nnrth of' *4 8 1 Clay <br /> (3) TYPE OF WORK (check)• q-1 4 <br /> 3 Sand <br /> Nt w Well JW Deepening © Recondictoning C] Destroying © 43 4 <br />' <br /> If destruction,describe malerral and p oeedure in Item I1 4 <br /> -9 11 Sand <br /> (4) PROPOSED USE (check). (S) EQUIPMENT. 73 lop <br /> Domestic ® Industrial ❑ Municipal ❑ Rotary 91 100 TQ7 Sand <br /> Irngatlon ❑ Test Well ❑ Other ❑ Cable ❑ <br /> 107 123 clav <br />' Other ❑ <br /> 123 1.32 Sqn-d- <br /> (6) CASING INSTALLED- <br /> STEEL OTHER If gravel packed <br />' SINGLEK] DOUBLE <br /> Gage Diameter <br /> From To or of From To <br />' ft ft D9am Wall Bore £t ft <br /> 9 13 8" 12 <br /> p <br /> Size of.hoe or well ring 1/8 Ssae of gravel <br /> s:scrtbe lolnc W gl d ! �"�} !y;,!lr•��� "� 1 <br /> (7) PERFORATIONS OR SCREEN- <br /> Type of perforaaa s or name of screen <br /> Perf Rows t <br /> From To per per Size <br /> ft fc row ft m x m <br /> 117 117 J x <br /> 1 <br /> (s) CONSTRUCTION. <br />' Was 1-surface sanitary seal provided? Yea ❑ No R To what depth ft <br /> Were any strata sealed against pollution? Yes❑ Na JQ If ves note depth of strata <br /> From it to ft <br />' From ft to ft Work started 4/25, 66 Complexed 4/26-,66 <br /> uerhod of.ealsps; WELL DRILLERS STATEMENT <br /> WATER LEVELS: Tbrs weld was drilled under my lur:sd:ctron and this report is true to the best <br /> Depth of my knowledge and belief at whish water was first found if known Ft _ <br />' Standing level before perforating if known ft NAME <br /> Standing level after PerforstLhg and daVClp .A fc (person firm or corporation) {T'yped or prsntrdy <br /> (10) WELL TESTS- Address 2024 EAST CHARTER WAY <br />' nip test made? Yet ❑ No Z If yea by whom? STOCKTON CALI ORNA I <br /> 4 <br /> gal/m.n srtth it.drawdown after hrs SIGNEnl 1 ,T �,t-L A <br /> Temperature of water Was a chemical apa[ysu made? Yes ❑ No WT(� (Weil Driller) �s` <br /> as electric loit made of well? Y. Q No If yes attach copy License No - ` "60 2 Data__April 2 6 - -, 19 `-'O <br /> rr <br /> SKETCH LOCATION OF WELL ON REVERSE SIDE <br />' DWR 186 (REV 9 167911 a3o 10 as 30M TRIP OO A oar <br />