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ORIGINAL STATE OF CALIFORNIA <br /> Do not fill in <br /> THE RESOURCES AGENCY <br /> 1e with DWR DEPARTMENT OF WATER RESOURCES No. 060029 <br /> vof Intent N,, 4 56 WATER WELL DRILLERS REPORT stite bell No <br /> I _ <br /> L'e nntt No fir D it, 78-1581 Other W ell No L � <br /> OWNER 'Iti33e del Auch Cons't. ( 12) WELL LOC Tot t1 deptl>_j:�Ltt DLpth of completed well�it <br /> 1369 Lincoln Bled. Era111 ft to ft Porro[tion (De,L n13L by a31or ch trrtcter ii7e or mlterl d) <br /> n Lip — <br /> 2) LOCATION OF WFLL0 - 3 fine sand <br /> Can <br /> �' (See Instn tc ttom) sandstone <br /> e <br /> i S tint, a t7tt Fla r, L�'f,]1 �lln3bef 3 — 7 sandstone <br /> L11 tddrL,S If d3lfttent Froin 1bov,--LjD 7 - 12 soft brawn ay <br /> -n,h,3 - 29 hard graycla ,' <br /> I R m�;e Section <br /> DI,tIML Eram cities meds rulroids fence, etL 29 - 341 co r and and small rock <br /> 34 - 52 graya <br /> 52 - 60 'course 4and and small rock <br /> 50 - 80 soft gray clay tree roots & sm,roc <br /> Nf (3) TYPE OF WORK , <br /> New Well EX Deepemni, ❑ <br /> Recnnstructton ❑ — \ <br /> Reconditioning 0 ,\ — <br /> S, 1 <br /> $anzontal Well [] �� — 11 <br /> Destruction ❑ (faesenbe <br /> destruction m-Itenals an <br /> • procedures In Item 12 — <br /> �l 4 (4) PROPOSED USE• - <br /> >r DatueShL r — <br /> Irrigation ❑ — <br /> Industnal ❑ — <br /> Test Well 0 <br /> S tack ❑ <br /> Nluntcip311 Q — <br /> NYELL LOCATION SKETCH Other ❑ — <br /> EQLIP\LENT (6) GRAVEL PACK Int to 91 Reverbe ❑ Yes)7 No rJ Stze I — <br /> 1hle ❑ Air ❑ Di-imeter of bonne 14 ; Q = <br /> ther ❑ 8ucket ❑ Plrked frnmrPtJ� to g 't <br /> (—� CASING INSTALLED (8) PERFORATIONS — <br /> etl ❑ P13stic fM Concrete ❑ Type of perforation or size of screen <br /> From To Dia Gage or From To Slat - <br /> ft €t 1n Ll all ft ft size - <br /> 61 6 61 81 - <br /> } <br /> WELL SEAL <br /> as surfice sanitary seal pn)vrded4 les )0 No C] if yes to depth-510—ft — <br /> %%ere strati sealed i�.atnst polIutmxi� l es ❑ N)( E)( Inten if Ft — <br /> Method of sealin• mix Work it-irted 19 Complet 19 <br /> I10) WATER LEVELS WELL DRILLERS STkTE\fENT <br /> epth of first water 1f known ft 7hts well tcus drilled undo my fur dtcttan d this reynrt is true to the best of my <br /> Stlndtni, le,cl after «ell Lumpletmn _ g knomled};e a beh[.f <br /> 11 , WELL TESTS SIGNED <br /> t, we 11 te,t to idea les +� No ❑ If ves hs whom' (W Dnller) <br /> ,pt of tL,t Pump a 8-tiler 0 ilr bft x NkXIE Canada Pump S es and Service , Inc. <br /> DLpth to N,tt/ti r at st art of test /} ttt At end of test It r� /ff Fer un, fimi 990 <br /> 11 <br /> (Typed or printed) <br /> fLh lre,C N F 11 nun lfterJ h,)ILrs `7,'iter temperature kddreSg P-Ll- Box 990n11 toLINsi, n1tdtj Yes � No ] IE a City Antioch _ Calif_ z1p84509yc, ht t�hom �s clrLtnc lot, in tde� les LLj Na It 1e, 1tt3Lh Lupy to this report License No lute of this report Nam 14, 1978 <br /> 188 tnry 7766 IF ADDITIONAL SPACE IS NEEDED USE NEXT CONSECUTIVELY NUMBERED FORM <br />