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STATE OF CALWORMA <br /> RIGINAL Do not iii in <br /> THE RESOURCES AGENCY <br /> lie with DWR DEPARTMENT OF WATER RESOURCES NO. 060031 <br /> IN "f Intent .o 'WATER WELL DRILLERS REPORT b rte «ell Vo _ <br /> Pt mut No or D ttt Other «ell No `( <br /> OWNER Yt,nt Del Auch Cons rt. Co. (12) WELL LOC Tot,l dLpth81 ft Depth of compiLted well 78 tt <br /> its 1369 Lincoln Blvd from it to ft Formation (Dev nbe by ailor thiricter •ILL or mated d) <br /> t% <br /> Tracy , Calif. P _ <br /> 12 1"LOC4TIYN o WELL 0 3 fine sand <br /> do oa �n (Ser fnsttfi�tfocu) <br /> ti u Owntr• ti6elll vuniher <br /> LII tddre•% if rldtcrent front thrive 652 E. Watters Rd' 6 - <br /> lo%sn•hrp Ranfte seLturn Lot #4 12 - 50 gray.caly a -brown sandy l a <br /> r•t tote from cities muds rlrin,id• fences etc 50 - 58 cour and and small rock <br /> 58 - 79 light apd-,dark qray clay <br /> - small rock tree roots <br /> (3) TYPEOFOF WORK <br /> New Well [9 Deepening El <br /> t Reconstruction ❑ - <br /> /L�./f� Reconditioning []t ` \\ - <br /> fw �� ,t <br /> 7 Horizontal Well ❑ \ - <br /> >2�� <br /> Destruction I] (Describe �- - <br /> destruction materials and <br /> procedures in Item 12)" - - <br /> (4) PROPOSED USE� - <br /> Damectic �jT - <br /> Irrigition © - <br /> Industrial ❑ -- <br /> Test Well ❑ - <br /> Stoc k C <br /> Municipal ❑ - <br /> WELL LOCATION SKETCH Other ❑ - <br /> 7017 EQUIPMENT (fl) GRAVEL PACK <br /> Ftof try Ell Retene C] Y- cX tier ❑ Stzr <br /> v' _ <br /> ea <br /> hle f- - <br /> ❑ Air ❑ Diameter of bore <br /> Ether ❑ Bucket ❑ P-tcked from-------!j;�tri It - <br /> CAST\tG INSTALLED (8) PERFORATIONS - <br /> eel ❑ Plastic (M Concrete lam'' Tspe of perforation or size of screen - <br /> Fronl To Dia Cage or From To slot - <br /> kt ft in 'vVall ft ft size — <br /> 61 6 6 6 - <br /> 0911 WELL SEAL 77,�ct = <br /> as surf ice sanitary seal provided? les LSI No 1.1 If yes to depth_—iO—ft <br /> here ctrlti cealed against ppRution° Yes ElNi, Zx Intend ft - <br /> fethod of +e'tltn� entima .note cement mix Murk •torted I9_/t— Completed lrrw 144 1978L- <br /> 110) NATER LEN ELS �L ELL DRILLERS ST-�TENfENT <br /> epth of first water if known R They well was drilled ander nut purtst tchnn n thrc report ry trete to the hest of my <br /> Stinding level tfter well contpletton tt knowledge and beim{ <br /> I1) WELL TESTS su'NED <br /> tti %tell test made, Yes No C If res, by whom- rptnAda4 e eller] <br /> %Pe of teat Pump J Basler ❑ -kir lot `t 1%IE <br /> natia La a] <br /> Depth to water at st in of test it At end of test fti7'0• o(P rsnxa fidr torpor-ttion) t Typed or print <br /> h•ehtrge 30 gllrnun ntter�_ w <br /> 1--hours Water temprrate Address r Antioch, Calif. —Zi94509 <br /> t tnalysis %nude? les E No If ves by whom i City P <br /> 0 elettnL lot; made? Yes ❑ NO If res atttth Lopv to this report License %og93 Date of this repo <br /> Pr fag (REY 7 10, 1F ADDITIONAL SPACE IS NEEDED USE NEXT CONSECUTIVELY [NUMBERED FORM <br /> 1 <br />