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STATE OF AAUFORNIA <br /> ORIGINAL THE RESOURCES AGENCY Do not fill lin <br /> File with DWR DEPARTMENT OF WATER RESOURCES <br /> WATER WELL DRILLERS REPORT No. 370476 <br /> Notice of Intent Na 0-9 6 nt_7 _ �( q State Well 3Va <br /> Local permit Na or Date (% ,( J Other Well No1� a <br /> (1) OWNER: Name RObext H01MS (12) WELL LOG: Total depth 230 ft.Completed depth 205 ft <br /> Address 7547 N. Pershing Rd. from ft. to ft. Formation <br /> City Stockton Ca. ZIP 95200 (Describe by color,character,size or material) <br /> 0 - 8 Top soil <br /> (2) LOCATION OF WELL(See instructions): , 8 - 14 Fine brown sand <br /> County ' r ZQgWin —Owner's Well Number 14 — 36 Brown C11 <br /> Well address if different from above 36 — 39 Brown sand <br /> Township Stockton Range d section 39 - 72 may <br /> Distance from cities,roads,railroads,fencer,eta _ 72 -- 91 Sand <br /> 91 -- 108 Slue clay <br /> 108 - 1.17 Blue sqnd <br /> 117 - 1.80 Blue <br /> �• (3) TYPE OF WORK 180 — 203 Blue S <br /> Now,Well IN Deepening ❑ 203 — 227 Vue C1 <br /> Reconstruction ❑ 227 — 2 0 <br /> Reconditioning ❑ <br /> 1 4a <br /> Horizontal WcU ❑ <br /> Destruction ❑ (Describe <br /> destruction materials and pro <br /> cedures In Item 52) 10 <br /> (4) PROPOSED TJ _ <br /> 8<� <br /> Domestic Priv. <br /> Irrigation <br /> Industrial q <br /> Test Well O Q <br /> Municf [] <br /> O er [ <br /> WELL LOCATION SKETCH ibe) <br /> (s) EQUIPMENT. 'k. <br /> CK — <br /> Rotary KI Reverse ❑ Nv SI <br /> Cable ❑ Air ❑ Cof here t <br /> Other ❑ Buck m 7 4 <br /> (7)CASING INSTALLED. <br /> steel ❑ Plastic ® ret Ty of [ or aize of <br /> From i . Gage or t — <br /> ft E i Wall size _ <br /> 0 20 1 160 193 li = <br /> PVC <br /> (9) WELL SEAL: _ <br /> Was surface sanitary seal provided? Yes KI No ❑ IF yes,todWh 1 n n ft. — <br /> Were strata scaled against pollution? Yes ❑ No❑ Interval ft <br /> Method ofineding Bentonite Workstarted 19w Com feted Ig <br /> (10) WATER LEVELS: WELL DRILLER'S STATEMENT.- <br /> uoplhoffirstwater.lfltnown ft This well was drilled under al <br /> jutYsdfctton and this report is true to the <br /> standing level after well completion ft, heal d q knowledge and fielie� � , <br /> (11) WELL TESTS: slatj Bkkr. <br /> 'tas wren test spade? Yes Cl No ❑ If yep b whom? {Wall DrEI er} <br /> ype of test Pump © Bailer (� Air lift [3NAME Calwater Drilling ng gCo.,Inc. <br /> Depthtvwateratstartoftest ft At end of test ft ��[{ppee,rrsson,firm onto <br /> Discharge gal/min after hours <br /> Water temperature Address-300 S. kdT 0]/Y rporation}(Typedarprinted} <br /> Chemical analysis made? Yes ❑ No❑ If yes,by whom? City TL=10Ck, Ca, _ZIP 95-480 <br /> Waielectrielogmadis Yes El No JF ym attach copy 10 this report License-No 3-21252 ^-Date oftNsreport. 11—,'j-90 <br /> UWR 106(REV. 12-136) IF ADDITIONAL SPACE IS NEEDED. USE NEXT CONSECUTIVELY NUMEERED FORM <br /> 1• <br /> 1 <br />