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ORIGINAL LOCATION NOT CHECK�C <br /> File Original,Duplicate and Triplicate with the WATER WELL DRILLERS REPORT Do Not Fill in ' <br /> DIVISION OF WATER RESOURCES -D C (see+tons 7076,7077,7'071,water Code) <br /> O <br /> SOX 1079 STATE OF CALIFORNIA—DEPARTMENT OF PUBLIC WORKS Sate Wtll No <br /> r LCRAMENTO 9 CALIFORNIA DIVISION OF WATER RESOURCES ;9;23 Oti,tr Well No�F—&A.a*-,(_7 f <br /> Region <br /> 1) DRILLER. (person, firm, or corporation) (8) LOCATION OF WELL <br /> Name <br /> County <br /> Address 646 SOUTH CALIF^RNIA STREET R F D or Street No <br /> S.TOCKTON, CALIFORNIA <br /> OWNER <br /> Name rrank vir <br /> Address Rt Box 208 (9) WELL LOG <br /> Stockton+ California Total depth of well 90 <br /> Formation Meation size of water Gravel-- <br /> (2) Proposed Use (Check) Eqtupment 0 fr `° aft Top Soil <br /> Domestic ® Industrial ❑ Rotary {] 3 8 YeUovr 1 <br /> Irrigation ❑ Test Well ❑ <br /> Cable ] 8 16 Brown Sand <br /> Municipal El Other Dug Well El 16 28 Yellow Clay <br /> ❑ Other Cl 28 3 Brown Sand <br /> (3) CASING• 36 Blue Clay <br /> • 74f, ofA so 1.416/ga casing left in well 1 0 Brown Sand <br /> 70 <br /> 3 . Brown Clay <br /> 3 90 Grave <br /> Type and site of shoe or well ring i <br /> s ( � <br /> 4) PERFORATIONS os— <br /> � Ih <br /> type of perforator used <br /> Perforated ft to ft holes per <br /> Diameter of perforations in, length an <br /> t <br /> (5) WATER LEVELS: <br /> Was electric log made of well? Cl Yes Ej No If yes attach copy <br /> Depth it which water was first found 6 ft -- <br /> Standing level before perforating ft <br /> Standing level after perforating ft <br /> Vote your ohservation of any ehsnge in water level while drilling ��; ,Js ==Js!'Sa - .� .` <br /> sa as a surface saniiarY wal provided? <br /> (6) WELL PUMPING TEST work started 1C-3-52 19 completed 1-d-3-52 19 <br /> Capacity gal/min ft draw down Date of Report 10-23—S ",-19 <br /> WELL DRILLER S STATEMENT <br /> �ss rill grand packet? This well was drilled asttler my ?uruilu Irotr and this report is True to the br <br /> re any aria sealed sgaintr polluu°n? of ray knouledge and belief <br /> Attach _ <br /> If abandoned <br /> Temperature Wet a 1hemical analysis made? copy �SIGNLDI STOCKTON AfsKATUM_$e MOTOR `,ORKS <br /> If abanJoneJ was well capped? Well Drsllrr — — <br /> (7) TYPE OF WORK (check)• License No ....{J���� _ Clas�lhcation — -- <br /> New well�] Reconditioning of well ❑ <br /> Dated <br />