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• ORItINAL WATER WELL DRILLERS REPORT Do Not Fill ru <br /> file Qrlginal,Duplicate and Triplicate with the (seeeteu sora,sosr,tura,�p.t.e e.d.) W 1`et <br /> DIVISION OF WJJER RESOV2CO <br /> r 0 M[N o s CALIFORNIASTATE OF CALEFORNIA-^-09PARTMENT OF PUBLIC WORKS State Well Na�'r'�" �?C 1 <br /> DIVISION OF WATER RESOURCES f Other Well No. <br /> . Region - —— - - — - --�— _ <br /> DRILLER (person, firm, or corporation) (8) LOCATION OF WELL. <br /> Name Clark- Well Drilling Co. <br /> County <br /> Address 202L E. Charter Way R F D or street No <br /> Stockton 6, Calif. _ 300 ft East of Cemetarv_SAne <br /> 200 tj North <br /> OWNER <br /> In the City _of Stnt ktnrn <br /> � ---- <br /> Name San Joaa in Cemetdry <br /> Address Stockton Calif. (9) WELL LOG <br /> Total depth of welt <br /> Formattan Mtnuon stat of water gravel— <br /> (2) Proposed Use (Check) Equipment 0 f t to 2 it Adobe <br /> Domestic ❑ Industrial Rotary ❑ <br /> 2 15 Hard-Ran <br /> 5 95 Tellog e1gy <br /> Irrigation ❑ Test Well ❑ Cable [Z 1 <br /> Dug Well ❑ 95 a02t Soft_ sandy glay <br /> Municipal ❑ Other ❑ Other ❑ 102 152 $ ue Clay <br /> (3) CASING 1 2 160 Hard blue glay <br /> ft of sn 16/to cas,ng lef[ in well 160 208 Blue clay <br /> 20 2 Sand <br /> 21$ _. 12 12 .__ 214 21 Hard blue clay <br /> Type and size of shoe or well ring =X ' <br /> • '4) PERFORATIONS <br /> t ype of perforator used 'hop Gut <br /> Perforated fc to it hole[ per in <br /> 6 <br /> --- 21,4._.,... <br /> Dtatntter of perforations JL716 X I , length an <br /> (5) WATER LEVELS- <br /> ,%is electric log made of well, 0 Yes =NO If yet attach copy <br /> Deprh at wbs,h water was first found _ 7[I it <br /> St.nd,ag level before perforstung fc <br /> Standing IITel after ptrforatsdg ft <br /> Note your obteev.tion of any thaagt in rater level while drilling <br /> v s a surface samrary seal prov,deds• <br /> No <br /> (6) WELL PUMPIA TEST•- _• y Wor4 ,tarred t+ Complesrd l9 <br /> Capacity ~&X/111;n ft draw down Date of Report - <br /> WELL DRILLERS STATEMENT <br /> Was well gnvet pat ktJs _ P �. J <br /> Thu well wee rlrrllrel aatfrr wry fnrrrdret,oa e,ld this report a true 10 the Gr <br /> .len any straw StAtJ augs 241utwnT of ray Arrowletdge ens!lrrLrf <br /> ,r1 Attach I 1 01 a, 11 Dr Go <br /> Te,aper.[ure `i -.Wu a eMsnle♦11r eIN�lyrse twadei �s <br /> SIGNED _ <br /> If abandaneJ was will eappedt - l "-•�"I y� - r!f Dre r �Y - <br /> a �_.... _ — _.i <br /> (7) TYPE OF WORK (cbeck): Ltaenu No e7(6Q - _ __ <br /> ;Z- _..Cla.otficstaon <br /> New well M Reconditioning of well Q <br /> 3/19/5.3 <br /> Deepening eicutang well Q Dated__... .....-�...._ � .. .... ...�,. ...... . 19..Y <br /> .tam i,sit tort overt Q s►o <br />