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IGINAL STATE OF CALIFORNIA Do not fill in <br /> THE RESOURCES AGENCY <br /> DWR DEPARTMENT OF WATER RESOURCES �I 110. 142839 <br /> If Intent No. WATER WELL DRILLERS REPORT State well Nn. <br /> f ennit No. or Date Other Well Nac2goTaos _ <br /> I) OWNER. Name B• Goold "L� or, (12) WELL LOG: Total depth ft. Depth of completed <br /> sP •O • Box 190 from ft to ft. Formation (Describe by color, character, size or material) <br /> Stockton, Ca. yip <br /> - r, ST HOLE, WAS T)RT <br /> '2) LOCATION OF WELL (See instructions). 11 _ r 5 <br /> TIE 1) BY <br /> try a-a Joaquin Owner's Well Number e — <br /> AS <br /> address if different from above Cit of Manteca - D�_qILLE�D A RDING {{TO �+ <br /> l'ownship Range Sectio B r OOOLD .:.P vl.1�O+ 5" <br /> snce from cities, roads, railroads, fences, etc. 1 C DAve , Ci O�i TA�C,.T�R• G OLD FOR LOG <br /> (3) TYPE OF WORK: <br /> New Well Deepening ❑ <br /> Reconstruction ❑ - <br /> .. <br /> ' Reconditioning ❑ <br /> Horizontal Well ❑ <br /> Destruction ❑ (Describe �\`�'•- <br /> destruction materials aaa1; <br /> ' procedures in Item 12Y = <br /> (4) PROPOSED gSE - <br /> Domestic ^ C <br /> Irrigation ❑ = v <br /> ' Industrial ❑ <br /> Test Well ❑ <br /> Stock Q , - <br /> Municipal <br /> WELL LOCATION SKETCH i t.other ❑ - <br /> 5) EQUIPMENT: i6) GRAVEL PACK: <br /> ary 7 Revense r Yes No ❑ Size <br /> 2611 <br /> le [] Air ❑ k�_ter of bore r <br /> Other ❑ Bucket ❑ packe�irnm 0 to --f� <br /> CASING INSTALLED: ' (8) PERFORATIONS: f Ul—f to - <br /> r�ti <br /> el JN Plastic ❑ Cn)lc�.te{1`. Type of perf ,-, <br /> CASING <br /> qy $ - <br /> t - <br /> From To Dia. Gaga-er Fr� To \ <br /> in. Wall Et. ft. / slZe - <br /> 0 2 3,`, 22 2 re ic - <br /> � - <br /> 8 p ful-fl r) -WIVELL SEAL: 11b 1? ' - rre--urface sanitary seal provided? Yes No [j If yes, to depth)06 ft. <br /> Were strata sealed against pollution? Yes ❑ No ❑ Interval h"J@e - <br /> li — <br /> thod of sealin '�" York start 19 Cnmplet 19 <br /> 0) WATER LEVELS: WELL DRILLER'S STATEMENT: <br /> Depth of first water, if known - fr This well war drilled under my jurisdiction and this report is trite to the best of my <br /> Z knowledge an�d bb�0ef. <br /> Startling level atter well cnmpletio + <br /> 1) WELL TESTS: P.G & E . y <br /> MAN well test inane? Yes No ❑ If yes, by whom. (Well.DAller) <br /> test Pump sailer ❑ Air lift C� NAIME r•1n S Bros . Drill n� Co,. inC . <br /> y ) ' is i ts 142 . (Person, firm,or corporation) (Typed or printed) <br /> I7 t wateF••tM,atn 7P�:� At end of e, <br /> - 6 <br /> Address ress <br /> Irg. 2600alfmin after ursWaser temptratrrC Mode")� o P .lar_ laya • <br /> 5�50 <br /> - <br /> ca! aaalysisS made? Y_cs;}r'j,r? ,Nb-Z If.yes. by whom? lo-16-78 <br /> Was electric logy dtitd 2 Yes ❑ No ff.y . attach copy to this rtport Licence Nn, ate of this report_ <br /> JWFI 198 IRery {s 11FIONAL SPACE IS NEEDED. USE NEXT CONSECUTIVELY NUMBERED FORM <br /> Ij� ��`r � <br />