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CLARK WELL & EQUIPMENT CO. <br /> Contractor's Report <br /> (1) OWNER: (11) WELL LOG:11S 113 <br /> ame f e e i A n n a l Chem! -g;' ^cP ny Totai depth ft. Depth of completed well ft. <br /> Address 77T_aol1 sh 'OT lurid 4� �rmation: Describe�v color, character, als eflTrrlal, end structure. <br /> n r qJ ; �Q ft.to <br /> C—s ..ft. � . <br /> �athror, alifo.nia ., <br /> D 13 0 and <br /> (2) LOCATION OF WELL: � � --1 o C lay <br /> Countycr y1,,�1 Owner's No. '7 �1 �1� 1�f9 �2ild <br /> Street No. i+Qe bi-f� is^o�, �ondd at cz4y 25 bl�lf <br /> 29ng <br /> �� Rp z 3 <br /> 94 C 12i r <br /> (3) TYPE OF WORK (check) j� 97 <br /> New well Deepening ❑ Reconditioning ❑ Abandon ❑ <br /> 7 <br /> If abandonment, describe material and procedure in Item 11. 103 S a nr) <br /> (4) PROPOSED USE (check) r.^•4Tll t (5) EQUIPMENT: <br /> Domestic C] Industrial E] Municipal Y'❑ Rotary ® " <br /> Irrigation ❑ Test Well ❑ Other Cable ❑ <br /> (6) CASING INSTALLED: if gravel packed " <br /> Single Double ❑ Gage " <br /> n or Diameter from to <br /> From ft.to ft. Diam. Wall of bore <br /> +1 1 1 12" <br /> ,ii,. <br /> 1 �n 1 11 <br /> Wall-Shoe size �t Size of gravel: n 7� 11 <br /> Describe Joint algia,, " <br /> (7) PERFORATIONS: o„1e <br /> Type of perforatior used " <br /> Size of perforations In., length, by In. <br /> From ft. to ft. Perf. per row Rows per ft. <br /> 6D S o To,,, <br /> `'?_arP ,: rf_ 10C I - 1101 .• <br /> (S) CONSTRUCTION: .• <br /> To whet <br /> Was a surface sanitary seal provided? Yes No❑ depth n 1 <br /> Were any strata sealed aganist pollution? []Yes ❑No If yes, note depth of strata " <br /> From ft. to ft. '� '-a� 90 1 ''iay v0 <br /> I Work started 19 Completed 19 <br /> Method of Sealing T amen+ rQUt CONTRACTOR'S STATEMENT: <br /> This well was drilled under my jurisdiction and this report is true to the best <br /> (9) WATER LEVEL of my knowledge and belief. <br /> 1� ft Clark ',,'ell ?: Egt:irment <br /> NAME Co. , Tnc. <br /> (10) WELL TEST By 20 24 ,;.aS t Charter ";:'ay <br /> Water pumped G.P.M. Address <br /> con down ft. Stockton, California 95205 <br /> A lift ft. <br /> Yield of well G.P.M./ft. <br /> H.A. (Signed) <br /> Temperature of water Chemical analysis 371560 2 r1ay Z0 <br /> Was electric log made of well? 0 Yea ❑No License No.___-- Dated----------. 19 <br />