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w�:"�� . _ a� -,-;j A 2 le6s L <br /> I <br /> MAY <br /> OaIGINAL WATER WELL DRILL REPORT', Do Not FiU Ills <br /> t . _ <br />' File with DWlt (Sections 767tr70to,-7ostr-7432,, ::" �- w-. - —- <br /> ;rte''off' THE RESOURCES AGENCY OF CALIFORNIA � ff'9.f60 <br /> DEPARTMENT OF WATER RESOURCE s""wdl No f <br /> Ot6r WCU N 4 <br /> (1) OWNER (11) -WELL LOG.- <br /> Name <br /> OG:Name f al l imote 1 Total depth 1�� fc Depth of completed well it <br /> ' Address 5.7 it 7,r. -M r Z - T ? r In i— r Parmat,o. Describe by color,rbsrorler,size of material,and sertsciarr <br /> LD,: -,on, _ i r Q ft to ft <br /> (2) LOCATION]` OF WELL:, __ _ It 1" " 1: <br /> County Owner s comber if any, <br /> Township Range and Semona�1t,..y tie Z. <br /> Distance from eines 1`01416,raalrnads etc - <br /> r a <br /> (3) TYPE OF WORK (check)• %1 j8 1J <br /> Now Well ® Deepening ❑ Reconditioning C] Datroymg ❑ d 1v } �' f 1 <br /> 11 destructroa,descrrbe 6,1'1`,.6 and Qroeedrare m Ite. 11 10 � + <br /> ' (4) PROPOSED USE (check): (f) EQUIPMENT: 108 117 6--n-ay clay <br /> Domestic ® Industrial ❑ Murucipal ❑ Rotary - © 117 177S "1r.L, <br /> Irrigation ❑ Test Well ❑ Other ❑ Cable ❑ 143 1, <br /> Other ❑ <br /> (b) CASING INSTALLED <br /> STEEL OTHER If gravel packed <br /> SINGLE bo oOUJaLE ❑ <br /> Gage Diameter <br /> From To or of From To <br /> ft <br /> ll ft Dtam Wall Bore £t. ft <br /> Size of shoe Or well Ting ft Size of ltravel 1� <br /> Describe joint ° '1• '-''E Y <br /> (7) PERFORATIONS OR SCREEN <br /> Type of perforation or name of screen <br /> Pe[f 310W8 <br /> From To per per Stu <br /> ft ft raw ft in x in <br /> 1 <br /> (8) CONSTRUCTION- _ <br /> Was s surface s2nsnry seal provided' Yes M No ❑ To what depth r'�^ ft <br /> Were any strata sealed again'pollution? Yes ❑ No❑ if yes note depth of strata <br /> From ft to ft _ <br /> From ft to ft Werk its teedea r`a <br /> r� '19 � Campteud` t'� - in9 <br /> ' Method of sealing _rv'U; WELL DRILLER'S STATEMENT <br /> WATER LEVELS Thrs well was drilled under my turrrdretrora end thrs report u true to the best <br /> (9) of my knowledge and belref <br /> Depth at which water was first found, if known 'i ft 't <br /> ' Staadsag level before ptrforatsag d known ft NAME <br /> StaOdtn levet 'fur ft (person firm cr corporstton) (Typed or prtneed) <br /> perforating and developing Add <br /> ry <br /> 10) WELL TESTS rdS ! :2' j,ndrea Atria <br /> ,ximp test made? Yes MI No © if es br wham? <br /> s� Rol/ansa with 1� it drawdown gfetr � '} +- ?tet r SLGN4n1 ,. <br /> J (Wd!Drltfer)�t re_ q:s <br /> Temperature of water Was■chemical anallras made? Yes ❑ 'No p9 61 <br /> Was electric log made of well? Yes [] No ❑ if yea at tach copy License No <br /> 6 '6 tea Rpril 17 1966 <br /> 1 SKETCH LOCATION OF WELL ON REVERSE SIDE <br /> r,wo s tall ,oe, . .., swan-oto io_ee soµTaIPOG oaP <br />