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ARCHIVED REPORTS_XR0004893
EnvironmentalHealth
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LOUISE
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1196
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3500 - Local Oversight Program
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PR0545438
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ARCHIVED REPORTS_XR0004893
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Entry Properties
Last modified
3/9/2020 3:45:00 PM
Creation date
3/9/2020 2:03:03 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0004893
RECORD_ID
PR0545438
PE
3528
FACILITY_ID
FA0000848
FACILITY_NAME
QUIK STOP MARKET #2121
STREET_NUMBER
1196
Direction
W
STREET_NAME
LOUISE
STREET_TYPE
AVE
City
MANTECA
Zip
95336
APN
217-410-43
CURRENT_STATUS
02
SITE_LOCATION
1196 W LOUISE AVE
P_LOCATION
04
P_DISTRICT
003
QC Status
Approved
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EHD - Public
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ORIGINAL WATER WELL DRILLERS REPORT Do Not Fill In <br /> 11`11e with DWR (Seecsons 7077,7080,7081,7082,Water code) <br /> THE RESOURCES AGENCY OF CALIFORNIA vi,; N? 44736 <br /> DEPARTMENT OF WATER RESOURCES State well No <br /> • (1) OWNER- 11 WELL <br /> �Toral <br /> ) LOGName First Christian Church 58p depth ft Depth of cometed well ft <br /> Address pe t e OX Formation Desnsbe by cores rherscter,seta of a.aterul •a stracterr, <br /> Manteca Calif.iseil t ft <br /> (2) LOCATION OF WELL: 20sond ft <br /> 0 21 * <br /> County SanoaCIIin O�wnner-number if any 2117_ 1. <br /> Townsr 01 to silty br cl <br /> hip Range and Sectson T wn e v • rl ri >✓e C 34 iJ <br /> firm silty br & gry-br el <br /> Distance from cities road, railroads etc 354 fta West Union Road <br /> 200 ft. north l ouise Ave. T <br /> (3) TYPE OF WORK (check-). 51 <br /> New Well [7 Deepening ❑ Recond,tio,ung ❑ Destroying mgry erg-hr to❑ <br /> 1 f destruction,descrrbr material and procedure rn Item 1I <br /> t5k AP 'h r f-I to grv-br g'--nd <br /> (4) PROPOSED USE (check): (5) EQUIPMENT: <br /> Domestic [X Industrial ❑ Muaicl al Rotary ❑ <br /> p ❑ <br /> Irrigation ❑ Test Well ❑ Other ❑ Cable <br /> Other ❑ 82 8 51= Soft hr SS la hr coar- sand <br /> k <br /> (6) CASING INSTALLED <br /> STEEL OTHER If gravel packed10 C)2 br S <br /> SINGLE 2C DOUBLE ❑ S to nem- micr, qpnd <br /> 2 96 T <br /> Gage Demeter 1 96 101 T <br /> From To or of From To 41 br C to T c <br /> ft ft Dem Wall Bore ft, ft 115 br $r.7 Cp b & u Vj <br /> o 140 la to T <br /> $ 2 116 Igo br SS to coar. br <br /> 120�y <br /> ' & aryl <br /> Size of shoe or well rinK $ 6 Size of stravel 1-32 1-34 gry sand <br /> Dewnbe)pint welded cl & <br /> rock t o br al <br /> (7) PERFORATIONS OR SCREEN. T <br /> T pe of perforation or name of acres <br /> • ry <br /> Perf Rowe <br /> From To per per Size <br /> ft fc row ft to Min <br /> ar. <br /> (8) CONSTRUCTION: <br /> War it surface,anitarr sal provsded? Yts_Z No ❑ To whir depth ft <br /> Were any strata sealed aRalnat pollution? Yes No Q If yes note depth of sues <br /> From 0 [t co it <br /> From ft to fc Work started 9 Completed <br /> Method of sesthisir CQment G WELL DRILLER'S STATEMENT <br /> 7,411/66 <br /> (9) WATER LEVELS• This well utas drilled under my Iurrrdtction and ibis report is true to the best <br /> Depth at which water was first [pend Lf known it of my knowledge and belief <br /> Standing [coal before perforating of known fc NAME <br /> Sundsn level afrer rforatinsr and developing ft (Parson firm or eorppration) (Typed or printed) <br /> (10) WELL TESTS. Address P. G. Pox b <br /> Dump testmade? Yes Np ❑ If,esFll=vi?anee Drillers <br /> �> <br /> d sal/min with (t drawdown after his [$tGNEp] <br /> emperacure of water Was a chemical analyns made? Yes ❑ No 0 �1 r7 / ( i Drilrrr) <br /> Was electric log made of well? Yes ❑ No ❑ If yea attach copy 24 0-102 .� Tlate� 41 6� 19 <br /> License No f —__, <br /> SKETCH LOCATION OF WELL ON REVERSE SIDE <br /> DWR lie ,REV a 47, <br /> 86391 930 10 as 7011 TRI►Q Q OSS <br />
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