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W <br /> ORIGMAL STAraOF CALIFORNIA Do not fill in <br /> THE RESOURCES AGENCY <br /> 4F' wlth DWR DEPARTMENT' OF WATER RESOURCES No. 164941 <br /> of latent No WATER WELL DRILLERS REPORT state well va_ — <br /> 'L, ermtt No or Date_ 86-91.2 Other Well No Q2S!QGE2_< <br /> (1) OWNER, Name_ S t 0Kton SportsmensC u b (12) WELL LOG. Total de L4_54 it Depth of a>1—l-0-2ft <br /> Ad front it to ft. Formation (Dewmbe by color, character, size Dr matenal) <br /> Qty--_ _ _ Starktn_n _ CST _ zip 5201 0 -58 Slue Sand <br /> (2) LOCATION OF WELL (see instructions) 58 -80 Blue Clag 0 -95 San d <br /> Catmty 5.an . n a n U 11 owners well Numhe' 95 -109 C l a Wall address if ddlerrnt from sbov Sang <br /> Towmhip_ St0Ckton ft., C 109-113 <br /> Distance from rides,roads,railroads,fences,etc mi . west <br /> 0 a <br /> ' <br /> Airport Way <br /> north side <br /> (3) TYPE OF WORK, <br /> ' New Well)b D.%.e .X ❑ + <br /> Raconslruatlou ❑ <br /> Rocondipoalap ❑ <br /> ' Horbxontal Well ❑ <br /> Destruction❑ (Describe <br /> destruction mateoals <br /> .procedures,p ItemIV <br /> (4) PROPOSED <br /> ' Domestic <br /> Irrigation 0 <br /> ladustnal ❑ <br /> ' <br /> El GYeISI <br /> ncunicl J <br /> WELL LOCATION SKETCH Other ❑ <br /> 11 <br /> Rotary 0 Reverse ClNo - Srze <br /> 9 ' <br /> Cable ❑ Air ❑ DTiibe rr of bogo; <br /> in n <br /> Other ❑ Bucket [] ark ErC — <br /> (7) CASING INSTAr1 131 (S ERFOILA <br /> steel❑ Plastic Cl <br /> Co1� <br /> Type of ore of scat �S <br /> ' FTO <br /> f mo Dia. Gaft Cl WAa�'f'o�r gft ft. �< = <br /> 0 en <br /> (S) WELL SEAL, M <br /> Was surface sanitary seal pro-ded? Yes 1 1 No ❑ U yss.to dept-.ft <br /> Were strata sealed syainst poUutiou? Yes❑ Na ❑ 1 <br /> ' Method of s Work start 9 Compinted� 18 <br /> (10) WATER LEVEL-St WELL DRILLER'S STATEMENT <br /> Depth of first water, if lreowrl_, - It This+aril was drWod under mp r„risrllCHaa and thlt report is er to the bees of my <br /> Standing levo] ager well completion _ _ 9 - knowledge and b#IW <br /> ' (11) WELL TESTS, Sic <br /> Was wall test made? Yes ❑ No a If yes, by whom? (well Driner) <br /> Type of test Trump❑ Bader❑ Air lift o NA H S N N I N C S BROS. DRILLING CO. , INC . <br /> Depth to water at start of tert------ft. At and of test—._. —t (Perron,Dun.or corporntion) (Typed or printed) <br /> al/min after�ou,s Water tempera Ad <br /> ' �,�l anal made? Yes ❑ No M If yes, by wlwm? <br /> akctrio log made? Yes 11 NO VJ If Yes,sttnch copy to this report Licence No- .4Q8_1 3 »to of this repo 1986 <br /> AlftlR 188 (pt%V 7 7d) IF ADDITIONAL SPACE IS NEEDSG. USE NEXT CONSECUTIVELY NUMBERED FARM <br />