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ARCHIVED REPORTS_XR0004841
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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LOUISE
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2901
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3500 - Local Oversight Program
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PR0545440
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ARCHIVED REPORTS_XR0004841
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Entry Properties
Last modified
3/9/2020 6:08:00 PM
Creation date
3/9/2020 2:31:30 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0004841
RECORD_ID
PR0545440
PE
3528
FACILITY_ID
FA0003845
FACILITY_NAME
MUSD-DISTRICT OFFICE
STREET_NUMBER
2901
Direction
E
STREET_NAME
LOUISE
STREET_TYPE
AVE
City
MANTECA
Zip
95336
APN
19811004
CURRENT_STATUS
02
SITE_LOCATION
2901 E LOUISE AVE
P_LOCATION
99
P_DISTRICT
003
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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1 9 0 <br /> ORIGINAL STATE OF CALIFORNIA Do not fill in <br /> ' THE RESOURCES AGENCY ��� 219026 <br /> File with [SWR Dff'[SWR ]DEPARTMENT OWATER RESOURCES <br /> %,?..f: <br /> ha_ WATER WELL DRILLERS REPORT state Weft No <br /> No or Date 84-585 other well he� rn _ZC <br /> (i) OWNER Nam Joe Machado (12) WELL LOG: Total depth 1 40 ft Depth Of completed weL.-9�t <br /> Adder 3949 E. Perrin R d. from ft_ to ft Formatlan (Deserfbo by color, character size or material) <br /> ' Clty Manteca CA 0 - 8 Topsail <br /> Sand- <br /> (2) LO ffilgN OF WELL (see Instructions) 0 .. 0 C 60 Saa a <br /> County _n_ O a Q U 1 n _ ownez's Wall Nnmber _ 90 Sand " ' <br /> ' Well address If difCment from abov — <br /> Township as eett k�12 a Qe s a n <br /> Dis Fro cities,roads,rat' , cte 3949 E. Perrin 125 — <br /> 135' .=M <br /> Mi . west or"A'i rpor ay- 135 - <br /> ' north side - <br /> (3) TYPE OF WORM — <br /> ' New Well IC Deegenmg CI L'�s <br /> Reconstruction ❑ �/} <br /> Reconditioning ❑ '� <br /> HoAmntal Well ❑ 'ti <br /> Destruction ❑ (Descrlbe <br /> destmetioa Xnalorials UFO" v <br /> procedures in Item 1 <br /> (4) PROPOSED _ AA <br /> Domestic <br /> Irrigation y'�*1L ❑ <br /> Inaustrsal ``�� ''`1 ❑ <br /> ' T <br /> Sto0 <br /> all �f <br /> ck <br /> Muafarp <br /> WELL LOCATIOV =TCH t)ther ++ ❑ °` <br /> ' (s) EQtM%1)&NTr ,(�6) cRAV ac. <br /> Rotary <br /> Rotary Reverse ❑ YmAd <br /> +'�, <br /> Cable <br /> Q Air ❑ fp�ld`g� of bore <br /> Other ❑ Bucket ❑ psc el[' t ti — <br /> ' (7) CASING INsTALLBD. � (8) RFORAT till <br /> ti <br /> Steel C3Pbastic{� Cera N Type of perfo or 2 of,,Groan — <br /> From To ,- Fromm xo <br /> fL ft Waft <br /> 94 " 6^1, 160 7 4 <br /> (9) WELL SEAL <br /> ,,Vas surface seaitary seal provided? Yas ] No ❑ U Yes.to&P&—SA---Jt <br /> ' <br /> Were stmt,, sealed ,,g mt pollution? Yes❑ No 101 In t. — — <br /> hfeawd of wafln Work sw I9 cor- let.A —14} <br /> (10) WATER LEVELS. WELL DRILLER'S STATEMENT <br /> Depth of first water, ifkrra 1 2 This well rias drilled under my}arfadkdon and report is true to the bort of My <br /> Standing level after well—111 tiny R knowledge and <br /> ' (11) WELL TESTS SIGNED. <br /> Was well test made? Yea ❑ No,)a if Yes, by whom? ( c D er1 <br /> Type of taut ft-p❑ Basler❑ Afr lift 0 NAM Hen 3'h s Bros. Dril1 <br /> Depth to water At start of test_ fR At and of test It <br /> ' <br /> 35209-6 Typed <br /> DlSharytw gal/min Water temriAdd firda aF ; . or prined} <br /> J11111-1 analysis made? Yes ❑ No❑ If yes, by whom? City. p-9'c 3 5� <br /> electric fog mode? TO ❑ No ❑ If yW.attach copy to this repot Lieensc Ne. 290813 Date of thls reportfinjEffrKs <br /> ' nWR tae (REV 7 761 IF ADDITIONAL.SPACE IS NEEDED USE NEXT CONSECUTIVELY NUMBERED FORM <br /> i <br />
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