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ORIGINAL STATE OF CALIFoRN&A Do not f7l in <br /> THE RESOURCES AGENCY <br /> File with DWR DEPARTMENT OF WATER RESOURCES NO. 168986 <br /> er Intent Na - WATER WELL DRILLERS REPORT State Well N y <br /> ' ,colt Na or Dale,.$-57Q Other Wall Nn ac c?6 & <br /> (I) OWNER: ram (12) WELL LOGS Total dep6LU .(k Depth of eompinted we1L 4�ft <br /> Addres 4450 E. Perrin Rc)ad from ft to ht Formation (Desesibe by color, character, site or matedai) <br /> ' City r'Manteca, Calif. ... yip 1 <br /> (2) LOCATION OF WELL (see mstructions) 5 - 11 Brown Cla <br /> County 91U. Owner's W.11Number <br /> ' Well addrm If different horn above 25791 S. Al rt Way 11 - 64 Gray sand <br /> rn <br /> Towhfp�PYCa A.nge_ - 12 !•a ;. s"� 54 73 Brown cls <br /> Distances from ertlee,mads,milroads,fences,etc 73 - 90 Brown clay & sand streaks <br /> 90 100 Pioml clay <br /> 100 - 125 ]BrbFi clay & sand streaks <br /> 125 — 136 Brmm sand <br /> (3) TYPE OF WORK: - 144 Brown Clay - <br /> ' New Well ❑ 144 = d S S <br /> Reconstruction ❑ <br /> Reconditforung ❑ <br /> Horizontal Well ❑ <br /> Destructian I.] (Describe <br /> destruction material <br /> sd <br /> procedures iu Item 12 <br /> (4) PROPOSED USE.' - y;, ,• ,%� t )) <br /> ' Domestic p271V <br /> Irrigation, ❑ <br /> Indusuial [3 <br /> Tat Ivell ❑ . : ' — <br /> Stoe�n <br /> WELL LOCATION SKETCH \\/ Other ❑ — <br /> ' (3) EQUIPMENT, (0) GRA'Vq-,PACK <br /> t <br /> Rotary Reverse 13lies Noti� S <br /> 1 rr <br /> Cable [] Air ❑ Pfimbter of baro ' <br /> ' Other Cl Bucket 0 Pqc fjora��, _tt 4� —� `,► — <br /> (7) CASING INSTALLED's �� (s)NfERFORAATIOkke <br /> Steel❑ Plasdo(/ Con-"10' Type of perfd;thols or a of scree,&rw From TO ;, Dia Lige dr Frori'I\,4 vg To Slr:t" - <br /> ' ft ft(c\ :to Wall ft ti1�vft 'e ' 'sizes <br /> 1 6 160 120 � 140t-. <br /> Pvc <br /> r <br /> (9) WELT. SEAL: <br /> Was surface sanitary seal provided? Yes es}" N9 1f Yes,to depth-50--ft <br /> Were strata sealed against pollutfna? Yes O Na © Interval ft <br /> Me" of sealia }3EL1tOIllte Work start.,& 19 complet 1 <br /> (10) WATER r EVF S WELL DRILLERS STATEMENT <br /> Depth of first water, If imao This well was drilled undrr my jurfsdfcdon and this report is trur to the heat of my <br /> Stu tlg level after well completf t kno,oladae and belief J <br /> ' (ll) WELL TESTS Sirman i iff ,_ Bkkpr. <br /> Was well fast made? Yes [] No ❑ If yes, by whom? (Well Driller) <br /> Type of tett Pump ❑ Basler Cl Air lift❑ NAME Calwater Drilling Co., Iric. <br /> Depth to avatar at start of test ft At end of tear A i6tsot rhinD,PL ro tom) (7I ped or printed) <br /> ' +el/min aFrx_ hours Water tempera Address-- _ iUUU 111 — <br /> �, Turlock, Ca 1 Z5 80 <br /> I W- analysis made? Yes ❑ No ❑ If yes, by whomT <br /> W—OW" <br /> alechio WS mada2 Yes Q No ❑ If yes,attach copy fA Aria mport Chani.No 321252 ataof this,epo,t3-25-88 <br /> tae &pev y yes) IF ADDITIONAL SPACE IS [NEEDED USE {NEXT COAISECUTIVELY NUMBERED FORM <br /> 1 <br />