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5W+ ✓f!J 9rA78 OF CAMFORNIA <br /> ORIGINAL , THE RESOURCES AGENCY Do not fill in <br /> 40 <br /> ' Fi1e vvilh D�11R DEPARTMENT OF WATER RESOURCES <br /> WATER WELL DRILLERS REPORT N0. 375549 <br /> Notice of Intent Na ?.4/ <br /> 4"t --360— State,Well No. <br /> Local Permit Na or Date--9-1—0 4 7 3 Other Well N <br /> (1) OWNER Name F d C a r d Q 7 a (12) WELL LOG Total depth 9-8 0_ft.Completed depth 2.3.0_fL <br /> Address 445Qfrom£L to fL Formationescrib <br /> City Manteca, C a 7,Ip 95336 � e by color,character,size or matenal) <br /> 0 -3 To Soil <br /> (2) LOCATION OF WELL(See instructions) 3 -- 15 Clay <br /> ' County— San s o a p u i n Owner s Well Number 15 -60 San d <br /> Well address if different from above 60 — 73 C1a <br /> Township Range Section 73 -96 Clay with Sand Streaks <br /> Distance from cities,roads rnslraads fences,etc 96 — 102 San d <br /> ' Y, M1 . South of z4,7--S5 102 - 109 C 1 a <br /> We5t side 109 - 111 Sand <br /> 111 - 140 C 1 ay <br /> (a) TYPE OF WORK. 140 - 16 8 Bdue <br /> ' New Well n Deepening ❑ 168 -218 d <br /> Reconstruction ❑ 218 —2,K C110,1 Sand <br /> Reconditioning ❑i 232 SanT Fi <br /> ' horizontal Won ❑ — <br /> Destruction ❑ (Describe <br /> destruction materials and pro- <br /> cedures in Item 1.2) <br /> (4) PROPOSED US V— <br /> Domestic <br /> Irrigation <br /> Industrial 0 - <br /> Test <br /> Test Well O ❑ <br /> Munfel ❑ _ <br /> O er Eq <br /> ' WELL LOCATION SKETCH be) <br /> (5) EQUIPMENTGR <br /> I AY CS <br /> Rotary ❑ Reverse Yd ` No <br /> ' Cable [I "Ir E3 t oflwrc tt — <br /> 0thrr ❑ Bucket-0 r® — <br /> M CASING IN517ALLED6 (8)PER DRTI <br /> Steel Plastic ❑ 1 7 of f anerstuof = <br /> From T I Gage or t <br /> ft f r Wall Noolsize <br /> u <br /> T <br /> (9) WELL SEAL,. r nr� — <br /> ' <br /> Was surfawmnitarysealprovldedP Yes Ix Ne ❑ Ifyes todepth 60 ft = <br /> WerostratasealmlapimrpollutlonP Yes❑ No❑ Interval ft <br /> 30- 6 r <br /> Method of sealing — Work started 19 Com leted 19 <br /> (10) WATER LEVELS WELL DRILLER'S STATEMENT <br /> Depth of flrsrWater.If known fl r '►. "� <br /> SWndsn Ievel after wellcom completion 1 1 This well roar dri le under rt j�trEtstktton And ANt <br /> pos) tress to itis <br /> / S p beat of my krrowfe ge on beH <br /> (11) WELL TESTS yyy{{{,,,yyy , <br /> tru weal tat made? Ye No❑ if ya,by whom? H(=N N I N GS S�`d t We Drill, ) <br /> �of teat Pump SEE sailer 13 Air lift ❑ NAMEH E N N 1 N G S B R O S. DRILL , rCO. , NI. _ <br /> ' towateratstartaftat fL Atendo£test fL pros orwrpoewttem)( 7Mwpr�d) e <br /> ATTACHE© Address 3525 <br /> Discharge gal/mi:tafter 6 t waterremperaturo M O i)E 5 T 0• C A <br /> Chemical analysis made? Yes ❑ Pio K1 If yes,by whom? City— , , zip 95356 <br /> ' Waselectric made Yrlo" No❑ ff M attach CM to thfis ToEnt License No. `?9 0 R 1 9 Date of this repartM A R-2 Fr s 19.91 <br /> own tee OMY 12-SM IF ADDITIONAL SPACE 15 NISE 9D.USE NEXT CONSUCLrnVELY NUMBERED FORM 96 V6333 <br />