Laserfiche WebLink
STATE OF CALIFORNIA <br /> 'r ORIGINALAL <br /> � � THE RESOURCES Ar3gNC I Do not fill 4n <br /> ' File with DWR DEPARTMENT OF WATER RESOURCES <br /> 'Wotice of Intent No. WATER WELL DRILLERS RESORT N0. 323479 <br /> Local Permit N89�-2227 State Well No, <br /> No.or Date Other Well Na. <br /> i <br /> i <br /> Address-230 Tndijrtr:Laj I GGA Total depot==244=&Gampleieel depth==I=-Q=ft. <br /> City � ZIP <br /> p.,,,,,,, from fL to ft: Formation(Describe by color,character,size or materia!), r <br /> ,�-�1D110— _ .� <br /> }. (2) LOCATION OF WELL(See instructions): - 1 <br /> ODunly a a U� Owner's Well Number — See Attached Lo i <br /> Well address if different from above — <br /> Township Range—AP, .Section 19 <br /> Distance from cities,reads,railroads,fences,etc. — ) <br /> Il �. <br /> (3) 'TYPE OF WORK: — <br /> See Attached Map New Well Lf Deepening ❑ <br /> Reconstruction <br /> 1 <br /> Reconditioning Q <br /> Horizontal Well ❑ — <br /> Destruction ❑ (Describe <br /> destruction materials and pro- <br />+ endures in Item 12) <br /> (4) PROPOSED US F,/ <br /> Domestic _ <br /> Irrigation <br /> Industrial <br /> Test Weil \�f\ ❑ <br /> Munlel ❑ <br /> O er _ <br /> a <br /> WELL LOCATION SKETCH iS)\M0Ito Ilg n, j <br />` (5) EQUIPMENT: kk, <br /> CK:RWary$] Reverse ❑ NoCable [ Air © of here <br /> Other ❑ Backerty — <br /> i, i <br /> (7)CASING INSTALLED (8)PEA OTI — <br /> steel ❑ Plastic Ex n et T of ( 'on orsiro <br /> From. i Gage or t -- <br /> I <br /> ft f Wall t size _ <br /> 0 62 Sch 80 162 0,010 — <br /> r i <br /> (9) WELL SEAL: _ <br /> I <br /> Was surface sanitary seal provided? Yes CK NO El if yes,to depth�_(L <br /> Were strata sealed against pollution? Ym a No n Interval 0-452 —_ft. <br /> -d-(sealing Work started 1t3 Z Cgmplotod 10 . <br /> (10) WATER LEVELS: WELL DRILLERS STATEMENT: ! <br /> Depth of first water,if known ft. <br /> Standing level afterwellcompletionft This well to drilled"ad ruleer m /urisdicifon and this report is true to the <br /> best of ge and bel , i <br /> (11) WELL TESTS: <br /> sign < �j.a' ,rr�..�. Ri.ahand H. Lake <br />' Was well test made? Yes ❑ No If yes,b whom? (Wo I Driller) <br /> ype of lest Pump ❑ Bailer Air lift ❑ NAME <br /> epth to water at start of test ft. At end of test R. (Person,firm,orcorpomtion)(Typed orprinted) <br /> DrschMe gel/min after hours Watertemperature Address <br /> Chcmtealonalyasmade? Yes No O IfyLw,bywhom? City ZIP <br /> es, <br /> ' Was eleclrie log made Yes A No ❑ If yattach copy to thrs report License Na � Jr ('-�7 _ <br /> Date of this report G/2 t7/90 <br /> OWR 188(REY. 32-66) IF ADDITIONAL SPACE IS NEEDED, USE NEXT CONSECUTIVMY NVMaERED FORM06 96355 <br /> i <br />