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ARCHIVED REPORTS_XR0004534
EnvironmentalHealth
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3500 - Local Oversight Program
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PR0545484
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ARCHIVED REPORTS_XR0004534
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Entry Properties
Last modified
3/11/2020 1:56:17 AM
Creation date
3/10/2020 11:16:31 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0004534
RECORD_ID
PR0545484
PE
3528
FACILITY_ID
FA0003714
FACILITY_NAME
LACHHAR CHEVRON*
STREET_NUMBER
334
Direction
E
STREET_NAME
MAIN
STREET_TYPE
ST
City
RIPON
Zip
95366
APN
26115041
CURRENT_STATUS
02
SITE_LOCATION
334 E MAIN ST
P_LOCATION
05
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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} r f <br /> STATB OF CALIFORNIA 4 <br /> ORIGINAL. ` THE R9S0URCE3 AGENCY <br /> File with DWR DEPARTM1=NT OF: WATER RESOII Do not fill to <br /> co <br /> Notice of Intent No. 249231WATER WELL DRILLERS REPORT No. 323486 <br /> f <br /> Local Permit Na or Date_ 89— .)22$_ <br /> State Well No, <br /> Other Well No., <br /> 1.1 VVYLIttt: arae ds <br /> Address . T6!al deptht.Comp eted depth 71158ft. <br /> from it, to ft Formation(Describe by color,character,size or material) <br /> City >u _zap ?s 6 _ <br /> (2) LOCATION OF WELL(See instructions): t <br /> County Safi 3oa mn Owner's Well Number - 6CI ee a d L <br /> gg <br /> Well address if different from above <br /> Township 25 Range8F"Section <br /> Distance from cities,roads,railroads,fences,etc. — <br /> (3) TYPE OF WORK: ^ <br /> See Attached Map New Well (N Deepening ❑ <br /> Reconstruction ❑ ^ <br /> Recondilioning ❑ r <br /> Horizontal Well 0— <br /> Destruction <br /> Destruction Cl (Describe — <br /> destruction materials and pro- <br /> cedures in[tern 12) <br /> (4) PROPOSED US <br /> y Domestic <br /> *� Irrigation <br /> Industrial _ <br /> Test Well ❑ <br /> Munk{ I VVV ❑ ^ O ) <br /> O er <br /> WELL LOCATION SKETCH ibe) ito <br /> (6) EQUIPMENT. 1 CRAV CIL. <br /> I <br /> Rotary 11 Reverse ❑ \ No i <br /> Cable ❑ Air <br /> ❑ '4 ele (bare <br /> Other ❑ Bucke `Qchgd mm <br /> (7)CASING INSTALLED. (8) PIZO T[ _ <br /> Steel Plastic Ex T of a or size <br /> From T i IGage or T t — <br /> fL IK t . Wail k. size <br /> a - <br /> _- i <br /> (9) WELL SEAL: <br /> Was surface sanitary seal provided? Yes ® No ❑ If ye%to depth 138 ft. <br /> Were strata waled against pollution? Yes IN No❑ Interva: 0-138 ft <br /> i` Method of sealing Work started-- 9 f 7 19—M Comgleted 199_ <br /> (la) WATER LEVELS: WELL DRILLER'S STATEMENT: <br /> Depth of fine water,if known EL <br /> Standing level after svellcornpletion This tae11drilled urrd¢r EM <br /> this report is true to the <br /> best of=v�pd be1(11) WELL TESTS:srelltertmade? xd Signed Ric- ak N Lake <br /> ❑ NOM Ifyes,bywhom? cWellDrt er) <br /> ppooftest PUMP ❑ Railer ❑ Airlift ❑ NAME P1tC}lex Drilling (!0 <br /> I <br /> Depth to water,(,tart of lest (L At end of{a{ fL (Perso firth,or corporation)(Typed or printed) I <br /> Discharge gal/min after hours Water temperature Address <br /> Chemical anImade? Yes IN No [7) ifyc%bywhom? CanO e Lab atyIp 443Q,; <br /> Waselectric mads Yes® No ❑ if yes,attach copy to this report Llcense No._2 6-308; .0 7 Date of this report 43120,190 <br /> oWR see(REV. 12-86) 1F ADDMONAL SPACE IS NEEDED, USE NEXT CONSECUTIVELY NUMBERED FORM <br /> 86 96363 <br /> I <br /> i <br />
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