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ORIGINAL STA76 OF CALIFORNIA Do not fill in <br /> i <br /> T14E RESOURCES AGENCY <br /> c File with DWR DEPARTMENT OF WATER RESOURCES No. 226857 <br /> it e of Intent No. WATER WELL DRILLERS REPORT state Well No <br /> Permit No. or Date., - 1 � – Other Well Na��S� � S^7 - <br /> 41) OWNER* Arlin Walker <br /> Addres 1 B St• from ft. to It. Formation (Describe by color, character, size or material) <br /> a r a s,^Al. rip <br /> 0 - O soil <br /> (2) LOCATION OF WELL (see i4structions): Sand <br /> � <br /> ,, �,, 9 - 1 S1�ale # <br /> Covuly ��t3,U�v Owners Wall Ntvabar <br /> Well address if different from above — 2 cl#,y26 <br /> I <br /> Township— Rang Sectio an ��� k <br /> Distance from cities,roads,milmnds,fences,etc 16 1 Mi e O •�» ay } <br /> -imile east of Manley, north side 47 -- 58 \ 8 d <br /> Ripon 56 - ay- <br /> 65 <br /> E) Shale & clay <br /> (3) TYPE OF WORK: 0 2\�- Sand t <br /> Naw XWell Deepening❑ 82 ✓ lay & Shale <br /> Reconstruction ❑ 9b g '1•13.and <br /> Reconditioning ❑ <br /> Iforizontal Well 0 � k — JQ <br /> Pa@ t <br /> Destruction Q (Describe 1 R Sand . <br /> destruction materials pd it <br /> ,procedures jn Item 2 — S a <br /> I (4) PROPOSED <br /> t Domestic 129,, Aa <br /> fniga ions ❑ <br /> ti <br /> Indust i E) <br /> T. Well ! ❑ � 11 <br /> s <br /> bfunizip all, <br /> WELL LOCATION SIQ;'i'CH Other ❑ —' , <br /> f5) EQUUIPMBNT, (B) CRAVI3I <br /> LN <br /> RO ( — <br /> Rotary Reverse ❑ ! } Na sit 1y� <br /> Coble 0 Air Q �1x�t�te`r of bore <br /> Other © Bucket D 4 end`rom 1 6 ` <br /> (7) CASING INSTALLPMD!t- (8),-,PERF IO e <br /> Steel❑ Plastic Conceettell Type of pe[F6�i'og or fze of scree 5 – <br /> I <br /> From Tom Dia. e• r Fr$ Ta <br /> ft Etat all ft. fte <br /> 0 1 y 160 16 • 1 sc e - <br /> (9) VYELL SEAT.: <br /> Was surface sanitary seal provided? Yes No ❑ If yes. to depth---5D---R, <br /> Were strata sealed against 1lution? Yes© No Cl Intervel�ft <br /> Method of s e V onite Work started. ►+ lg Compla 19 <br /> (10) WATER LEVELS: WELL DRILLERS STATEMENT: F <br /> Depth of first water. if kn t Thh ivelf wtw drilled under my jurisdiction and! report !4f trite to the best of my <br /> Standing level after well cnmpletfe t, knowledge and belief• <br /> (11) WELL TESTS: SIGqZD <br /> Wits well teat made? Yes [3 No[( It Yes. by whom? (Well Driller) r <br /> Type of test Pump p Bailer❑ Air left 0 SAME Hennigs Bros• Drill g CO• nc. t <br /> Depth to water at start of test it. At end of test _ rt (Person firm,or corporation) (Typed or printed) <br /> #"'I- <br /> aarKe� cal/min aftor_.— � hours Water tempera Addmsl - 35U Pe 8ndol <br /> City O ;p <br /> ptf, eYes CI , 1�(a It yes, by whom?nlectrlc log'phade? °�YeS r• l+}e; ,If Yet.attach copy to this report License(!0 29081 to of this report <br /> DWR 188 (REV._7,7ei IF ADDITIONAL SPACE IS NEEDED, USE NEXT CONSECUTIVELY NUMBaRTrD FORM <br /> I <br /> r'. �7 �� _:j•;:1 rpt: <br /> I <br />