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SR0081473
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4200/4300 - Liquid Waste/Water Well Permits
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SR0081473
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Entry Properties
Last modified
3/16/2020 4:52:30 PM
Creation date
3/16/2020 2:02:46 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
FileName_PostFix
SSNL
RECORD_ID
SR0081473
PE
2602
STREET_NUMBER
11065
Direction
N
STREET_NAME
ALPINE
STREET_TYPE
RD
City
STOCKTON
Zip
95212
APN
06304023
ENTERED_DATE
11/26/2019 12:00:00 AM
SITE_LOCATION
11065 N ALPINE RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
TSok
Tags
EHD - Public
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LOCATION N( 39-715 <br /> ORIGINAL STATE OF CALIFORNIA $HEE, <br /> He Original,Duplicate and Triplicate with the DEPARTMENT OF PUBLIC WORKS <br /> 011 OF MATER RESOUAIES <br /> P.0.BOX 1079 <br /> DIVISION OF WATER RESOURCES <br /> P.O. <br /> SACRAMENTO S.CALIFORNIA <br /> Do Not Fill In <br /> WATER WELL DRILLERS REPORT State Well No._-----___--- <br /> Other WellSection7076 7077 �i A"WaterCode) <br /> ( ,� Region.--., _• <br /> cI ry <br /> (1) Driller: ddz, j ► e�, �i 1'� (2) Proposed use or uses (check): (3) Equipment used <br /> Name_. I.:;. ,r.^. �j 2. C Domestic ❑ Municipal E] (check): <br /> Address_` ) Irrigation Industri 1 ❑ Rotary ❑ <br /> 1 ;~ ___�__ estic and Test well ❑ Cable Q <br /> License No. _ ? r�� 'Classification _.___._+ P, 4r at - Du well <br /> a,� . Egg ❑ g ❑ <br /> a � r ----—------ _ Other___---------- <br /> -7 <br /> (4) Type of work (check): <br /> { New well W Reconditioning of well ❑ <br /> Deepening existing well ❑ <br /> (5) WelClog: 1 L' /•S � I/ J <br /> ®� �'�-' J + <br /> Total depth of well-...-/_ _.._ft. Give details of formations pencltrated,such as silt,peat,muck,sand,gravel, clay,shale,sand- <br /> stone,hardpan,rock.Include size of gravel (diameter) and sand (fine,medium,coarse),color <br /> Depth From Ground Surface of material,structure (loose,packed,cemented,soft,hard,brittle). <br /> ---- 3-_�.ft. <br /> 1 4- <br /> ,> <br /> a, » to <br /> —.------------ <br /> to » <br /> •----------•--- ---- — <br /> » » a, <br /> » of » <br /> ,r <br /> -----•--••-- <br /> >, to it <br /> is 11 win WIFIeft bg� <br /> to to <br /> - <br /> If additional space is required,continue on DWR Form No. 246 Supplement, and attach to respective report copies. <br /> (6) Casing left in well: -- -- <br /> LENGTH DIAMETER SINGLE.DOUBLE.WELDED. LBS,PER FOOT OR SEATING BELOW <br /> FT1 CHES """— OTHER y`Y GAGE OF CASING GROUND SURFACE.FT. <br /> w <br /> -----•-------------- -— - —— <br /> Type and size of shoe or well ringf _1.Welded joint94Yes ❑ No <br /> i <br /> t D.W.R.FOAM No 246 REGIONAL WATER POLLUTION CONTROL BOARD COPY 23471]•so 40M OUIN BPO <br /> a <br />
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