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ORMNAL. STATE OF CALIFORNIA e ONLY — N <br /> . File With DWR WELL COMPI&MON REPORT <br /> Puge_L„of 1 Refer to lxstruetton Patupblet $TATE WELL NO ISTAT10N Na EJ <br /> Owner's Well No _ Ne 391105 <br /> $® (� ❑ <br /> DatD Wask began �� Feb �r Endod 8 Mar 91 •l V LAll7UaH LONGITUDEL eftl Permit Agency <br /> Permit Na 91-0435 Permit Date 95Feb99 <br /> GEOLOGIC LOG 1, ' 11'I[ELL OWNER <br /> ORIENTATION (/) ,X_VERTICAL HORMCMAL —ANGLE _($PEC(FYIFN;irnp,%.�. ¢Y�a I 1 e s �Hifl a dDK?PTH FRGAA DEPTH TO FIRST WATER 8 8 go BEI.Ow SURFACE ,tatl,ri AddlSURFACE DESCRIPTIONFt to Ft lla mbe ra4ter g gnaw$me,Calor,em i ., V +' * $TATE ZIP <br /> A10 113 r Sand �, . ) ,' b�I�4Tess• EGL!&OCATION i rse. <br /> 113 150 ! C1 ay ,�,' } " <br /> 152 ' Sand ` ` L>SCDuntq ,t <br /> 152 160 CLa ;• i ' ',.�` gook Page •Q Parce1Q <br /> 160 164 Sand'-, <br /> :-)� ' M~ <br /> __164 ` ` ' '`+ To P____ Range Secti <br /> 165 ' CY,a `� �, pax �' , ,, <br /> t ' ti " );ttt,Llde. I„.,_ NbITTH LQltg,ttlde r , WEeT <br /> 165 170 t e r r DEQ MIAL $rc DEQ ANN DEC <br /> 170 - LOCATION SKETCH ACTIVITY(r} <br /> 1 a r, ` <br /> NORTH NEW WE" <br /> 180 208 rt, `'\ ATSaNIREPAIR <br /> 208 210 ; CZat '�+, } " _ !, 1 Down <br /> 210 , 224, ; sp na <br /> 224 " 274T _01z 9 <br /> 274 ' 280 '.-+ " SaAd <br /> DESTROY(Daeerfbe <br /> � + •^"j j 0 j0 PtacaCrxaseadlHaratrafa <br /> IIWsr QEOLpeICLpp 7 <br /> PLANNED USES) <br /> m <br /> , � NAJIITQRIIlO <br /> WATER SUPPLY <br /> F ` PuhQa <br /> � r � Ir<fastlon <br /> r r <br /> r _.. ladue[rlel <br /> 'MOT WELL <br /> SOUTH <br /> OATH=C PROTEC- <br /> ' ' llfustrate or�esor8.lbe{Distance of Well from undmetlrs —OOTHER(Speouy) <br /> suck <br /> r r <br /> PLEASS ACCURATE&COIWPLEM <br /> r ORLLL,NG <br /> i , METHOD FLULD <br /> 1 WATER LEVEL & YIELD OF COMPLETED WELL <br /> DEPTH OF STATID <br /> j ! WATER LEVEL, _.8 R_(Ft.)& DATE MEASURED <br /> EambmTED YIELD' (GPLQ A TEST TYPE <br /> TOTAL DEM OF BORING, 2 8❑ (Feet} TEST LENOTH (Hrs)TOTAL DRAWDOWN (Ft) <br /> TOTAL DEPTH OF COMPLETED WELL��_(Feet} 'May trot be rgwesenwke of a well'Y long--rerm yield <br /> DEPTH CASING(S) DEPTH <br /> ANNULAR MATERIAL <br /> FROM!SURFACE HOLE TYPE ✓ FROM SURFACE TYPE <br /> DIA ,C m AMTERIAL1 INTERNAL GAUGE SLOT SIZE <br /> Ft to Ft DTAMETER OR WALL W ANY FILTEA PACK <br /> CE- BEN <br /> - <br /> (inches) GRADE (Mehra) THICKNESS (inches) Ft to Ft MENTTpNITE FILL <br /> r <br /> r <br /> —204 ' 11 <br /> r <br /> r t <br /> , <br /> , <br /> , <br /> ATTACHMENTS (4) CERTIFICATION STATEMENT <br /> aeorbglo I,the and Igned,certifyort is complete and accurate to the treat of my knowledge and belief <br /> -� W+II Cautrueilon Diagram NAME L NC. <br /> ( YU4.OR 0 <br /> ScuJWalsrCherelcalAnalraae Wter y, StocktbnJ CA 95205 <br /> ADDPESS <br /> .— ower cDT �� � �� 371560— <br /> ATTACH ADOMOMA!_INFOAM/ITxw N=IT EMT$ Sid FII E IIF R TE ICHC47 L14ANSE rnIMBER <br /> DWRIBS REV T-Se IF ADDITIONAL SPACE IS NEEDED, USE T CONSECUTIVELY NUMBERED FORM <br />