Laserfiche WebLink
r <br /> ORI .t-cr:AI. � ' STdTE OF CALIFORNIA S 39-675 f <br /> fd1B Or! A,Oupiiafa aid Trlplitale W6 the� DEPARTMENT OF PUBLIC WORKS <br /> Of11151 H` 'wAre� ��soul�r� s � =Y. v <br /> P BOX Iola _ - DIVISION OF WATER RESOURCES <br /> SACRAMENTO <br /> S,CALIFORNIA � f <br /> Do Not Fill In <br /> WELL DRILLERS,R. REPORTREPORTState Well No� _��^��� <br /> WATER <br /> ` f ether Well Nv— <br /> (Sectfoas 70747dyY,7078,Water Coda) Region--..— <br /> (1) Driller: / (2) Proposed vee or uses (check), (3) Equipment used <br /> Name_— � � �� Domestic ❑ Municipal ❑ (check) <br /> Address....__ ��` L___ Irrigation4 Industrial ❑ Rotary <br /> ! ❑ <br /> m'01- Z, v Domestic and Test well ❑ Cable <br /> License NO Classi&cation- _ _ Irrigation ❑ Dug well ❑ <br /> Other______ Other__,_.. <br /> OWAeC: <br /> ___-- <br /> Nalrle—___ <br /> (4) Type of work (check) <br /> _ � •_ .,.sem <br /> New well ❑ Recondltion►ng of well ❑ <br /> Deepening existing well <br /> (5) Well log: <br /> Total depth of well-J-6-3- ft. Give details of formations penetrated, such as silt,peat,rztuck,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,battle) <br /> / l ;�.. <br /> to <br /> 45 <br /> I _.] is- <br /> so <br /> JI 11 /J <br /> 11 Il <br /> is Y <br /> — <br /> so <br /> i <br /> 11 ]] ff <br /> 11 J1 <br /> ---_.ter—...._ .--.�.�T_..�....- .. ..-. .'� ..-..._^f .... .... ..� .... - <br /> f] f1 1f <br /> If additional space is required,continue on DWR Form No.246—Supplement=` nd attach to respective report copies <br /> (6) Casing left in well <br /> ! <br /> LENGTH DIAMETER 9INGLE DOUBLE WELDED L139 PER FOOT OR eEAUNO BELOW <br /> FT INCHES + OTHER GAGE.OF CASING GROUND BURFAC6 FT <br /> Type and size of shoe or well ring,_ —Welded joints--A Yes ❑ No � <br /> D W R FORM No 246 REGIONAL WATER POLLUTION CO74TROL BOARD COPY �»�,>yO JeN 7UIN+�`o� � <br /> I <br />