Laserfiche WebLink
ORIGINAL <br /> FIle,0rl91naI,Ddpllcale aad Triplicate WNh lw r SuRrm 2 <br /> DIVISION OF JAPER IESOURUS �T <br /> P Q BOX 1079 <br /> SACRAMENTO S,CALWORNIA-i <br /> J <br /> WATER WELL DRILLERS REPORT' Do N t N i In l <br /> State Well No. ._ <br /> (Secuons 7076,7077,7078,WatorCode) <br /> Region----.— -- <br /> (7) Perforatxona- J <br /> Type of perforator used- <br /> Perforated— <br /> sed_Perforated-__ _-Jt Hole size-___ _._ . No of holes-_ <br /> VP <br /> a. --•......— .....__�_._.--..fr aa—.._..�._.�_.�- �.,—ar ra as .. ._.._,-.—........��,., of as a. --..�— - -- <br /> lr of f, _..�....._.,..........��......- <br /> 1J ,/ Jr al fa —....-.__....�.—.....�.-.�_. <br /> 7k It tp <br /> 'a ....... .... ar »..�- .._._..—.as fa as It of fr ......_......_—_..�. <br /> (8) Water levels- (9) Well puntpmg test: <br /> Depth at which water Date of test _--By whvm_11P0___ <br /> first encountered _ —__r_—.ft Depth to water when test started-- <br /> Depth to water G P M.at beginning of tele._..-_ r <br /> before perforating_ __ _--- —ft Drawdown from standing level— ft <br /> Depth to water G P.M at completion of <br /> after perforating-------___._rft Drawdown at completion of test ....,...w._--_-___.-__-_-.--.._ft <br /> Note any change 1n water level while drilling Length of time tested— __— <br /> � .r� Temperature of waiver-- <br /> 'Was <br /> axer'Was gas present in water? ❑ Yes 1qNO <br /> (10) General- <br /> Wag well gravel packed?_._-_��_---Size of roclt.___---__-----Thickness of pack <br /> Was a surface sanitary seal provided?------ <br /> Were <br /> rovided?— --Were any strata sealed against pollution? ❑ Yes ❑ No If yes, attach detailed description <br /> Strata sealed _-_--_--- <br /> Was analysis made of water? ❑ Yes A No If yes, attach copy. <br /> Was electric log made of well? ❑ Yes ]t,NO I£yes,attach copy IFOR OFFICLEW, 11SC 0- <br /> a If well abandoned,was 1t plugged and sealed?-_.._._ <br /> Method of plugging and sealing— ._ <br /> (11) Location: (12) Titne of work: <br /> Nortb Section No = __ _ Work started date l- i Completed date A :I <br /> r�yya aviiship__+ d�Je, _ Date of thls report ..✓�u'u <br /> ase&Merldlan WELL DRILLEIt'S STATEMENT- <br /> how location of well in Sec- This well w,4,dr111ed under my jurisdiction and this <br /> j tion,thus ()C) report is true to the best o�m Anowledge-and belief <br /> I Distances to section lines from ° y <br /> well, LIT or S_.,Mt2 ft. [S1CZ4E0]__ <br /> and E or yw_:G&Vft 1►rtl l3ralirr <br /> ! Show location of nearest By <br /> known wells thus (Q) C•r+rt�a 1 <br /> License No � . C Classification <br /> 1 MILE Distance to nearest known <br /> well_(2_$7m__ft <br /> Dated_ 19......... <br /> r)W R rOAM NO 240 REGIONAL WATER POLLUMON CONTROL BOARD COPY 23972 1 50 b4 OWN gra <br />