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t3FtIGiIVAL ` r 39-620 1 <br /> STATE OF CALIFORNIA <br /> art§a WDUPlitalund Triplicate w11h the DEPARTMENT OF PL)HL.IC WORKS <br /> .4lON flF WATER RESOURCES [`y, WATER <br /> RESOURCES FC <br />' P O SOX 1079V6 r e DIVISION OF iltATER RESOURCES <br /> 9ACRA14ENTO S CALIFORNIA <br /> Do Not Fill In <br /> WA'F'ER WELL DRILLERS REPORT 5 State Well lrlo._A S�.���V4<���� <br /> Other well No._ r <br /> (Sections 7076,7077,707 e,Water Codo) - <br /> Regton---- - —— — <br /> (1) Driller: (2) Proposed use or uses (check)• (3) Equipment used <br /> DName_leat,e=��I ._F la.�l g_Gc?•,__�#!c1• Domestic Municipal ❑ (check): <br /> Ca Address-522_W�_Sant lana ,St,. Irrigation ❑ Industrial ❑ Rotary ❑ <br /> Domestic and Test well Cable <br /> License No__.$ —Classxficat:on _-Q-57_--_ Irrigation ❑ Dug well ❑ <br /> W Other----____--- Other_ <br /> W S Owner: <br /> Name�>3 Seniw_�en Sehool>_—_ a of work check <br /> O � ��- - - (4) Type ( 1 <br /> U Address__TI3cyP,, _L`a3,3 f+ New well Reconditioning of well ❑ <br /> Deepening existing well ❑ <br /> C <br /> (5) Well log: <br /> Total depth of well j§0_, ft Give details of formations penetrated,such as silt,pear, muck,sand, gravel, clay,shale,sand- <br /> stone,hardpan,rock Include size of gr-tvel (dtameter) and sand (fine,medtum,coarse),color <br /> Depth from Ground Surface of material,structure (loose,packed,cemented,soft,hard,brittle) <br /> __ _ll____ft tQ____28—ft <br /> _27_ .A1 <br /> ---51---- " - 6 — " o al <br /> SU cky ftrd Gr ay 03 aY <br /> AgInd <br /> �r 1 <br /> 87----" >!-_-15g------., Ye11ax stAely c:3 A ._._........ i .� <br /> 204 _28a SM chy %rel Gray-Clay <br /> _hQ3L_ „ » IM va C2 ey <br /> Hard -qMn1w_1R1i Clay <br /> -372-- Blue Spnd <br /> T .x.1.6 —_, ..__42Q_ > Hard_StiAY Mme-Mai: <br /> _4228 - - ; ' ---435--_�» <br /> If,iddltlonal space is required,contmue on DWR Form No. 246---Supplement, and attach to respective report copies <br /> r (6) Casing left in well <br /> LENGTH DIAMETER StNG,LE DOVSLE WELDED L33e PER FOOT OR SEATING BELOW <br /> FT INCHES OTHER GAGE OF CASING GROUND 3u R(=ACC FT <br /> y� <br /> Type and sloe of shoe or well nng—_---Wilde joints--0 Yes Ug No <br />' D W R Fo,Im No 246 REGIONAL WATPR POLLUTION CONTROL BOARD C 239722 3o 404 7VYN sap <br />