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ORIC,IINAL• <br /> File prtyWl,Onplreate and Triplicate with iha SFIT 2 <br /> DIVISION OF WATER RESOUR(L&A <br /> P O JJa�ox I q,,s+ , �1 <br /> k..FSAMENTO S,CALIFORNIA f^- <br /> . , WATER WELL DRILLERS REPO✓R FT v Doof Fill Ips <br /> State WEII No <br /> (Sections 7076,7077,7Q7$,Water Cade) t <br /> Other Well No <br /> Region-- <br /> (7) Perforations- <br /> Type of perforator <br /> Perforated—­­_f t to� �ft Hole slze_— -__—No Of holes—____--_ <br /> -----------•-- <br /> ar ... �_.._-__•.. T Jr ar T_ __..._.�_.._#, v Ja �.—_-�......__•---____—'� ,1 as ra _�_...,_�- - <br /> ,f Ja <br /> ra sa <br /> (8) Water levels: (9) Well pumping test: <br /> Depth at which water Date of test__ <br /> first encountered— 4916"T_ 6 ft Depth to water when test started <br /> Depth to water G PIM at beginning of test_______ <br /> before perforating.. - Drawdown from stanchng level-- <br /> Depth <br /> evel -Depth to water G P M at completion of test---- <br /> after <br /> est _,_.. --after perforating—_. ---f C. Drawdown at completion of test--- —ft. <br /> Note any change In water level while drilling - Length of time tested----- <br /> Temperature <br /> — �- <br /> S'emperature o£ water <br /> Was gas present in water> ❑Yes ❑No <br /> (10) General: <br /> Was well gravel packed?__.._ _Size of rock_ _.._Thickness of pack— <br /> Was <br /> ack Was a surface sanitary seal provided? _. <br /> Were any strata sealed ag-unst pollution? ❑ Yes [] No If yes, attach detailed description <br /> Strata sealed-- <br /> Was <br /> Was malyw made of water) ❑ Yes ❑ No If yes, attach copy. <br /> Was electric log made of well) ❑ Yes ❑ No If yes,attach copy <br /> If well abandoned,was it plugged and <br /> blethod of plugging and selLng--__ - <br /> (11) Location. (12) 'Pune of work: <br /> North Section No__ _�_____�__ Work started dattU-],_J'. _Completed date <br /> Township_____­—_ D tte of this report_—lQ--P6.51­ <br /> Base&Merid:an­­__v WELL DRILLER'S STATEMENT- <br /> Show location of well in Sec- This well was drilled tinder my 1jurisdr0on and this <br /> tion,thus (X) reliort is true to the best of sny knoialedge nitd belief <br /> Distances to section lines from <br /> well, N or S—--_ft. JSIC,1Enj AT90—KT0N AP!AT—M—&;JM —R Of <br /> R or W..____._-,,,£t. <br /> Show location of nearest ay <br /> known well, thus (0) License No 67$50_ assificat=on_C-57 <br /> 1 MILE Distance to nearest known <br /> well_____ __—ft Dated-10141----Aa <br /> ❑W R FonM No 246 REGIONAL WATIER POLLUTION CONTROL SOAaD COPY „ql=,60 40V VIN CPO <br />