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°R�'�A°� WATER WELL DRILLERS REPORT Do Not Fillfix <br /> F+le�v11h DWR <br /> {seetrons 7019,70a0,1091,roes,water Cod.) <br /> THE RESOURCES AGENCY OF CALIFORNIA �' S$4 6 <br /> �'�It <br /> � <br /> DEPARTMENT OF WATER RESOURCES state well No <br /> (WM other Wel!T4- A2E--a <br /> (1) OWNER: (I 1) WELL LOG: <br /> Name Ruth "Arats, Total depth 352 <br /> ft Depth of complctrd well 352 It <br /> AddressCalifFornsatto•s De[crlbe by color,rhwurhf,ifse of•setrrfel,and st x"ure <br /> ft:to ([ <br /> (2) LOCATION OF WELL; 0 ey 4i5 to soil <br /> Coon[ San Joaquin Ownsr's number.It an e+ o'� eilow clay <br /> TowAship,Range.andsacttoa T,'2­­X '• ea, 0 wt84,2gravel & lar a roeks 4 d1au <br /> D,s[aaee from citim,roedr,raumAdr etcNorth side of Linden R . d4 «+ 132,3) brown cla <br /> 132 w 50•Aboulders 0- in dia,m, <br /> 3) TYPE OF WORK (cher ): 150 *9 1 ala <br /> New Well If DecPmmg ❑ Recoadtclon[ng C] Dntroying ❑ 15 — 164o ctuick sand <br /> r f deslrmason,describe nrstertal and PMCLdure to IteM II 764- t►. 1 •'j $ clay <br /> (4) PROPOSED USE (check): (S) EQuipmENT: 168 ►» 180Vaoarse sand—clean <br /> Domestic ❑ Industrial ❑ Munlclpal ❑ Rotary ❑ 180 w 200 4khard grey cla <br /> Irrigation X] Test Well❑ Other❑ Cable 91 200 *. 204 ''? soft grey Ola <br /> Other El 204 ... 22 � hard re ala, <br /> (6) CASING INSTALLED: 224 240v brown clay <br /> STRELr OTHER: If gravel packed 24o sLs 248-%--v sandwloo Se <br /> S]NOLE_t] oaas:,E p 248 «» 260 1 blue clay <br /> 260 N 2 4 ' sandstone«hard <br /> Gage f From <br /> From Dla264 � 268 3 brittle cla <br /> 'Fo or Oof TOft tt D+am W311 Bore £c f= 268 E. '�w and b ue clay_ <br /> 0 <br /> AQ _ 14 10 2 2 2 6 � b t e cla8 12 io 276 «• .a 12ackad sand <br /> s,.c of slave or wdl anAl 4 x 5isa of xnvel Fi y <br /> Describe j.jpc <br /> sa <br /> (7) PERFORATIONS OR SCREEN: .., a, <br /> ay- <br /> TZpq of penfantsoa or nurse of aereen 116eis3PQA <br /> Perf Raw 32Qw340,11 hard blue clay <br /> From To per per S1za to ,u) <br /> it it row £t It] x1n <br /> 180 168 1 <br /> 212 1 <br /> (8) CONS'T'RUCTION: <br /> Was a surface saa[tary sftl o dcdf Ye[ Q Na l] 'ro what Jepth fr <br /> wen any sunta ualyd ags,asr pollunoq? Yrs Na❑ if yea,aa[e depth of atnn <br /> r,rom ft to ft <br /> From ft [o fe work starve 5,10Y9 Camplrrtd 19 <br /> ids:thnd of miltp WELL DRiLLER'S STATEMENT <br /> (9) WATER LEVELS` Thu yell was drilled render my IDrAdretlon and fbir report is true to the beat <br /> Depth as <br /> of-y kno+vledge and belwf <br /> which watrr war 51st found,sf known (c <br /> Standsnd [avd lefnre perfondan if known ft NAME John L, Panero, Jr, <br /> Staadtn ]cud after {ors[top snd daveio aa; £t (Perwo firm,or oorporatson) (]'lied or pstaead) <br /> (10) WELL TESTS: AddreseT� 11935 So. Van Allen Rd. <br /> +s san [est madef Yea 0 Nd if yea by whom? ,u as oTl (i • 95320 <br /> di «ai/mut with ft drawdown Attu hrs S1aNRD] <br /> Te>eperaenre of wacrr was a chemical mslynt made? Yes El NO 0 r W�J { rff Driller) <br /> War elect Foe mads of wv1El Yes o No ❑ If yea attach MpY LtClns! Nal 20-L 24 � Tlated 5-22 <br /> SKETCH LOCATION OF WELL ON REVERSE SIDE A <br /> DWR 18$ (Rry 9 86) 5939t-950 to-as tow'r R[r(9.4 o9P <br />