Laserfiche WebLink
LOCAZION NGT CHIECh, <br /> t n ORIGINAL WATER WELL DRILLERS REPORT Do Not Fill In <br /> file Original Duplicate and Triplicate with the (Sections 70745,7077,7078,Winter Cade) N? 32904 <br /> REGIONAL WATER POLLUTION Start Well No <br /> CONTROL BOARD No <br /> STATE OF CALIFORNIA -� <br /> 0 (rprery epproprvetr nssmber) ocher Woll No..._=-z Z <br /> l 1) OWNER (11) WELL LOG <br /> NameI,ar+- Ila C�C�7 — Total depth I� St_ Depth of completed reEl <br /> Address Rt♦ i BOX- 2520 Formation Itis abe by color,character rows of ateterial,and otrrclrn <br /> Lathrop, Cali • ft to ft a� <br /> Hard Dan <br /> (2) LOCATION OF WELL Sand <br /> c-li—San Joaquin Ownnsanmber tf.n,- Sandy <br /> A F D orStrcetNa North side of- Thomsen Rd. 72 u- Coarse sand <br /> Sec. 28 TIS R6E 74 i6O Clay <br /> _i no 104 Fina sand <br /> Sandy104 116 <br /> 116 ] 2n Finpsand- <br /> (3) TYPE OF WORK (check): 320 1 -1-1 Mqy <br /> ,.33 135- Sand &. caml-ng clay <br /> _ <br /> New*ell 12 Deepenutg ❑ RewndiclonmS ElAbandon E] <br /> If abandonment,deserrhe tmatarrel end procedUrt in Rein 11 ,l_�t` ]e��_ Sand & g rii irp <br /> (•4) PROPOSED USE (check) (5) EQUIPMENT. <br /> Domestic ❑ Industrial ❑ Municipal ❑ Rotary ❑ <br /> Irrigation ® Test Well ❑ Other 1:1 Dug <br /> 1 <br /> Dug WeII ❑ <br /> (6) CASING INSTALLED- If grave] packed <br /> SINGLE 9; DOUBLE G■ge <br /> Or Diameter from to <br /> From it to ft Dram Wall of Bore it fr <br /> 0 144 - -- IL----12 <br /> Type and size of shoe or-7,ell ring 3Z8 X L I Stre of$ravel <br /> Describe Joint Welded <br /> (7) PERFORATIONS: <br /> Type ofperf^2_tined SI_-,nl-_.clat --- <br /> S>.xe of perforationsto,lmxth,by an <br /> Frei fl <br /> Lft to w Row.per it _ <br /> LLT ) 1),.^ ft Puff per r[ o — 1 <br /> (8) CONSTRUCTION: <br /> Was a surface unitary seal provided? ❑ Ya X No To what depth it <br /> Were any strata sealed■gatn.t pollution? ❑ Yea X No if yea note depth of strata <br /> Fmm ft to ft <br /> Method of Sealing warp started 41122/55 <br /> /22/55 19 Camplated 1 /2 A 19 <br /> (9) WATER LEVELS: -WELL DRILLERS STATEMENT <br /> This well woi drilled Slider my jurisdiction acrd thrt report is true to the bell of <br /> Depth at which water was first found $ ft my knowledge and belsef <br /> admg lc.e]before perforating ft _NAME (tel' rk WAI I Dr7ul I i ng Qn, <br /> dsnx le►d afar perforating ft (Pcrson hrmor corpurauon) iI'ypr,t or of,-"d) <br /> Address 2024 E. Charter Way <br /> (10) WELL TESTS. S k <br /> WIN■pump toot made? ❑ Yes 2 No if yrs by whom? <br /> Yxld gal/stud With ft dray dawn afttt her V,11 <br /> mea Driller <br /> Temperature of water Was.chamtal analysis ttuds? ❑ Yea No License No <br /> G' Dated- <br /> 4/2-6/00-55- <br /> Val <br /> ated_ . / 5--Was elecrrsc lot made of well? 0 Yes 0 No 05629 3 54 Soni Qum(D sea nWm m-viii s", �� - <br />