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, pry�J D _ MENT OF HEALTH SERVIC , <br /> OFFICE OF DRINKING WATER <br /> Well Data _ <br /> I system Num.e: sF S�rl �� ,, y,},r i.c System. NYe. 40" 13! <br /> source of Infarmatfoa: L ca3c-T=e Recarcis <br /> Coiiccted by' c.Ft Br <br /> Date: = 1005 <br /> (3) .itxmbar or Name: �_���� <br /> Date Drilled + tea, L�O Aj "— <br /> (4) State Weil Nu=ber. 4614 W. Tuner Rd 4614 W Tuner Rd <br /> (5) Location.: (Address) Lodi CA LcLL CA <br /> Dtstance to nearest sewer or other sewage <br /> dsaol facility (sepac tank/leac-iucid 1 000 Ft:. 500 Ft. <br /> Dsais=nce to other wells (acnve/acandonea) ?, 00—Ft. <br /> I <br /> (6) Housing- Type I Lone v <br /> Condition VIA <br /> P.t Depth (if any) NIAN/A - <br /> Floor (material) Cc=ete Ccmrete <br /> Drainage yes es <br /> (7) Well Depth: DU <br /> (8) casing- Death 1601 , <br /> Diameter $� -1-ISI <br /> Kind <br /> He:gat above floor ne I I r <br /> Distance to htgnest perforation I <br /> Sealed (yes/no) Yes i Yes <br /> Gravel Pack (yes/no) I <br /> 4a Conuuctor casing depth <br /> Camductor camng diameter 1 <br /> Annular seal (depth/type) I No i <br /> �,9) Did Sanitary Seal Terminate in an Impervious <br /> Strata? (Yes/No) NO I <br /> imaezv Strata Tbxcx.(From Ft to _ Ft) I <br /> (10) Water Levels-Depth to: <br /> Static 20' 1 20' i <br /> P=vm <br /> 6a I 60' R <br /> (1 I) Well Yield (gpra): 4 <br /> i <br /> Based on N/A J mea m=ement <br /> Date Measured ',\V A I 'March, 1990 I <br /> Pumptng Rate A 270 s1 <br /> (12) Fnmp: Make W I Peerless i <br /> Tyne ii i MSF i <br /> Canacitf, SPm 90 i <br /> Lubrication mineral o3_1 None 7 <br /> Power 480 V U.S motor I DIESI Ctimi dns e I <br /> AwaHarf Power None I None <br /> Control pressure switch I Pressure swatch <br /> Disczarg'e Location (above or below ground) acove gopv i <br /> Dtscaarge to HQI(i-ircr r- 1 <br /> Depth of puutn bowls60' I i <br /> S' 3) Freque=c7 of Usa:(stanaby/daily) 7aLv ( stanabv i <br /> ) Flood H�srd: `lone i None <br /> t_5) Remarks & Defects: (can use other side) i <br /> (16) Land Use on �Z,eckarge is <br /> Area (dc:Lss on vacs; <br />—17) Attach Well L�t-T- <br /> 1 � <br /> ODW ,'el <br />