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11, -' '- 11 3 ISS7 <br />' ORIGINAL WATER WELL DRILLERS REPORT �i ��NZt Fill IseFile with DWR (s.cttoata 707.0,70110,7021,7022,Water code) ls3 M 4 t4 - 3 r— 2.A <br /> THE RESOURCES AGENCY OF CALIFORNIA N. ,t 44896 <br />' DEPARTMENT OF WATER RESOURCES tate WeIIWSI e•- 3 <br /> other Well N. 19 7 <br /> (1) OWNER- (11) WELL '7LOG: <br /> Name V2.ctor feisncr Total depth 104 it Depth of completed well 77 it <br /> Address n� y n Fotmatson Descrsbr by color cbsrseler,size of..rimal red streelare <br /> it to 7 it <br /> (2) LOCATION OF WELL- <br /> County Owner a number if any "1 ,.T_ — <br /> q A <br /> Township Range and Seetton is 4 -TS,00 _ n _— <br /> I Distance from ewer roads railroads etc f �d_�y H <br /> Just ti of b-cei Fer ark-at .t.io-:�nLOTl n, 77 <br /> (3) TYPE OF WORK (check)• _ <br /> New Well ID Deepening ❑ Reconditioning ❑ Destroying ❑ 4' <br /> it destruction,describe material and procedure in Item 11 77 ge <br /> 96 87 <br /> — <br /> L <br /> (4) PROPOSED USE (check). (S) EQUIPMENT: f o Q4 <br /> Domestic & Industnal ❑ Municipal ❑ Rotary ® r 1 q n <br /> Irrigation ❑ Test Well ❑ Other ❑ Cable ❑ r fin <br /> Other ❑ <br />' (6) CASING INSTALLED: <br /> STEEL OTHER If gravel packed <br /> SINGLE DOUBLE ❑ <br /> Gage Diameter <br /> From To or of From To <br /> it it D12M Wall Bore Ft. it <br /> 63 011 12 <br /> IStze of shoe or well ring S,re of xrarel <br /> Describe iomt 1 <br /> (7) PERFORATIONS OR SCREEN <br /> Type of perforation or name of screen <br /> Perf Rows <br /> From To per per Size <br /> it it row it in x in <br /> (8) CONSTRUCTION- <br /> Was a surface ra0ttary iia]provided?Yet No ❑ To what depth it ,n <br /> were any strata sealed agu0ae pollunonl Yes❑ Na If yet note depth of strata <br /> 1 fit' USE "',! <br /> I <br /> From it to it <br /> From it to it Work started 7 %Z6714 Completed 7/,14",--?, <br /> r4 ,-- 9 <br /> Method of sciih.g WELL DRILLER'S STATEMENT <br /> (9) WATER LEVELS: Thu well was drilled under my lurssd3ehon and this report n true to the best <br /> of my knowledge and belief <br /> Depth at which water was firs[ found sf known it I r <br /> Standing I[vel before p<rfora ring tf known ([ NAME <br /> Standing level after perforating and developing ),41 ft (Person firm or Corporation) (Typed or prrxied) <br /> (10) WELL TESTS- Address 303 3. " tt „(a <br /> '3r [etc made? Yes ❑ No Q If yes by whom? - n r <br /> x,1/min with ft drawdown after hrr. SIGNED] <br /> D <br /> mperature of rater Was a ehem,ul a0alyua model Yet ❑ No ❑ fZLt � i rifler) <br /> o <br /> was electric In made of well? Yes ❑ No If yea atneh eepy License No ted 14-1 - . I — <br /> SKETCH LOCATION OF WELL ON REVERSE SIDE <br /> IOWR 188 (REV 0 SSI 06203 ago 10 40 goes 7Rir A nap <br />