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l <br /> STATE OF CALIFORNIA Do Not FYII In ` <br /> THE RESOURCES AGENCY <br /> ORIGINAL �W ''� �;. ;�� MiTARTMENT OF WATER RESOURCES �N2 . 7178 <br /> FIlewithDWR Dater "Od-: - ;ee6WMIER WELL DRILLERS REPORT ScateWellNts. <br /> Ocher Well No ",7- <br /> (1) OWNER: 1) WELL LOG: G <br /> Name4;=.,n_DD=% :Epg e S p,� S A v I tA (!01Total depth 196 ft. Depth of completed well 196 ft. <br /> Address � a rney a a?.Y12 Formation: Describe by col-,rbaracln,ii=,.f material,and st-cl., <br /> Lodi, <br /> 9 C^ 1 o fr.to ft. <br /> (2) LOCATION OF WELL: Q 4 f o r cc; <br /> County San Jo a.a a in owners number.if any 4 6 t,rd r r^r <br /> Township,Range,and Section 1—a 3—J.`! R'—d"'E Sec. 22 6 2 h;,.rd _a n!+ ^t v1 e <br /> Distance from QciCt,roads,railroads.erc. Sou $_C.�.� Of 1-li.rney �j2 = G� bre ta <br /> r lo - <br /> 1 o •y <br /> T- n 1_ r-: of C ^ti `.e ? rti ss <br /> PLcJ n <br /> (3) TYPE OF WORK (check): R� — 1 C 4 G r A ;• v —�� <br /> New Well ff Deepening ❑ Reconditioning ❑ Destroying ❑ 1 C�: 1 L nr^ -- i i y,j <br /> If destruction,describe material and procedure in Item 11. 1 4o -- 1 ^6- <br /> (4) <br /> (4) PROPOSED USE (check): (S) EQUIPMENT: 1 '^ — 1 �Ir r y 1 V 2127 <br /> Domestic [ Industrial ❑ Municipal ❑ Rotary ❑ 1 -64 196 <br /> Irrigation ❑ Test Well ❑ Other ❑ Cable ] 1 ?6 — ? <br /> Other ❑ <br /> (6) CASING INSTALLED: <br /> STEEL: OTHER: If gravel packed <br /> SINGLE ® DOUBLE ❑ <br /> Gage Diameter <br /> From 1 u or of From To <br /> ft. fc. Diam. Wall Bore ft. ft. <br /> 0 12 <br /> i 12 12 c-)ndu to r - tae <br /> "Size of shoe or well ring:V�� v? Size of gravel: <br /> Describe joint jut t,,Tell <br /> (7) PERFORATIONS OR SCREEN: Wow Code Sec.13752 <br /> Type of perforation or name of screen <br /> Perf. Rows <br /> From To per per Size <br /> ft. ft. row ft. in.x in. <br /> (8) CONSTRUCTION: <br /> Was a surface sanitary seal provided? Yes 13 No❑ To what depth -50 ft. <br /> Were anv strap scaled against pollution? Yes❑ Nolt if yes,note depth of strata <br /> From ft.to ft. <br /> From ft.to <br /> f" Work started — 2 197 2 ,Completed '5 9 19 2 <br /> Slerhod of sealing re Ce-on WELL DRILLER'S STATEMENT: <br /> (9) WATER LEVELS: This well was drilled under my jurisdiction and this report is true to the best <br /> r� <br /> of my knowledge and belief. <br /> Depth at which water was first found,if known 120 ft. T <br /> Standing level before perforating, if known ft. NAME Joh Pan P re Jr. <br /> Standing level after perforating and developing ft. (Person,firm,or corporation) (Typed or printed) <br /> (10) WELL TESTS: Address 11975 S Van Allen <br /> r r n <br /> Was pump test made? Yet ❑ No ❑ If yea,by whom? �a y^n v?�� i 7 LO <br /> ',Id: gal./min.wish ft.drawdown afree he.. (SIGNED] <br /> Temperature of water Was a chemical analysis made? Yes ❑ No ❑ (Well Driller) <br /> Was electric log made of well? Yes ❑ No ❑ If yea,attach copy License NO. 120724 Dated_ 3'-'x'0 , 19?2 <br /> SKETCH LOCATION OF WELL ON REVERSE SIDE plate D-1 <br /> DWR 188 (REV.9.68) -' 2!179-91509.68 30M TRIP QD 06P <br />