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Ina <br /> s � <br /> ORIGINAL � STATE OF CA1..IFORNIA Do not f U in <br /> RRL7 THE RESOURCES AGENCY pp�� --�. <br /> Pile with DWR DEPARTMENT OF WATER' RESOURCES No. - <br /> of Intent No 'WAFER WELL DRILLERS REPORT State Wen No <br /> Permit No,or Date CONTINUED FROM X1fi11393 54224 Other Well No. <br /> (I) OWNER' ivame-- He— — (12) WELL LOG: Total depth– #-Depth of completed we11 tt <br /> Address 1111 Van Ness from ft. to ft. Formation (Describe by color, character, size or material) <br /> Cly Fresno. Ca. y:p 9 3.721 708 - 725 sax hard clay <br /> (2) LOCATIOJoaquin-OF WLL (See instructions): 725 - 730 hard cla <br /> County ban Ownees.wen Numbs VXX2 #2 <br /> Well Address if different from above D av is Ranch <br /> Townsh.p Rangy{– Sect. <br /> Distance from cities,roads,railroads,fences,eM <br /> (3) TYPE OF WORK: <br /> New Well EX Deepening❑ <br /> Reconstruction ❑ – <br /> Reconditioning Q <br /> Horizontal Well ❑ – <br /> Destruction❑ (Describe – <br /> destruction materials 29 v <br /> procedures in Item – <br /> (4) PROPOSED - <br /> Domestic <br /> Irrigationv <br /> in <br /> Industrial ❑ <br /> ThWell ❑ <br /> S <T U - <br /> 'WELL LOCATION SKETCH <br /> \\/4 Other ❑ <br /> (5) EQUIPMENT: (6) GRAY L ACKS <br /> RoMry ❑ Reverie ® No Sizo <br /> �#,–J� <br /> %Cable ❑ Air 13rr of bore <br /> Other ❑. Bucket Q ffo t <br /> (T) CASING INSTALLEDr (8) ERFORA _ <br /> Steel L9 Plastic❑ Co to Type of p or a of scree – <br /> From To Dia. Ca wdr F To <br /> ft. ft in, all ft. ft - <br /> 0 700 1` 27 420 8Y3 - <br /> V Green - <br /> 8 x 3 - <br /> (9) WELL SEAL; <br /> Was surface sanitary seal provided? Yes❑ No XI If yes,to <br /> were strAta sealed against pollution? Yes❑ N1041C Interva; Et ^ <br /> Method of sealie Work started 1!) Completed 19 <br /> (10) WATER LEVELS: WELL DRILLEWS STATEMENT; <br /> Depth of first water, if This well scar dd edinder my jurisdiction and this report it true to the best of my <br /> Standinglevel after well completfo*! R knowledge a c� alae/ <br /> (11) WELL TESTS: SIGN <br /> Was well test made? Yes❑ Noll If yes, by whom? `��� (Nell Drtper) <br /> Type of test Pump 13Bailer❑ Air lift❑ NAME, W Drilling <br /> Depth to water at start of test------ft. At end of test_ rt (Perron,firm,or corporation) (Typed or printed) <br /> n ours <br /> Water tem rotors Address –9iV. _3Le <br /> m'g gal/min sifter k Pc A �,+-- <br /> eal analysis made? Yes ❑ Noyff If yes, by whom? City Fresno.—C-a. xp 93706 <br /> WAS electric tog made? Yes ❑ Nnit�F If yes.attach copy to this report License No 339912 nate of this report 4-22-80 <br /> DWR ILSs (Rr.V.7•76) IF ADDITIONAL SPACE IS NEEDED, USE NEXT CONSECUTIVELY NUMBERED FORM <br />