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ORIGINAL _ WATER WELL DRILLERS REPQRT <br /> Me with DWR J [. , Do Not,Pill lfnu <br /> (Sac Gant 7079s s yolo,Baal,yoa2,WatCade) <br /> THE RESOURCES AGENCY OF CALIFORNIA Luh N© 18383 <br /> 1 ti DEPARTMENT OF WATER RESOURCES 4Srate Well No <br /> Other Well No <br /> (1) OWNER <br /> (1 I) \VELE LOG <br /> Name California T,fater, Service Co. rpp pprr,, <br /> L'Lds�rC55 Taiaf depth /V fc Depth of completed well UV <br /> fc <br /> Fartaa[tan describe by roier,rharacrrr s!v of maserlal,end slritrlure <br /> S J s 0 <br /> ( )) LOCATION OF WELL 1` `° fr <br /> County 5` F. <br /> J a Owner s number if any —� <br /> TowastaiP Rsage and Section ,5 � <br /> Distance from peter roads tulrasds eta <br /> d z �F0''YelloGr sands clays <br /> (3) TYPE OF WORK (check) d D a x'av6l <br /> 1 New Well 6 68 3 Hard Propel? c I a s hard an <br /> Deepening © Recondtt,oning ❑ Deuroying ❑ 68 — Sands <br /> I/destritclson,dricrsbernalrrsal and prnredure iie Item 11 k chec10 Yellow gravelly clays <br /> (4) PROPOSED USE <br /> ( ) (5) EQUIPMENT, 0 tee, Oe�'Yell clays <br /> Domestic FX) Industrial [] Municipal © Rotary 1 0 <br /> Irrigation ❑ Test Well ❑ Other ❑ Cable ❑ .. <br /> OchGravel e a ds <br /> er ❑ ,. $1a.�y e <br /> 4 (6) CASING INSTALLED- _ 10 a e a a d <br /> STEEI-i OTHER It gravel packed 0 6� a <br /> SINGLE Xj DOUBLE E] y <br /> 8 <br /> Gage Diatnerer — 5 <br /> From Eo or of From To 0 — h.,11ti Gravel and scrod <br /> ft it Dtam WnII Bare ft, ft <br /> 1 .» IF n-Blue sandy clay <br /> rr tr 4 Q — 0053and blue clay <br /> 00 — .52016jSandy bIU2 C g s <br /> Size of rhm or well e-st Sixo of arsvelt 11 /all <br /> Describe Iron[ ripri <br /> (7) PERFORATIONS OR SCREEN <br /> Ty eef Perforation or name of screen Roscoe Mos3 rub.— p <br /> f <br /> Perf Rows <br /> From To per per Size <br /> ft it row ft m saes <br /> zoo 60 0 11 x z 8+1 <br /> (B) CONSTRUCTION- <br /> 'Was a surface tanuary seal provided? Yes 0[ No[] To what depth (r <br /> V4.0 any siesta sealed sponse pollution? Yes Na❑ 1(yer nate depth of strata <br /> From it ro fir <br /> From ft to It Wark starred �4 1,73-- <br /> 9 coospleted Alo19 <br /> Method of enitoL WELL DFLELLER'S STAT T <br /> (9) WATER LEVELS Is w ter d tied sand my 11insdieilon and thn report is !rift to Mr best <br /> Depth at which water wu Stu found if L—. it Of Tray kntnbledg a bjr <br /> Standing fivel before Perforatingif known it NAMEiii ¢I d 1 0 <br /> o. <br /> Seadmg level after Perforating and developing it Pcrtoo rm,or wtparaGva) (Ty Jed°r prfarrd) <br /> (10) WELL TESTS, Address g F1 Go <br /> p tat made? Yes No ]f yes b whom? <br /> i s Elllmsa with ft dtawdowaafter hes SIG <br /> Temperature of water Was a ehemleti anal to made? Yes❑ No 0 (Spill DnBer) <br /> Wet deeuic lag made aF well? Yes If ea attach eapY <br /> License Na - _68648 <br /> SKETCH LOCATION OF WELL ON REVERSE SIDE <br /> r � <br /> DWR lee 1AEH 9 es) f <br /> nasi oto Aa sa atrst�rair©�Omp <br />