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ORIGINAL STATE OF CALIFORNIA Do not fill in <br /> THE RESOURCES AGENCY �r 174474 <br /> —iv- <br /> � <br /> with UWP DEPARTMENT OF WATER RESOURCES No. <br /> Lnlont No WATER WELL DRILLERS REPORT State Well No d <br />' _ mit No or Date Other Well Ilo0016ell'J 0 1— <br /> WOO WN�Enl� Namci PicCprmlck & BaXter _ (12) WELL LOG ratat depth 372 ft Depth of completed well 0 ft <br /> Address C�12`'i Hill, 2200 Powell St. , 8th floor from It to ft rormnhnn (Describe by color character size or material) <br /> CL ty �meryvi e, Gal�fornia z,, 94608 Pulled 8-5/811 steel casing ' cash <br /> lodged in hole and was cut at 257' balance <br /> (2) L�Da�A�69 O WELL (See instructions) 174473 pulled from hale. Cut conductor casing off <br /> County �, Owne's Well Number <br /> Well address if different From above 1214 W. Washz n St Stockton 2' below round Ievel Grouted with cement <br /> Township hang. _bechen from-bottom of hole to,hs.tkface. <br /> Distance from cities,roads, railroads,Fences etc._ <br /> (3) TYPE OF WORK <br /> New We31 ❑ Deepening ❑ <br /> Reconstruction <br /> Ileconditiequng ❑ ,M1 — \� <br /> L old <br /> Honzootul Well ❑ +����\� �\ ��� <br /> Destruction I (Desmahe �}� <br /> destruction mntorinls nn <br /> procedures in Item <br /> (4) PROPOSED V�Es <br /> Domestic � ~ <br /> ImFntion ft ❑ '�.- }�. .r <br /> Industruil �4 �� ❑ s \3y��✓ "\�` ., 1 <br /> TpNWe11 ❑ ti \1,� f_ r� <br /> Stock, <br /> r i <br /> WELL LOCATION SKETCII \�i,,y Other rRa ❑ =• �� /r <br /> (S) EQUIPMENT (G) CRAVOL-PACK, tr g C v �c? ' <br /> Rotary ❑ Reverse [] X,s ❑ No)� Seco( <br /> Cable ❑ Air C1 hifuneter of horC <br /> Other ❑ Bucket {] �a�c ed f�iow.,.,..,.,. 7-, <br /> (7) CASING INSTALLEI) �� (Wprmronn'I'fb k V,, hyo' <br /> Steel -rh — <br /> ❑ F1asUti Q Cm1 a'ieteti{i] Type of perFd�irtion or i$e of screeq,i;Ft <br /> From To lain Ga'�1:or F'ip�� �0 ToSldt,-°' <br /> ft ft in Wall <br /> (9) WELL SEAL <br /> Was surface sanitary seal provided? Yes ❑ No ❑ If yes, to depth it — <br /> I Wove strata sealed agninst pollution? Yes ❑ No ❑ Interval _ it — — <br /> Nrethcd of sealfrur Work siarfed IS Complete 19 <br /> (10) WATER LEVELS WELL DRILLER'S STATEMENT <br /> Depth of first water, If known_ it This well was drtlIed under my furnsdtction and this report is true to the best of my <br /> Standing level niter well completion k knowledge and belief <br /> (11) WELL TESTS Slcrs al <br /> Was well test mode? Yes L7 No 0 If yes, by whom? (Well Driller) <br /> Type of test Pump ❑ Lit ler❑ Air lift ❑ NAME <br /> Depth to tivater it atart of test ft At end of test - - ft Person firm or corpora ion) (Typed or printed) — <br /> a <br /> —Di,rz ^al/gal/min.gal/min. tur <br /> after os Waterm23489 t. kings Canyon <br /> teperature Address g_,.,.,1—.r1 <br /> antlysis made? Yes [} No [} 1f yes, by whoinReedle Ca.s City 4 802 2Un93654 <br /> 5 <br /> electric log made? Yes C3 No 0 If yes nttaeh copy to this report License No 80 nate of this report9-30-85 <br /> QWR 11313 toav !>at IF ADDITIONAL SPACE IS NEEDED USE NEXT CONSECUTIVELY NUMBERED FORM <br /> I <br />