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-a6 U, <br /> TATE CALIFORNIA Do Not ,Fgll In <br /> E RESOURCES AGENCY 'Q <br /> PHewit SWR DEPARTMENT OF WATER RESOURCE, , N2 111925 <br /> WATER WELL DRILLERS REPORT ~"'.7 State Well No <br /> O/ �'..`<, ' Other Well No ( 5-1+93 W <br /> (1) OWNER f0 (11) WELL LOG �;j 0Z5Q7 81-7 <br /> Name F1' & Sukow Deyelopment 0jant . Total depth 97 it Depth of�lmpleted well 90 it <br /> Address Formation Describe by rolar rbararler sere of material and slrurt.re <br /> ManteCq , Calif. 0-5ft to it <br /> (2) LOCATION OF WELL <br /> County Owners number if any 20-26 CIAy <br /> Towrnhtp Range and section TPR B7R A4575 Distance from ettues roads railroads etc — <br /> (3) TYPE OF WORK (check <br /> New Well C[ Deepening ❑ Reconditioning ❑ Destroying <br /> 62-65 san� <br /> If destructum,describe material and procedure to Item 1I <br /> 65-78 cl-ay- <br /> (4) PROPOSED USE (check) (S) EQUIPMENT <br /> Domestic ® Industrial ❑ Municipal ❑ Rotary 95-97 <br /> Irrigation ❑ Test Well ❑ Other ❑ Cable ❑ <br /> Other ❑ <br /> ' (6) CASING INSTALLED <br /> If gravel packed <br /> STEEL X OTHER <br /> SINGLE Z DOUBLE ❑ <br /> ' Gage Diameter <br /> From 10 or of From To <br /> ft ft Dtam Wall Bore ft ft <br /> tae of shoe a,r well ting Srze of cravrl e <br /> De,cnbe larnt welded <br /> (7) PERFORATIONS OR SCREEN <br /> Type of perlunuoo ser name of screen 1 <br /> ' Perf Rows <br /> From To per per Size <br /> ft ft row ft to x in <br /> 80 90 1, <br /> ' (B) CONSTRUCTION• <br /> W..i su(laee sanitary seal provtded' Yrs Xl No ❑ To what depth 50 it <br /> ' Were Any stun sea4d against pollutions Yes ❑ No ❑ if yes now depth of straw <br /> From ft to it q i r� <br /> From <br /> it to ft Work started 1 ! —G 19 Completed 19 <br /> Method of sealing WELL DRILLER'S STATEMENT <br /> ' This well was drilled under my )unrdtctron and this report is true to the best <br /> (9) WATER LEVELS of my knowledge and belief <br /> Depth st which waxer was first found if known it <br /> )-tandtng level behneirfotating if knnvn l ft NAME Hennin S Bros. Drilling V n O• InC <br /> pandrn level aEeeq Et (Person firm or corporation) (Typed or printed) <br /> ptrrforarang and devllo mg <br /> (10) WELL TESTS- ` i Address 2300 W. Rumble Rd <br /> pump test made? Yes ❑ No If yes by whom? Modes}LO Calif. 0 <br /> Id tial/min with it drawdown after hrs [SIGNEI)] <br /> 1 �,emperatuee of water Was a clsem7eal analysts made' Yes C1 N o n (Well Driller) <br /> �}� <br /> Was electric log made of well? Yes C3No If yes attach copy License No_ 2go8l 3 —luted ' 19.-2 <br /> ' flWR 188 the`/ 9 Eel SKETCH LOCATION OF WELL ON REVERSE SIDE <br /> 67129-TSOIs>'a shun In-M hat• <br />