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DAR 2 41980 <br /> DUPLICATE <br /> STATE E OF tyALIFnRNIA <br /> do <br /> Drillers Copy Do not fill in <br /> THE RESOURCES AGENCY ^I <br /> DEPARTMENT OF WATER RESOURCES NO. 142845 <br /> Notwe of Intent No. WATER WELL, DRILLERS REPORT State Well <br /> [arca] Permit No. or Date_ r v- -iJ ' -1 Other Well <br /> oro on Co. er,,♦ cTe tea o 4 <br /> ( i) OWNER: Name-Count""anew-ul-n--- (I2) WELL LOG: Total depth 20ft. Depth of completed well-245 <br /> ft. <br /> Address -_ 222 E I eb@ye . from ft. to ft. Formation (Describe by color, chara(ter, sire or material) <br /> <:ity—_____—__—�tQcktQns Ca. Zip _-- 0 - 2 Topsoil <br /> (2) LOCATIO OF ELL 2 - 22 Sand <br /> (See instructions): n <br /> ('"onlY�Q � Owner's Well Number 22 - 2 Clay, <br /> Well address if different from above 2 - 29 Sand WoVI! <br /> 'Porvnship _Itange Section 2 - 50 an <br /> Distance from cities, roads, railroads, fences,etc.-Now Hope Sch*ol _50 - 55 An <br /> Intersection of Stockton St. Thornton1 _55 60 8&izd. <br /> Sacramento Blvd . , Thornton. Ca. 60 - 9 Bltte clay & s m <br /> Blue sand <br /> (3) TYPE OF WORK: Blue clay <br /> New Well Z Deepening ❑ 1 - 0 Blue sand <br /> Reconstruction El -153 - j. Blue C a <br /> Reconditioning ❑ _ i <br /> Horizontal Well ❑ .! - <br /> Destruction ❑ (Describe <br /> destruction materials grid .5 11 <br /> ] sana <br /> procedures in Item 12) _2' B1 <br /> 4 11e I <br /> ,f- y1+� t��_ i <br /> (d) PROPOSED USE: 0 - 160S 8nij ; <br /> Domestic ❑ _ <br /> 471 Cla <br /> I <br /> Irrigation ❑ _ <br /> Industrial Q - L, Sha" <br /> T!N Well Q _ Sand <br /> Stmt a - 1QO 8bial4, <br /> i Municipal Q - <br /> WELL. LOCATION SKETCH Other ❑ <br /> ,'5) EQUIPMENT: (8) GRAVEL: PACK: M0NTgj&Y i <br /> Rotary ❑ Reverse a Yes I No ❑ Size <br /> Cable ❑ Air ❑ Diameter of bore- - <br /> )they 1+ <br /> ❑ Hucket ❑ Packed from Q tq�-1N, <br /> r <br /> 7) CASING INSTALLED: (H) PERFORATIONS: screen <br /> 'teel Ej Plastic ❑ Cory-rete 0 Type of perf(Vatiofu or size of screen - <br /> From To Dia. Gage or From To Slot - <br /> ft. ft: ire. Wall ft. ft. size <br /> 225 teen - <br /> 160 <br /> �„ <br /> 9) WELL SEAL: //�� - <br /> Vas surface sanitary seal provided? Yes Cl No ❑ if yes, to depth-70--ft. - <br /> Vere strata sealed against pollution? Yes ❑ No ❑ Interval _ft. - <br /> trth"d of seulinc N Q11T�.^ <br /> ��—�-...:-i-ayi� *�i��ni► Work start _419 Completed IJ __ <br /> l0) WATER LEVELS: WELL DRILLER'S STATEMENT: � <br /> )e pth of first water, if This ueil was drilled under nuV hu rindinion nn<1 hi. rrp�,rt rn trot fu Nr. hest n( nu�f <br /> landing level after well completion-_ _ft. knotv:edRe and brlir/. � � I <br /> 11) WELL TESTS: SIGNED_._ll•j/,IA� f ye �. <br /> .'as well test mndr? Yes No ❑ It yrs, by schonr? p_C..��.; (Nell Driller) <br /> Ype of test Pomp I Bailer ❑ Air lift ❑ NANfE_Hgw4, r111inK_�y_Tnc. <br /> tepth to water kit start of test _ft. At end of test 129.4 erso rm, or copwrntiun) (Typed or p rated) <br /> rischarge_1_6_m,.l/min after hours Water temperaRrre Addmss- 3!55-Pelanda1eA_�B+____- <br /> Wa _ --hut'---� �_ <br /> hrmiaul anxlrsis made? Yrs i] No [I If yrs, by whom._ -_ City---Fist9t Ca - __ - p I <br /> ,'as electric lug made? Yes ❑ No �] If sys. anach copy to this report License No. 2901 __Date of this <br /> - I <br /> SWR tee (Rev. 7.76, IF ADDITIONAL SPACE IS NEEDED, USE NEXT CONSECUTIVELY NUMBERED FORM <br />