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37.1
<br />(10) WATER LEVELS:
<br />Depth of first water, if known
<br />ours Water temperature
<br />If yes, by whom'
<br />If yes, attach copy to this report
<br />P.G.&E.
<br />Air lift 0
<br />If yes, by whom)
<br />Bailer
<br />t. At end of test ft
<br />Modesto, 743 95350
<br />ate of this report 2-21-7
<br />WELL DRILLER'S STATEMENT:
<br />This well was drilled under my jurisdiction and this report is true to the best of my
<br />knowledge and belief.
<br />SIGNED
<br />(Well Driller)
<br />NAME Hennit! os D
<br />Address 250
<br /> fi YttatiTrIVI (*Typed or printed)
<br />City
<br />License
<br />Standing level after well completion
<br />(11) WELL TESTS:
<br />Was well test made? Yes jo No
<br />Type of test Pump Sc:i
<br />Depth to water at start of test
<br />Dischan4336 0 gal/min after 11
<br />Chemical analysis made? Yes 0 No lc
<br />V •-stv,tric log made? Yes 0 NoZ
<br />ORIGINAL
<br />File with DWR
<br />Notice of Intent No
<br />Local Permit No. or Date 76-889W
<br />0
<br />Ac
<br />CI
<br />(2) LOCATION OF WELL (See instructions):
<br />County San Joaquin Owner's Well Number
<br />')Vell address if different from above
<br />Distance fmn-i cities, roads, railroads, fences etc Thornton Rd.
<br />mi. North of Eigit Mile Rd. West side
<br />(12) WELL LOG: Total deptitildft. Depth of completed welL45.9.
<br />from ft. to ft. Formation (Describe by color, character, size or material)
<br />0=3 Top soil
<br />3=5 Clay
<br />5-9 Sand,
<br />37-49
<br />34-37
<br />9-34 Clays
<br /> Sa:4,e>
<br />49-57
<br />Township T3N Range R6E Section
<br />STATE OF CALIFORNIA
<br />THE RESOURCES AGENCY
<br />DEPARTMENT OF WATER RESOURCES
<br />WATER WELL DRILLERS REPORT
<br />Do not fill in
<br />No. 22652
<br />State Well No I "'"'" •s.,1
<br />Other Well Nn3A/#)5."-•
<br />7=614- Cl
<br />64-69 San
<br />/,....*
<br />TYPE OF
<br />New Well X
<br />Reconstruction
<br />Reconditioning
<br />Horizontal Well
<br />Destruction 0
<br />destruction materials
<br />procedures in Item
<br />PROPOSED
<br />Domestic
<br />frrigatio
<br />Industrial
<br />Tk t Well
<br />stNik.
<br />Municihv
<br />Other
<br />WORK:
<br />Deepening 0
<br />o
<br />0
<br />0
<br />(Describe
<br />ajsl
<br />1
<br /><S}
<br />\ .r2
<br />NI'
<br />0
<br />69,h63 'clay & shale
<br />1654290 -Good sand
<br />200-2Q6 BIA,clay & shale
<br />S O6_2l2 1riiue sand
<br />''''.'.. 152-223 , e' clay
<br />:2p227 ' 3,fr blu a d
<br />227--23,% iue clay,'/>
<br />230 --,2 5 , Fair s'gn d .pay.re.
<br />251-43) Blu, aa y
<br />A—,3 BuW----41ia1e
<br /><59 •=.3 0 Eiliel.ue sand
<br />.,,,,s,3 0)-3 5 ,-, Blue clay
<br />-390,Ftne blue sand
<br />) 190-4 '\-28,lue clay
<br />WELL LOCATION SKETCH \;\ 4 ,/iN 0 > 430 4'0,\V"'? Blue sand
<br />EQUIPMENT;\V'
<br />Rotary D Reverse X
<br />Cable 0 Air D<Ds
<br />Other 0 Bucket 0
<br />GRA
<br />ter of bore
<br />ACK:
<br />bkkeda Blue clay
<br />04 5 Fine Blue sand OW) 15 Blue c1a y
<br />av, rum 0 \t 450 \ —
<br />CASING INSTALLED
<br />Stee111 Plastic 0 C. 2.t el
<br />(8 )iERFORAT3 N,,,S,,..ouve red \
<br />Type of peno , ize of sore9C•Z)
<br />-
<br />—
<br />From
<br />ft.
<br />T
<br />f .C\
<br />Dia.
<br />> in.
<br />ltr
<br />Wall
<br />Fto
<br />tk. ,
<br />o
<br />ft.
<br />1):
<br />.1,,1\l'
<br />sl1 ee
<br />_
<br />—
<br />0 450",\ ,- A 4 15 0 45Q' 1 83c2-1 _
<br />, ....• *' _
<br />_
<br />(9) WELL SEAL
<br />Was surface sanitary seal provided? Yes 0 No X
<br />Were strata sealed against pollution? Yes 0 No
<br />Method of sealing
<br />If yes, to depth____ft.
<br />0 Interval ft.
<br />_
<br />—
<br />—
<br />Work stilled 1—'4 7_1971_. Completed 19
<br />IF ADDITIONAL SPACE IS NEEDED, USE NEXT CONSECUTIVELY NUMBERED FORM 43616450 7-76 SOM QUAD Or OSP - am (REV. 7-76)
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