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STATE OF CALIFORNIA <br />THE RESOURCES AGENCY <br />DEPARTMENT OF WATER- RESOURCES <br />WATER WELL DRILLERS REPORT <br />Work startcd..._ -27 n_8_o Completed <br />(9) WELL SEAL: <br />Was surface sanitary seal provided? Yes la No 0 If yes, to depth_l_a_ft. <br />Were strata scaled against pollution? Yes 0 No 0 Interval ft. <br />0" a •i Method of sealin <br />gal/min after hours <br />whom? Hennings <br />Air lift 0 <br />At end of test 109 ft <br />Water temperature <br />(12) WELL LOG: Total deptlft. Depth of completed welka_ft. <br />from ft. to ft. Formation (Describe by color, character, size or material) <br />6 - <br />14 - 16 Sand,\,„ <br />16 - 38 Clay \\•,,v) <br />8 _ 41 <and v" <br />- - 51 <br />51 57<\ San <br />57 _ 113\\ Gi.3r- <br />1 t 3,_, i 26 \\sand <br />126 (..;:.,'„,,,127 'Clay <br />-\t 1 San4 <br />1 s <br />clay <br />21 <br />1=1 231rA-,\/2.51 n.lcr <br />16r077 <br />Clay <br />D 325 Sand <br />alt: 3 <br />Clay o- Sand 9m 35-6 Clay <br />_ 364 Sand <br />Clay <br />„screen <br />(2) LOCATION OF WELL (See instructions): <br />San J Oa County Owner's Well Number <br />WELL LOCATION SKETCH <br />Stoci-s\.` <br />Mtnsicip I <br />Other <br />(5) EQUIPMENT: <br />Rotary 0 <br />Cable 0 <br />Other CI Bucket ID <br />(6) GRA PACK: 'nti41: <br />n Size Reverse X ..(sY"e X No <br />Air tcr of bore <br /> kl tea- <br />400\ <br />To Dia. <br />ft C•.‘ <br />G\4, W..dr <br />Wall <br />370 400: <br />210 <br />s. <br />FTo <br />h‘..,„\\ ft . <br />Reconstruction <br />Reconditioning <br />Horizontal Well <br />TYPE OF WORK: <br />New Well X Deepening 0 <br />n 1.6 <br />1 27 <br />1 34 <br />Destruction (Describe <br />destruction materials ançl <br />procedures in Item 217 ‘..) <br />PROPOSED 'SE.? 223, Domestic 0,225 <br />Irrigation(<1":\5 <br />Imliostrial <br />21,)\\).)- 256-7_ Clay <br />F‘56 - 2,77 \And <br />216 <br />217 lay <br />22,3 Sand- <br />225'Cla SA <br />8 cc <br />(8frl'ERFORA4t S <br />Type of nerfion or5tze of scree <br />_ 365 <br />3y0 Sand <br />3'92 - ).g49 394 400 <br />Clay <br />Sand <br />Clay & shale <br />No X If yes, by whom? <br />No If yes, attach copy to this report <br />WELL DRILLER'S STATEMENT: <br />This well was drilled under my jurisdiction and <br />knowledge and be iki. A, ) <br />SIGNED tit <br />NAME <br />Address g2693 <br />(11) WELL TESTS: <br />Was well test made? Yes i No 0 If yes, by <br />Type of test Pump Bailer 0 <br />Depth to water at start of test ft. <br />4.1 analysis made? Yes D <br />Was electric log made? Yes 0 <br />report is true to the best of my <br />eiee <br />74, 95356 <br />(Well Driller) <br />Hennings Bros. Drilling Co.,Inc. <br />(Person, firm, or corporation) (Typed or printed) <br />1525 Pelandale Ave. <br />City Modesto,_ CA. <br />4„2„80 License No._______29.0.a13_—Date of this report <br />DWR 188 (REV. 7-76) IF ADDITIONAL SPACE IS NEEDED. USE NEXT CONSECUTIVELY NUMBERED FORM <br />210 <br />Do not fill in <br />No. 071446 <br />State Well No <br />Other Well No0 Ai 4E 74 <br />ORIGINAL <br />File with DWR <br />of Intent No <br />Lot..ai Permit No. or Date <br />/9 <br />- 4 Topsoil <br />4 - 6 Shale & clay <br />(7) CASING INSTALLED: <br />Steel X Plastic El C lisc`ret <br />From <br />ft. <br />Well address if different from above <br />Township Range Section <br />Distance from cities, roads, railroads, fences, etc Thornton Rd.. <br />south of DeVries Rd., endd of road, . <br />west side <br />(10) WATER LEVELS: <br />Depth of first water, if known It <br />Standing level after well completion 55 static ft.