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....�N.M+.•. _. y <br /> r . <br /> '{5 STATE OR CALIFORNIA <br /> f ORIGINAL THE RESOVRCES AGENCY Do not /ill in <br /> File with DWR DEPARTMENT OF WATER RESOURCES <br /> WAITER WELL DRILLERS REPORT N0. 257290 <br /> Notice of Intent No. <br /> Local Permit No.or Date� � 2S� 0,Sible We Na <br /> r <br /> O'her well Na <br /> (1) OWNER: Name_L E<✓ UJ 1.4'C_ (12) WELL LCC: Total ?:pth 2o it Compte:eddepth.LIE- <br /> Add,ess I h I NO 1 J Al from ft to ft. Formation(Describe'by color,character,size or mat <br /> City sFi Rho 5 3 0 - <br /> (2) LOCA ON OF WELL(See instructions): 1 <br /> T� . <br /> . CountyS'�'=��OAQG i M Owner's well Number M('V �`' •� —l.�_ Si( ¢Qa i!f' t 4. roe.�M_t.;.. <br /> Well address if different from above i�tionl AD '34N'rA <br /> Townshipfi Z S Range Section �I — �7du St'1 rotSM <br /> (stance from cities,roads,railroads•fences,ete Mw t� 3O0 oe� �e.7 -24, ✓ `�i V r�� SQtA <br /> a,-d 161 �,. u- FI' — <br /> (9) TYPE OF WORK. — ••;.,ra4 LII��ii <br /> n New Well Deepening ❑ <br /> 8 Reconstruction ❑ <br /> 4 <br /> Reconditioning ❑ N <br /> F '$A-NrA" Horizontal well ❑ — * awr7i ty� ; <br /> Destruction ❑ (Describe <br /> destruction materials andI <br /> HI AlAL cedures in Item 12) *r7sfrtf4'� ry" <br /> (4) PROPOSED US <br /> Domestic — S h i 3t�fbls+� o'. <br /> ;Y• <br /> Irrigation <br /> ` L Industrial <br /> tt Test well Munici 1 ❑ c-.•.,PeiW.a' <br /> O er I lZJ 6L <br /> WELL <br /> _ <br /> WELL LOCATION SKETCH be) <br /> y <br /> (S) EQUIPMENT.- CRAYCK — tiya4 <br /> Rotary.❑ Raventr'❑ NO I - .�y,,.4�c'n. '• <br /> '• <br /> Cible. ❑ .`Air. ❑ eta bore •S } t <br /> �ev Other ra. <br /> y y ,. <br /> >7�lAt <br /> (7)CASING INSTAL!ED (8) PER Ti <br /> Steal ❑ T of on or sim of <br /> From T i Gage or t <br /> ft' f 1 Wall t. size ` <br /> Q 1- wa 1 O.olO -- <br /> - <br /> (9) WELL SEAL-. <br /> was surface sanitary seal peovldod? Yes No❑ If yes,to depth ft <br /> Were strata aeabd u YapP No❑ Inte (t <br /> Mathodcf..H,[ .5 c s.rOa.il"G <br /> ' rl Work started1 1932 Complete O Ig r1 3 ' <br /> (10) WATEP. LEVELS: WELL DRILLERS STATEMENT: <br /> Deptb of firm voter,If known it <br /> t' This well was drilled unrirr m urisdictlon and th Is31w; <br /> l. Stmdirrs level after well compktbe ft best of my knowledge and&1lt f �" v, <br /> C ^�' <br /> s <br /> W1as well ELL test eu le?? . Yas,9 No❑ If yes•b�vl.?o+ r„/r7. i^fG 517�� p y� e <br /> byµ; <br /> Type a(tem Pumps❑ - Miff 41� Air Wt NAME S( E7CTizu M E^F'C.� a�t�D Nl ING. � .rrin4 <br /> ;F\ Depth to 5eratwaftof� 8fl rt Atendoftat 3 ft 2 Z arsw�firm,prpofperalspn)(T or <br /> Dlaehar' p7)tninafter hourWater mper ore Address Jrw (-1`t K i L+k -•:. <br /> Cl,.enic.l atulysis code? Ya No❑ If yes by whom? City C� ZIP <br /> 'was electric log made Yn No If vaarech ro r tothis report License Na ri2 Z 6RDate of this �{{ <br /> r rrt 2V ' '•4k''3ti <br /> ryxl . <br /> VN'R lite(RtV. 12-8e) IF ADDITIONAL SPACE IS NEEDED. USE NEXT CONSECUTIVELY NUMBERED FORM <br /> - <br /> .'. <br /> ^' ani'K'pi.wu r.....—x..7 ql.' ''1r ^”' a^^"^wrrau.r�s so.«..........-.� �•` <br /> _C�} � r•11r l w"�'Gi,l ^�,.} i;<r,1 r t1r k'� 4'a4 <br /> � >'t� r,Y�t,. , nti.h Y`+':'!''t`7 •. - I t. �:��'`,'y 'v .�r4 <br />