Laserfiche WebLink
M1 I <br /> QUADRUPLICATE ACJ G1 1978 STATE OF CALIFORNIA Do not fill in <br /> Use to comply With THE RESOURC;S AGENCY +{ p �+ <br /> -local requirements SAN JC7j�t OF WATER RESOURCES NO. 120636 <br /> Notice of Intent No. 10-7 HEALlWAMENROTELL DRILLERS REPORT state Well No. <br /> Local Permit No. or Date �. <br /> Other Well No. <br /> (1) OWNER: Name HELM'S TRACTOR CO. (12) WELL LOG: Total depth ft. Depth of completed weI ft. <br /> Address 23100 S. RA SS ON from ft. to ft. Formation (Describe by color, character, size or material) <br /> City racy, a zi 0 - 2 top Soil <br /> 2 - clay s e <br /> (2) LO QT_I(j�TIF_,ULL (See instructions): 1 _ 24 �$ <br /> County_ aSt �i �iuit��II1l Owner's Well Number <br /> Well address if different from above — y <br /> Township Range Sectio <br /> Distance from cGiiuI r gr•ad)�% <br /> � i . — Sal <br /> U <br /> v <br /> (3) TYPE OF WORK: <br /> New Well] Deepening ❑ <br /> Reconstruction ❑ — <br /> Reconditioning ❑ — <br /> Horizontal Well ❑ — n�� <br /> Destnuction ❑ (Describe — <br /> destruction materials <br /> procedures in Item — <br /> (4) PROPOSED - <br /> Domestic _ <br /> l <br /> Induction O ❑ — V <br /> Industrial ❑ <br /> '(t Well ❑ _ <br /> .toe - <br /> Mcm",p ( ` <br /> WELL LOCATION SKETCH �/ Other ❑ — <br /> (5) EQUIPMENT: (6) GRA PACK: <br /> Rotary Reverse ❑ e; n No Si <br /> Cable ❑ Air ❑ i\efer of bore — <br /> Other ❑ Rocket 0 110 — <br /> (7) CASING INSTALLED) \ (8) PERFORA�YiO S: — <br /> Steel p Plastic Co% <br /> c?�t Type of pe r n o\r\\ze of scree From Tt Dia. G, a- r F To 1 — <br /> ft. f Wall f . ft. S - <br /> IL60 190 3- <br /> (9) WELL SEAL: - <br /> Was surface sanitary seal provided? Yes$ No ❑ If yes, to depth5o ft. <br /> Were strata sealed against pollution? Yes ❑ No ❑ Interval ft. — <br /> Method of sealin• b®21toaite Work started 19 Completed-19— <br /> (10) <br /> ompleted19(10) WATER LEVELS: WELL DRILLER'S STATEMENT: <br /> Depth of first water, if known ft. This well was drilled under nu <br /> y jurisdiction and this report is true to the hest aJ mg <br /> Standing level alter well completion ft. knowledge and belief. , <br /> (11) WELL TESTS: SIGNED �T Q G `6 ri x r d ?Lc ? <br /> Was weBll test made? Yes E] Nn ❑ yes, by whom? ❑ - KENNINGS BROS Dnl <br /> 1'ylc of test Pump ❑ Bailer ❑ Air lift NAMED RILL NG CO.7 INC. <br /> Depth to water at start of test ft. At end of test f[ i� rs or um ration T ed m printed) <br /> Discharge Address 3J� ejancta e db04 <br /> g gal/min after hours Water temperahrre Ode <br /> Chemical analysis trade? Yes E] No [j If yes, by whom? Cit3' MOdJ�eS ol Cali July <br /> 4 <br /> Was electric log made? Yes ❑ No ❑ If yes, attach copy to this report License No. 290813 Date of this reportv 1 78 <br /> DWR 188 (REV.7.76) IF ADDITIONAL SPACE IS NEEDED. USE NEXT CONSECUTIVELY NUMBERED FORM <br />