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Do not fill in <br />No. 185796 <br />State Well No <br />Other Well No <br />ORIGINAL <br />File with DWR <br />Notice of Intent No <br />Local Permit No. or Date <br />THE RESOURCES AGENCY <br />DEPARTMENT OF WATER RESOURCES <br />WATER WELL DRILLERS REPORT <br />STATE OF CALIFORNIA <br />19 Work started 19 Conn:acted <br />WELL DRILLER'S STATEMENT: <br />512268 Date of this report <br />DWR 188 (REV. 7-76) IF ADDITIONAL SPACE IS NEEDED. USE NEXT CONSECUTIVELY NUMBERED FORM <br />S'EO -D-51--14-(0 <br />( 1) OWNER: Nam. ( 12 ) WELL LOG: Total depth ft Depth of completed well ft <br />from ft. to ft. Formation (Describe by color, character, size or material) <br />4 ..,, ci zitzrr_Ze__ _ <br />L CATI N OF <br />_ <br />(2) WELL ( See instructions): <br />Coma tbA_,/ Owner's Well Number74(..)-0 - <br />Well address if dill rent from above <br />_ <br />Township_IA-1 Range4Z- Sectionj223 - <br />Distance from cities, roads, railroads, fences etc - <br />- <br />_ <br />_ <br />TYPE OF WORK: 7(.‘ Zle1.6 <br />New Well 0 Deepening 0 <br />Reconstruction 0 <br />Reconditioning 0 - <br />Horizontal Well 0 - <br />Destruction 0 (Describe _ <br />destruction materials <br />procedures in Item <br /><?, % ---...-- ,cel‘..a PROPOSED <br />Domestic <br />Irrigatiot/P-"\ - <br />Industrial .1.N \' \ <br />Well , \ V - - <br />St \ ) - /1 <br />Mtmic -/--•M <br />WELL LOCATION SKETCH Other 4$4061",, ----, <br />EQUIPMENT: GRA PACK: <<, <br />- <br />Rotary 0 . Reverse 0 0 No S' (%) . . <br />Cable 0 Air 0 . . ter of bore <br />Other 0 Bucket 0 rom , <br />CASING INSTALLED PERFO S: - <br />Steel 0 Plastic 0 C.. to Type of pei4nize of scree <br />From <br />ft. <br />T Dia. <br />in. <br />G• • , or <br />Wall <br />F To <br />ft. <br />_ <br />s* — <br />— <br />( 9 ) WELL SEAL. <br />Was surface sanitary- seal provided? Yes -10 No 0 If yes, to depth <br />Were strata sealed against pollution? Yes 0 No 0 IntervaL_ ft <br />Method of sealing <br />(10) WATER LEVELS: <br />Depth of first water, if known__ ft <br />Standing level after well completion ft. <br />( 11) WELL TESTS: <br />Was well test made? Yes 0 No 0 If yes, by whom? <br />Type of test Pump 0 Bailer 0 Air lift 0 <br />Depth to water at start of test ft. At end of test ft <br />Discharge gal/min after hours Water temperature <br />Chemical analysis made? Yes 0 No 0 If yes, by whom? <br />Was electric log made? Yes 0 No 0 If yes, attach copy to this report <br />This well was <br />knowledge <br /> <br />SIGNED <br />NAME <br /> <br />Address <br />City <br />License No <br />lied under my jurisdiction and his report is true to the best of my <br />ruler) <br />SPECTRUM ORATION, INC. <br />(Person, firm, or rporation) (Typed or printed) <br />2825 E. YRTLE STREET <br />zip 99209 STOCKTON , CA