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ORIGINAL <br />File with DWR <br /> <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. 185776 <br />State Well No <br />Other Well No <br />Notice of. Intent No <br />Local Permit No. or Date <br /> <br />( 1) OWNER: <br />Address ,97/'./ Namedeze ‘,./zeeezdez (12) WELL <br />from ft. to <br />LOG: Total depth___ft. Depth of completed well_ft. ,4/.41/70,ze ft. Formation (Describe by color, character, size or material) <br />City --•____:___________zip‘9,•ei..; <br />(2) LQCATIN OF WELL (See S instructions): <br />Coun I Owner's Well Number <br />- <br />1/C9 <br />- <br />- <br />Well address if different from <br />TowrishipW <br />above - <br />k\ <br />Range... Section. <br />Distance from cities, roads, railroads, fences etc _ <br />- <br />% <br />..••••-••://41:177../de.)4;2 <br />TYPE <br />New Well 0 <br />Reconstruction <br />Reconditioning <br />Horizontal Well <br />Destruction 0 <br />destruction materials <br />procedures in <br />PROPOSED <br />Domestic <br />Irrigation <br />Industrial <br />t Well <br />St <br />Munici <br />Other Ally <br />OF WORK: <br />Deepening 0 <br />0 <br />0 <br />0 <br />(Describe <br />_,.• • Item .1" <br />P. <br />• <br />• <br />24:44 <br /> <br />#r A>PI.4" <br />\,, <br />- <br />- ' <br />- <br />— <br />\ <br />sN, <br />- <br />\ \ <br />WELL LOCATION SKETCH <br />EQUIPMENT: <br />Rotary 0 Reverse D% <br />Cable 0 ' Air .r <br />Other • 0 Bucket 0 TO <br />GRA <br />No .. <br />of bore <br />PA : <br />S. S I <br />- <br />• <br />CASING INSTALLED <br />Steel 0 Plastic 0 C <br />1F0 S: <br />Type of per‘qta n o e of s ree (--.., - <br />From <br />ft. <br />T Dia. <br />in. Wall <br />F..... To <br />ft. 4 <br />\. - . _ 44f.,e) . ,0 _ <br />WELL SEAL <br />Was surface sanitary seal provided? Yes 0 No 0 <br />Were strata sealed against pollution? Yes 0 • No <br />Method of sealing <br />If yes, to depth ft <br />— <br />• <br />0 Interval ft - ' <br />Work started _19 Completed 19 <br />WATER LEVELS: <br />Depth of first water, if lmown <br />Standing level after well completion <br />ft <br />WELL DRILLER'S STATEMENT: <br />This well was dçiU under my-jurisdiction and this eport is true to the best of my knowledge a eef.- <br />/ SIGNED ..,-7.7. <br />ft. <br />( 11) WELL TESTS: <br />Was well test made? Yes <br />Type of test Pump <br />Depth to water at start of <br />Discharge gal/min <br />Chemical analysis made? Yes <br />Was electric log made? Yes <br /> <br />0. No 0 If yes, by <br /> <br />0 Bailer 0 <br /> <br />test ft. <br /> <br />after hours <br />whom? <br />NAME <br />(Well air' ) <br />SPECTRUM EX 47RATION, INC. Air lift 0 <br />At end of test ft <br />Address <br />(Person, firm, or corporation) (Typed or printed) <br />2825 E. MYRTLE STREET Water temperature <br />whom? 0 No 0 If yes, by <br />0 No 0 If yes, attach <br />City STOCKTON , CA 71p 95205 <br />copy to this report License No 512268 Date of this report <br />DWR 188 (REV. 7-76) IF ADDITIONAL SPACE IS NEEDED. USE NEXT CONSECUTIVELY NUMBERED FORM <br />