Laserfiche WebLink
11 ) OWNER:I <br />jin 95330 - <br />Sand & <br />jLcmen..lasi£SS-iias.A <br />19. CompMed. <br />h <br />22 <br />'■•r <br />OCT. 24> 1904 <br />n a r ’ a « ■ * r v <br />. Section <br />East of Hwy 5 <br />\’<tM e «»f Intent N*«»— -------------------------------- <br />Uk-aI Permit No. or Date £4*13X2- <br />Di*. <br />in. <br />From <br />ft <br />------ <br />Air lift (3 <br />At er*l "I te«t <br />To <br />ftfrom <br />ft. <br />WELL DRILLER S STATEMENT: <br />Thif uw» drtllrd itndr' my jttritdicfUfn nmi thii r« port it tnif to thf hert of mt/ <br />IrntwImUr akm< Mirf <br />Sk.X ED -----------------------------------------——------------------------------------- <br />_______________ <br />__ _Pi»te <>( thlt rr;» rt X2Z- <br />I U ell Driller I <br /> wwmJKftWi.W'yjM.- ■ ,BC— <br />A ild re*« -2525-2ELA2IDALE JIVE.---------------------------- <br /><■.«___nouESj. <br />tUrenw . 29GB <br />QUADRUPLICATE <br />Use of comply wMi <br />local roqvlrotnotrts <br />(3) TYPE OF WORK: <br />New Well Ij Deepening <br />Recorwtniction <br />Reconditioning <br />Horizontal Well <br />Dratruction (Describe <br />destruction materials and <br />procedures in Item <br />^ZZ□__ <br />□___ <br />o <br />____ <br />□ ___ <br />Send--------- <br />Blue Clay <br />Sand______i <br />PlMtic jp <br />To <br />ft <br />W atrr teiw|»eratu»e_____ <br />« h<•m- ... <br />atta< h < ,«p? to tbit report <br />IS NEEDED USE NEXT CONSECUTIVELY NUMBERED FORM <br />(9) WELL SEAL: <br />Wm inrfuce tanHery <~1 provided? 'erjp <br />Were •frat, waled afainat pollution? Yea Q <br />Metfod .4 .ealme <br />(10) WATER LEVELS: <br />Dearth of first water, if known----------- <br />Staodinic level after well <«»mp>ett«m— <br />(11 • WELL TESTS: <br />\\»» well teat made* <br />„h<inr% <br />vX: » >"• h' <br />Ye- I NX 1* <br />IF ADDITIONAL SPACE <br />•TATI OF CALIFORNIA > <br />THE RESOURCES AGENCV\ ,• <br />DEPARTMENT OF WATER RiSJBOURCES <br />WATER WELL DRILLERS <br />GrS» ot Wril <br />No If yea. to depth.gQ----------It. <br />| N<» C Interval .ft. <br />WELL LOCATION SKETCH <br />(5) EQUIPMENT! <br />Rotary J3 <br />Cable O <br />Other O <br />(7) CASING INSTALLED: r\ \ w <br />Steel O Plastic Concrete y <br />Gai <br />If \r». by <br />Type *»f lost Pump C ' Rriler '3 <br />Depth to mater At etAH of IrV ——- — •’ <br />Dm-harer*. _____kaI ’n‘n after— <br />Oiemical anah«is pudri* <br />\K «« r)e« Uli but u .mIc* <br />\<l ’rrss 34 W. Mossdale----- <br />(?ity,, -------------Lathrop,-Ca----------- <br />(2) LOCATION OF WELL (See instructions): <br />C.......V San Joaquin Owne* Wen Number. <br />Well address if different fmm above <br />T«>wmh» o - - Ranee ------- <br />Distance fn>m Hties, mads, railmada, fences, etc. <br />Do not fit' In <br />-------- .d^No. 1'54234 <br />Well No <br />Other Well No <br />65 <br />2a. <br />125 IRQ Sand_____ <br />ISO 184 Clay\>X <br />184 216 Sand >2^ <br /> Stay V. ■ <br />Reverse <br />Air <br />Rue krt <br />(4) PROPOSED 06Er <br />Domestic <br />Irrigation / ' <br />Induatrial \ x <br />TeTt Well <br />Stock \ <br />Municipal <br />Other <br />(fl) GRAVEL'TACK: <br />Sw»Jp No'b' Si». <br />Diameter of bore_ <br />PacWd^rom- £0------ <br />(fl) PERFOMATION*: <br />Type of perfrrtrtftm or Hee ..f vreen <br />Slot <br />size <br />( 12) WELL LOG: T.Hal <lenrh?16 ft. Depth of completed well 185..ft. <br />fomr ft.to ft. F.um.tlon (DeuHbe hy color, character, rize or material) <br />^5- <br />-7fi <br />i25 Clay <br />______ <br />.■ - .. <br />______________■