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t '� •i STATE OF CALIFORNIA <br /> (ORIGINAL THE RESOURCES AGENCY Do not fall in <br /> File with DWR DEPARTMENT OF WATER RESOURCES <br /> WATER WELL DRILLERS REPORT No. 28613.3 <br /> Local <br /> of Intent No, State Well No.. <br /> Local Permit No. or Date Other Well NoA <br /> (1) OWNER: Name City of Trae (12) WELL LOG: Total depth ft.Completed depth ft. <br /> Address. 560 Tracy Blvd. 9531 from ft, to ft, Formation(Describe by color,character,size or material) <br /> City Tracy, CA ZIP 860 - 865 Brown. Clay Sticky WSmall Stringers <br /> (2) LOCATION OF WELL (See instructions):LVAC011. ? — o£ Gravel <br /> County Owner's Well Number 865 -872 Gravel- WC ay Lagers <br /> Well address if different from above 872 --8 5 BxaFtTt'l Clay W Trace of Gravel <br /> Township Range Section 5 — 95 -aravel & Rocks & Clay Some HER <br /> Distance from cities, roads,railroads,fences,etc. — tringeL <br /> Brorm Cla tiAy <br /> 912 -922 ray.. a ome Rocks <br /> rav _ rmm May <br /> (3) TYPC OF WORK: 926 rolm <br /> New Well ❑ Deepening © AFNP�pm Lay Hard SErUagers <br /> Reconstruction © e `y Layers <br /> Reconditioning © 96 o TTl U,5v W/Gravel Stl:'J.I.1 er,s <br /> Horizontal Well ❑ 3W lk"kOvs <br /> Destruction ❑ (Describe 85 BrN <br /> .W�*VlMfardtrj-ngers <br /> destruction materials and pro- 0 B. & me Gravel & Hard <br /> cedures in Item 12) O - tririg�� <br /> (4) PROPOSED US <br /> Domestic a 1 6" X " ndtictor <br /> Irrigationjkj�7�5aC k Pipe Gravel Tube <br /> Industrial 2" T%WSounding Tube <br /> Test Well 250 6 out Pal <br /> Munici ❑ _ Q <br /> o er 0 -,G� FCI X 5/16" Blank Casing <br /> WELL LOCATION SKETCH 0 4901 �l6" X 5 1.6" Ful Flo .070 <br /> (5) EQUIPMENT: C 98 —99V 16" X 5/16" Blank Casing with S E H, <br /> Rotary ❑ Reverse ❑ No iz \ <br /> Cable ❑ Air ❑ e of bore / <br /> 'Other ❑ Rueke c t. <br /> (7) CASING INSTALLED: (8) PER <br /> Steel ❑ Plastic ❑ n e Typ of #o norsizoo# r c Q <br /> From T (KDfa, Gage or Ttfr �j t — <br /> ft ft. Ii . Wall t. size <br /> (9) WELL SEAL:Was surface sanitary seal provided? Yes ❑ No ❑ If yes,to depth ft, <br /> Were strata sealed against pollution? Yes ❑ No ❑ Interval ft. — <br /> Methodofsealing Work started 19— Completed I9— <br /> (10) WATER LEVELS: WELL DRILLER'S STATEMENT: <br /> Depth of first water,it known ft. <br /> This well was drilled under my Jurisdiction and this report is true to the <br /> Standing level after well completion ft, best of my knowledge and belief, <br /> (1I) WELL TESTS: Signed <br /> Was well test made? Yes ❑ No ❑ If yes,by whom? (Well Driller) <br /> Pump ❑ Mailer ❑ Air lift ❑ NAME L:yers Bros. Well Drilling, Inc <br /> 4*p0e,,,h",f.t-,vater <br /> at start of test—it. At end of test ft (Person,firm,or corporation)(Typed or printed) <br /> charge.--- -- -gal/min after }sours Water temperature Address t��?50 F+�._ T t'_P_y Blvd <br /> Chemical analysis made? Yes ❑ No ❑ If yes,by whom? City Hanford CA ZIP 93230 <br /> Was electric log made Yes ❑ No ❑ If yes,attach copy to this report License No. 548214 -Dateofthisreport 8-16-89 <br /> DWR 18B(REV. 12-86) IF ADDITIONAL SPACE IS NEEDED, USE NEXT CONSECUTIVIwLY NUMBERED FORM 86 76355 <br />