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r s <br /> GUADRUPLICATE STATE OF CALPFORNIA <br /> Use of comply with THE RESOURCES AGENCY DO n01 fill in <br /> local requireumm DEPARTMENT OF WATER RESOURCES No. 173122 <br /> Soti.of Intent No WATER WELL DRILLERS REPORT State <br /> U,al Permit No. or Date 85_406 Other Well N,, _ <br /> ( 1) OWNER: Name Quality Assured Packing Plant (12) WELL LOG: Tota,depth4_451—ft. Depth of completed welh 95 ft. <br /> :\ddreu 6r.n3 fmm ft. to f. Fommlion (Describe by colnn, character, sue or material) <br /> City Stockton, Ca Zip - 15 clay <br /> (2) LOCATION OF WELL (See instructions): <br /> County_ SAn .l6aelniA Owner's Well Number <br /> Well address if different from all.ve 'I <br /> T,,u..MP Range Sectio -90 CI <br /> Distance from cities, roads,,-dreads,fences,Ne. <br /> 98 - 141 Cla-v <br /> 141- 141; Sand <br /> (3) TYPEI,OF WORK: - <br /> New Wall )o Deepening ❑ <br /> Reconstruction ❑ — <br /> Reconditioning Cl212-946 C ay <br /> Horiu(ntal Well ❑ Sand <br /> — <br /> Destruction ❑ (Describe — <br /> destruction --rials epi <br /> procedures in It.. 1,£y' <br /> (4) PROPOSED USE, 264-26S r1ay <br /> Dmncstie Q 262-276 Sand <br /> Irrigation ❑ <br /> 270-305 Clay <br /> Industrial 305-207 Sand <br /> Test Rell ❑ 3v-390 clay <br /> st,xk ❑ Q — <br /> Municipal ❑ 322-330 clay <br /> VMLL LOCATION SKETCH I Other ❑ <br /> 3 30-331 Sand <br /> (5) EQUIPMENT: 0) GRAVEL PACK: R 3 1— <br /> Rotary [R Reverse C) yes [A' No ❑ Sue and - <br /> Cable ❑ Air ❑ Diameter of bore--2-"- 161-370 Clay <br /> Other ❑ Bucket ❑ Packed from ,5,0 to�QF tit. - <br /> 372 Sand -44 L <br /> (7) CASING INSTALLED: (8) PERFORATIONS: - <br /> Steel 1p Phptie ❑ Concrete ❑ Type of Perforation or size of screen - nf, MAY 2 Q r <br /> From To Dia. Gage or Fmm To SlotRglay <br /> AQ-448 <br /> ft. ft. in. Wall ft. ft. size - <br /> 0 3116 220 1Z C <br /> (9) WELL SEAL: /� <br /> Was .,face sanitary seal provided? Yes 'A No ❑ if yes, to depth�i.V--ft. — <br /> Were strata sealed against pollution? Yes ❑ No ❑ Interval N, — <br /> Method of scaling Work start 19 Completed 19 <br /> (10) WATER LEVELS: WELL DRILL R'S TATEMENT: <br /> Depth of first water, if know ft. This .11 was drilled under my imisdictirm and this repair is true to thl bear of my <br /> Standing level after well completi knowledge and belie}. <br /> (11) WELL TESTS: SIG Er, <br /> Was well test made? Yes ❑ No Cj If yes, by whom? (Well Driller) <br /> Type of test Pump E) Ba ler ❑ Air lift ElNAME nor /r. <br /> r�r <br /> Depth to water at start of test ft. At end of test ft error, , a,or co,pormii,o F,'P or printed) <br /> Disobaige sil/min after I+oun Water tempera Address 35+95 DEI AldnAI F AVE <br /> Chemiml amIy.i. made? Yes ❑ No N If Yes, by whom? Cat), CA <br /> Wes electric Ing made? Yes ❑ No I If yes, attach 4 y to this report License No. ate of this repo L <br /> DWR 186 (REV.7.70) IF ADDITIONAL SPACE IS NEEDED, USE NEXT CONSECUTIVELY NUMBERED FORM <br />