Laserfiche WebLink
STATE OF CALIFORNIA <br /> ORIGINAL THE RESOURCES AGENCY Do not fill :n <br /> File with DWR DEPARTMENT OF WATER RESOURCES <br /> WATER WELL DRILLERS REPORT N0. 2989 5 <br /> 0e of Intent Noel, Stake Well No <br /> Local Permit Na or Date R —iz 213 S-1 /y�, Other Well No 0?SC�S��IDo61N <br /> (1) OWNER Name A 00 0 CC), (12) WELL LOG Total depth a? ft Completed depth Al;L ft <br /> Address from ft to ft Formation(Describe by color character size or material) <br /> City 401. C ZIP _ <br /> (2) LOCATION OF WELL (See instructions) _ —6,G— 6,GR 6 T <br /> Countv -5A P1 1%.10A 4201AI Owners Well Nurn bei M '5 <br /> Well address if different from above r <br /> Township Range J E Section _ <br /> Distance from cities roads railroads fences,etc &'4je,6'4's7 6e CF — <br /> O c' <5AL S7 IO A� ON F <br /> T ,C 7.49 Al Td �trF-tt _ <br /> (3) TYPE OF WORK _ <br /> New Well C9 Deepening ❑ <br /> Reconstruction ❑ _ <br /> ,5r—_7-7 �t �A C��'D Reconditioning El <br /> Horizontal Well ❑ <br /> 1 D���l Q� �� Destruction E3 (Describe — <br /> E3 <br /> materials and pro- <br /> cedures in item 12) _ <br /> (4) PROPOSED USE _ <br /> Domestic ❑ _ <br /> Irrigation n _ <br /> Industrial ❑ _ <br /> Test Well ❑ _ <br /> Municipal ❑ <br /> Other "04V/TOr219a ® <br /> WELL LOCATION SKETCH (Describe) <br /> (5) EQUIPMENT (6) GRAVEL PACK <br /> Rotary X4jJtiLWR Reverse ❑ les® No 0 Siz� <br /> Cable ❑ Air ❑ Diameter of bore <br /> Other ❑ Bucket L7 Packed from 4 _ — to 21�_5 ft — <br /> (7) CASING INSTALLED (S) PERFORATIONS — <br /> steel ❑ Plastic 54 Concrete ❑ Type of perforation or size of screen _ <br /> From Tri Dia Gage or From ^` To Slot — <br /> ft ft In Wall ft ft size <br /> ------------ <br /> (9) WELL SEAL <br /> Was surface sanitary seal provided? les 19 No ❑ If yes to depth 4 ft <br /> Were drat i sealed against pollution? Yes ❑ No ❑ Inlr rval ft — <br /> Method of sealing 7— Gievo 7 OC j1JI 74E Work started 19 C ampleted 19 <br /> EZ <br /> (10) WATER LEVELS WELL DRILLER'S STATEMENT <br /> Depth of first water if known fl <br /> g level after wellcom completion Z Z VE: ,`, ft This 1uf1 drilled 1(dge u er my 1uri5dretson and thn report 15 trot to tfu <br /> Standing P 1x sf a n -r wcdge n lief <br /> (11) WELL TESTS <br /> Was well test madeO Yes ❑ No ® Ifvts b) whnmrf �1t11Dn r) <br /> Wof test Pump El Baiter ❑ Air lift ❑ NAME D q L U" LIt7 �'>t <br /> to water at start of test ft At end of it sl ft (Pe n firm or rnrpor on) Typed or printed) <br /> Discharge gal/min after hours Wilt rltmplraluri Addrtss — <br /> ' r zrP -� <br /> Chemical analysis made' Yes X No [3 If yes by whom ✓ City — <br /> Was electric log made Yes ❑ No 54 If yes,attach copy to this report L 1 ivense No Date of this report �O p <br /> OWR 168 1REV 12-86) IF ADDITIONAL SPACE IS NEEDED USE NEXT CONSECUTIVELY NUMBERED FORM 86 96355 <br />