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LUUAIIUN NOT CHECKE ) <br /> ORIGINAL X TER WELL DRILLERS REPOI �T Do Not FW In <br /> File Original,Duplicate and Triplicate With the `" (Swtiwe 7076,7077,7078, Fater Cade) 1r 34964 <br /> REGIONAL 'WATER POLLUTION <br /> STATE OF CALIFORNIA �4 A� SuuTell No. <br /> —___._____ <br /> CONTROL BOARD No fj <br /> rl„art 4p.opriate■nsbrl Ocher Well NO.e — _ <br /> 1) OWNER: (11) WELL LOG: <br /> Name H_ E_ RIP,Tfv'HTSTT,F Total depth 1L0 ft. <br /> — Depth of completed well 140 ft. <br /> Address 2705 Country Club Blvd. Formation: Describe by color,cbarwirr,size of aaateria/, and structure. <br /> Stockton, Calif. A it.�n it. To; snit <br /> 4 1 -5 Rrnwn clay <br /> (2) LOCATION OF WELL: 7 S 1 k ” prntim <br /> county Ssn JnqQuin Ovum's number,if my— - 1 g- 27 Promm rl ay <br /> R.F.D.or Street No. -2 J 32 Rrnwn <br /> O <br /> �,,� •• /?n '• $117P tel AQ <br /> 1.i7 ,Cl C:r. -;a n <br /> 5 7 " Gra y sa7 std <br /> 73 75 " Blue clay <br /> (3) TYPE OF WORK (cbeck): 75 93 " kray sand <br /> New'well 6 Deepening ❑ Reconditioning ❑ Abandon ❑ 93 118 " Blue clay _ <br /> If abandonment,describe material and procedure in item 11. 118 " 120 Graze sand <br /> (4) PROPOSED USE (cbeck): (S) EQUIPMENT: 120 135 Blue clay <br /> Domestic ® Industrial ❑ Municipal ❑ Rotary ® 135 140 Gray Sand <br /> Irrigation ❑ Test Well E] Other ❑ Cable ❑ :: :: <br /> Du Well ❑ <br /> (6) CASING INSTALLED: If gravel packed <br /> SINGLE f7 DOUBLE 17 <br /> or Diameter from to "t \, <br /> From eft.to 95 ft. AllDitm. 1 ���Call of Bon it. ft. 4. \ <br /> Type and uxe of shoe or well rind Site of anvaft .. .. <br /> Describe joint •• • <br /> (7) PERFORATIONS: <br /> Type of perforate-used <br /> Sue of perforations in.,length,by in. " <br /> Frorn ft.to ft. Perf.per row Raw.per it. <br /> (8) CONSTRUCTION: <br /> Vas s surface unitary seal provided? ❑ Yes ❑ No To what depth ft. <br /> Were any strata n&W against pollution? ❑ Yes ❑ No if yes,note depth of strata .. ., <br /> From ft.to ft. <br /> Method of Sealing �Vclrk.tartod 1_2� IY 55 , compl.tad 1-24 55 <br /> , is cS <br /> ■ t f . <br /> (9) WATER LEVELS: WELL DRILLER'S STATEMENT: <br /> This well was drilled under my iserhdiction and Ibis report is true to the best of <br /> Depth at which water was first found It•, my inowled8e andrrybeelief.r} �l 7 <br /> `':-dina I..•I before perforating ft. NAME._ S1UCKy 717 T�MATL FLP, MOTOR I'MRKS <br /> dins level after perforation —.+rT� <br /> .��. ...,,� (Person,brm,or corpora uon? ITYNl Or prs•udJ <br /> Address 646 South Ca lifornia St. <br /> (10) WELL TESTS: S <br /> tncktnn_ Ca lifnrnia <br /> V..a pump te.t mads? ❑ Ya ❑ No If ya,by whom? _•'---_-— <br /> Ywld: Sal./rain, with it.draw down after hes. 1SIGN16D1_�._______ _ _ _._ --- <br /> b7850 vele er - – <br /> Temp—mre of weer Was.chemical aaalysi.mad.? ❑ Ya ❑ No License No.__-___--_�_—_. <br /> Y'as electric lot made of wall? ❑ Y. ❑ Ne aaus 344 now out.(D sro DWR Fonst No. 246 1n3V.3.54) <br />