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went "A' <br /> STATE OF CALIFORNIA <br /> ORIGINAL THE RESOURCES AGENCY Do not fill in <br /> File with DWR DEPARTMENT OF WATER RESOURCES <br /> WATER WELL DRILLERS REPORT N0. 325326 <br /> Notice of Intent No. State Well No. <br /> �j <br /> Local Permit No. or Date _8 9-2697 - � Q��'-��z Other Well No.o' S !r <br /> (1) OWNER: Name c (12) WELL LOC: Total depth 335 ft. Completed depth 24 ft. <br /> Address 3941 A 11 o l l t D r. from ft. to ft. Formation(Describe by color.character,size or material) <br /> City Iracy , Ca zip 95376 0 - 3 ToQ So 1 <br /> (2) LOCATION OF WELL (See instructions): 3 — 15 C l d <br /> County San d c a q 11 1 n Owner's Well Number 15 - 22 Sand <br /> Well address if different from above 27 22 - 1 4 5 Clay <br /> Township (2 Range % ion 4 T�) 145- 150 Sand <br /> Distance from cities, roads, railroads, fences, etc. 9 0 n 1 C QFj th n f 150- 230 C l a y %1. <br /> Durham230- 235 Set Graved �. <br /> Past side 235-- 305 C 1 a \ <br /> 305- 335 Blue\ dy Clay <br /> (3) TYPE OF WORK: <br /> New Well X Deepening ❑ <br /> Reconstruction ❑ <br /> Reconditioning ❑ �! <br /> Horizontal Well El <br /> Destruction ❑ (Describe - <br /> destruction materials and pro- ^' <br /> cedures in Item 12) <br /> (4) PROPOSED USF <br /> Domestic _ CJ <br /> Irrigation <br /> Industrial ❑ 1 _ l 1 J <br /> Test Well <br /> iVIUniCipA� Cl •i_ �, <br /> Other [ - <br /> ribe) <br /> WELL LOCATION SKETCH < (- — <br /> (5) EQUIPMENT: ( GRAVEL PACK S-and."-& <br /> Rotary M Reverse ❑ X1 No d Size G'r a v e 1 <br /> Cable ❑ Air C] -Nnet4,ofbore �I1 �� Z <br /> Other <br /> C] Z'tired from _`'td2A0 'EL <br /> �\ e, _ <br /> (7) CASING INSTALLED: (8) PER IOA�I <br /> Steel ❑ Plastic n Typefof <br /> From T Cage or t <br /> ft. f ii Wall t. size _ <br /> 0 160 220 4 3creen - <br /> (9) WELL SEAL: <br /> Was surface sanitary sea[provided? Yes X1 No ❑ If yes,to depth 120 ft. <br /> Were strata sealed against pollution? Yes ❑ No ❑ interval ft — <br /> Method,,f sealing RFmTnNTTF Work started N 0 u 7 I9-sa Complet 19- <br /> (10) WATER LEVELS: WELL DRILLER'S STATEMENT: <br /> Detrth of first water,if known ft. <br /> This well was drilled under my jurtsdic•tfon and this report is true to the <br /> Standing level after well vnipletion 2 C1 ft. best of my knoirledae and Iwhe(. <br /> (11) WELL TESTS: Signed ` U' <br /> Was well test made? Yes f3 No XX If ves,by whom? -tWell Driller) <br /> :•ypee of test Pump © hailer ❑ Air lift ❑ NAME H E N N I ,J G S BROS . DRILLING CO . , INC . <br /> Depth to water at+tart of test ft- At end of test ft _ (Person,firm,ormrporation)(Tvped or printed) <br /> Discharge gal/min after hours Water temperature Address ?_5 PFI A['I it A I F A V F _ <br /> Chemical analysis made? Yes © No" If yrs,by whom? City r1Q_u_9 C TQ s r A zip 4 rl3.ri 6 -- <br /> Was electric IN made Yes ❑ No Q If yes,attach cupv to this report License No. 29081 -1 Date of this reportD F C - 1 ' - 1 9 E <br /> OWR 11516 IREV. 12-88) IF ADDITIONAL SPACE IS NEEDED. USE NEXT CONSECUTIVELY NUMBERED FORM 86 96755 <br />