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,ear +i w: <br /> ORIGINAL. STATE OF CALLFORNIA ' Do not fill <br /> THE RESOURCES AGENCY 7 �l <br /> File with DWR DEPARTMENT OF WATER RESOURCES NO. 248569 <br /> •f Intent No. WATER WELL DRILLERS REPORT State Well No. <br /> L 4ermit No, or Date Other WeII No.o S,0SMLa—F- <br /> ( 1) <br /> a -( 1) OWNER: .came Cliff McCur 1 ey {12) WELL LOG: Total depth-1-1-5-ft. Depth of completed well 10 5 <br /> Address <br /> 769 Brandywine from ft. to ft. Formation (Describe by color, character, size or material) <br /> city_ Manteca zip 0 ' Top Soil <br /> (2) LOCATION OF WELL (see instructions): <br /> County San Joaquin Owner's Well Numher 1 - 51 Hard Pan <br /> Well address if differye�nt from above 4691 Durham FerryRoad - <br /> Township_ Trac+ Range —Section 51 - 201 'sand <br /> Distance from cities, roads, railroads, fences, etc _ <br /> Sand And Clay <br /> ' - 451 Clay <br /> (3) TYPE OF WORK: <br /> New WeII g) Deepening ❑ 451 </�41 Gravel <br /> Reconstruction ❑ - <br /> C C <br /> Reconditioning ❑ 54-1`, - 80" '-,'✓�,la <br /> ' 1Horizontal Well ❑ \* - <br /> yat'c, Destruction ❑ (Describe 80.1 - 821 Gravel <br /> destruction materials and <br /> procedures in Item 11) _ <br /> (4) PROPOSED USE:- 821 -.841 Clay <br /> .S Domestic <br /> Irrigation78-61, ❑ ' _ Gravel <br /> L Industrial ❑ - <br /> i Test Well ��' ❑ 861 - - 941 Clay <br /> i rZ <br /> Stock Q - <br /> !' Municipal ❑' 94' - 1021- Sand And Gravel <br /> WELL LOCATION SKETCH Other ❑ - -- <br /> (•i) EQUIPMENT: (6) GRAVEL PACK: 1021 - 115, Clav <br /> P.otary gj Reverse ❑ Yes ® No Q Size <br /> Cable Air ❑ Diameter of bore - <br /> Other ❑ Bucket Q Packed from 50' - <br /> 1 7) CASING INSTALLED: (8) PERFORATIONS: - - <br /> Steel kl Plastic ❑ Concrete ❑ Type of perforation or size of screen <br /> From To Dia. Gaga-0r From'.-, �_--�'To Slot - <br /> ft. ft. -in. Wall ft .�'; ft <br /> 0 0 +� + " 1015t �!/i6x4 - <br /> (9) WELL SEAL: - <br /> Was surface sanitary seal provided? Yes ] No ❑ If yes, to depth 50 1 ft. _ <br /> Were strata sealed against pollution? Yes ❑ No N Interval"fit. - <br /> .Llethod of sealing- bentonite Work startrvt rC 1964Completed—Ma=c 19 <br /> (10) WATER LEVELS: WELL DRILLER'S STATE.%vIE\T: <br /> Depth of first water, if known St To Zn+ h• This well coos rflled under my iurisdicrion and this r <br /> epurt is true to the bet n} m <br /> Standinut level after well completion--_— 1$' _ _ k• knowledge a belie}. � <br /> (11) WELL TESTS: SIGN ED <br /> Was well test mule? Yes r-, Nr.:W If yes, by whom? -n- (Well Driller) <br /> Type of test Pomp ❑ Bailer ❑ .air lift C] ',AW Martin Pump & Supply Inc <br /> Depth to water at start of tat -0- g• At end of test =ft (Person, firm, orcori-ratinn) (Typed or printed) <br /> 4nrt:e^ <br /> -0-,_;;al/min afte -0- ours Water teenperature -Q- Address 5 Reed Road <br /> � r , <br /> rI analysis made? Yes 0 So If yes, by whom? City Oakdale - 7;p 95361 <br /> %V- eleetrie Ing made? Yes ❑ No M If yrs, attach copy to this repnrt--0— License No. 360-851 _Date of this repo G <br /> DWR 188 (REV. i-ler 1F ADDITIONAL SPACE IS NEEDED. USE NEXT CONSECUTIVELY NUMBERED FORM <br />