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FIELD DOCUMENTS FILE 2
Environmental Health - Public
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EHD Program Facility Records by Street Name
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D
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DURHAM FERRY
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4491
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3500 - Local Oversight Program
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PR0544625
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FIELD DOCUMENTS FILE 2
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Last modified
7/3/2019 7:49:05 PM
Creation date
7/3/2019 4:26:46 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
FileName_PostFix
FILE 2
RECORD_ID
PR0544625
PE
3528
FACILITY_ID
FA0003113
FACILITY_NAME
ZAPIEN MARKET
STREET_NUMBER
4491
Direction
W
STREET_NAME
DURHAM FERRY
STREET_TYPE
RD
City
TRACY
Zip
95376
APN
25504003
CURRENT_STATUS
02
SITE_LOCATION
4491 W DURHAM FERRY RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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1 � 1 <br /> ORIGINAL STATE OF CALIFORNIA Do not fill i. <br /> THE RESOURCES AGENCY <br /> File with DWR DEPARTMENT OF WATER RESOURCES No. 065028 <br /> „f Intent No. WATER WELL DRILLERS REPORT ,tate Well\a <br /> �,._..r Permit No. or Date 87- 144 Other *Well No.635 0.5 E-z <br /> ( 1) OWNER: Netme Pete G i a m b a n c o (12) WELL LOG: Tonal depth-2-0,-ft- Depth of completed welts 5 v_: <br /> Address 4952 Durham Ferry R d . from ft, to ft. Formation (Describe by colomr• character, size or material) <br /> Tracy . Ca zip 95376 0 - 3 Top Soil <br /> (2) LOCATION OF WELL (See instruetiom): <br /> C: 4 Sand &mm�tti•�n Joaquin a n u 1 n Owner's Well Number- Grave 1 <br /> 4 r11 address if different from above 34 - 60 Clay <br /> Tonvnship Range Sectio 60 - 62 Gravel <br /> Distance from cities, roads, railroads, fences,etc. 62 - 1 <br /> 123 - 125 Graae��� <br /> 125 - 13�..Clay`,�. <br /> (3) TYPEOFOF WORK: 14 75 ,fl 17 7 Ql'a <br /> Np;Ne Well Deepening C11 7 Z ~ 7 9 G r a V <br /> Reconstruction ❑ 179 - •1-85 Clay ` <br /> Reconditioning 0 185 - 187 /G+r a v e l <br /> Horizontal Well o �k8-7 - 191 C l a <br /> Destruction i (Describe 191 - 4• <br /> destruction materials and <br /> procedures in Item 12). 194 205 Cla-y <br /> - <br /> SErDo(4) PROPOSED USE:- <br /> Domestic <br /> mestic <br /> Irrigation ❑, - <br /> Industrial ❑ - - <br /> Test Well ❑ - <br /> Stock ❑, - <br /> Municipal ❑ <br /> WELL LOCATION SKETCH Other - ❑ - <br /> (S) EQUIPMENT: (B) GRAVEL PACK: and <br /> Rotary Reverse L] Yes C \o ❑ Size U - <br /> Cable ❑ Air ❑ Diameter of bore IF - <br /> Other ❑ Bucket ❑ Packe&.jT.m 7 0 N 15 0__j, - <br /> (7) CASING INSTALLED: _ (8)''PERFORATIONS: - <br /> Steel � \\ - <br /> ❑ Plastic [ Coticlet Type of pe or�atlon r size of screeri.�;, <br /> From To Dia. Ger From` \! To <� 3bt�✓ - <br /> ft. ft," � in. Wall fl\\• ft. size} - <br /> 0 15 160 110 150 n - <br /> (9) WELL SEAL: <br /> Was surface sanitary seal provided? Yes [X No L; If yes,\to depth 70 ft. <br /> Were strata sealed against pollution? Yes ❑ No ❑ Intervat ft. - <br /> Method of sealin• Rpntnnitp Work started Jan , 2 19 Complete 19 <br /> (10) WATER LEVELS: WELL DRILLER'S STATEMENT: <br /> Depth of first water, if known_ ft. This well was drilled under my farisdiction and this rep.rrt is true to the best tit m, <br /> Standiri0 level after well completion 2,41. K, knowledge and belief. <br /> (11) WELL TESTS: �S/ SIGNED C ���Z,i'=A - <br /> W is well test made? Yes ❑ Nn G. If yes, by whom? (Well DMIer) <br /> T,pr •.f test Pump c Bailer ❑ air lift ❑ NAME H E_ N N I N G S BROS. DRILLING_ CQ - I N C _ <br /> Ihpth to water at start of test R. At end of test ft (Person, fimi, or corpomtion) (Typed or printed) <br /> ' •este r;a!/min ;titer hours Water temperihire Address 3525 PE L A N D A L E AVE - <br /> Al <br /> VE _Al analysis made? Yrs ❑ No Q( If yes, by whom? City M G D E S T 0 <br /> W.rs electric Inst made? Yes ❑ Nn RIf yes, attach copy to this report License No. 290813 Date of this repo <br /> 6WR 188 tREV. 7•78i IF ADDITIONAL SPACE IS NEEDED. USE NEXT CONSECUTIVELY NUMBERED FORM <br />
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