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ORIGINAL' STATE OF CALIFORNIA N%Wwl
<br /> THE RESOURCES AGENCY Do not fin in
<br /> Fife with DWR DEPARTMENT OF WATER' RESOURCES NO. 071438
<br /> f Intent No.
<br /> L.x:u Permit No. or Date WATER WELL DRILLERS REPORT
<br /> State Well No.
<br /> Other Well No.O ZS Obi Z Z
<br /> , I OWNER: Name BOb Hall (12) WELL LOG: 1 Or
<br /> ZI�b W. Total deP�.t. Depth of completed wel 95
<br /> ldurrss . �ne^s o n Avenue L--ft.
<br /> fn>m ft. to ft. Formation :Descnbr by a,lor, character. ;ize or material)
<br /> t, li3C?jt i i Zip 9537b n - tOzi S011
<br /> 2 LOCATION OF WELL (See instructions): - 18 elav
<br /> :,,unty Jan Joaquin O,tmW, Weil Number 18 - 2 sand
<br /> 'Xril address if different from above 24. - 4.b cla v '\\
<br /> Twnship Ran r I _ (�
<br /> t e Section gra V e
<br /> Distance from cities, mI �hwa ads, railroads, fences, etc old :Z 50 j (b _ kr, `+�V
<br /> anC t wwas li of Chrismax next to mart O5 - 73 � 1
<br /> L- ectric
<br /> 3
<br /> 80 - (7� sane
<br /> (3) TYPE OF WORK: 90 r% 15 0 'Clav
<br /> New Well Td� Deepening ❑ /'�-+�,
<br /> i Reconstruction Cj _
<br /> Reconditioning _ _ -
<br /> Horizontal Well V1 _
<br /> Destruction ,_ (Describe -
<br /> destruction materials and
<br /> Procedures in Item 12) - -
<br /> (4) PROPOSED USE: -
<br /> i Domestic _
<br /> Irrigation ❑' _
<br /> Industrial I _
<br /> Test Well u _
<br /> r Stock
<br /> Municipal
<br /> WELL LOCATION SKETCH 1 Other -
<br /> 5 EQUIPMENT: 6) GRAVEL PACK: -
<br /> R"mr, Reverse _ Yes I?" N,> J SizeSi r ds eve, -
<br /> C.,nie = Air 4 Diameter of bore ^ ?t -
<br /> !)the^ Bucket -' Packed rum SC to 95 .tti_ -
<br /> CASING INSTALLED: 4>`PERFORATIONS: -
<br /> ,teHi _ Plastic _ Concrete-_ Type of perfoi:ation or,size :if screen - L
<br /> from To - Dia. ' GaiZe-or Flom, l_ To Sloi
<br /> _t. i ft. in. I Wall ft. ft. size -
<br /> i 95 b, 160 wog F 70 screen I -
<br /> 3 WELL SEAL; 1
<br /> i
<br /> ..., ,uriace ,unitary seui pnrvtdeti? 'i es �,yr No = if ves, to depth 5 tt. I -
<br /> �'rre ,.:ata sealed i¢ainst p�llut on' Y `:o _ Intrnal
<br /> 2nl2ri
<br /> `.iem,Ki >f sealinY `.V;;rk started l� rCn ��y C J Cumuieteet 19
<br /> =J WATER LEVELS: — i WELL DRILLER'S STATEMENT:
<br /> De-En if first water, if known g.
<br /> I'hi.r well was lulled unri,•r n) 'tt n.cdirnnn and this r_ „rr 's eve to she best or
<br /> 1 loli i.
<br /> itandin, : ft
<br /> eve) aer well cun,pletiot>- rt, knntnledgI' and ^ ,
<br /> I
<br /> l WELL TESTS: SIGNED
<br /> X .veil test made? Yes _ M, :✓ if ves, by whom? (Weil Driller)
<br /> ,'.or •.f :est Pump _ Hailer _ Air liftHennings1-, i i Co. ,C:
<br /> v:�M _ ros . Dr___in Cize
<br /> Death :o •eater at start of test ft. At end ,f test ft ( en, Rrm, or cnT)raboq t ,Typed or printed)
<br /> nun .iter yours Water temperance
<br /> .Address 352 �eland�le ,.-venue;¢e ✓air , .. �
<br /> .ca! ln:llVStY made? Yrs _ No }f If yes, w whom'? City Modesto, Ca1i_ornia zip 95 So
<br /> •x.15 iecrnc Ing made? Yes � No 2' If ves, attach copy to this report .Licenw No. 29C8 1 3 Date.sf this report PTa h 25 = i '7-
<br /> GWR :a8 Ret. 7.713, IF ADDITIONAL SPACE IS NEEDED. USE NEXT CONSECUTIVELY NUMBERED FORM
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