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ORIGINAL STATE OF CALIFORNIA Do not fill in <br /> THE RESOURCES AGENCY n' <br /> File with DWR DEPARTMENT OF WATER' RESOURCES No. 076041 <br /> vee of Intent No. WATER WELL DRILLERS REPORT ,tate well No, <br /> A Permit No. or Date 81 -589 Other Well No <br /> L) OWNER: Name Don Most (12) WELL LOG: Total dep 1 0 ft. Depth of completed wel 1 0 It. <br /> wdress 8691 Almendra from ft. to ft. Formation (Describe by color, character, size or material) <br /> Cit`. Tracy, Ca. Zip 0 - Topsoil <br /> _') L a T0K ELL See instructions): _ 2 Clay <br /> nq2 C1 <br /> -hard <br /> County Owner's <br /> Well Number <br /> Well address if different from above 44 - 6F-San" grave <br /> T++svnship 0-2-5 Range S Sectio-2_7} 68 _72 ay <br /> Vp Distance from cities, roads, railroads, fences, etc. 8 0 11th S .- - an <br /> S .W. corner of 11th St. & Cabe St. - 81 <br /> Trac 1 - S*nd & gravel <br /> 8 - 1 <br /> Clay <br /> (3) TYPE OF WORK: 114 f 14 Sand & gravel <br /> New Well X Deepening ❑ 14 1 50 Clay <br /> Reconstruction ❑ - `� <br /> Reconditioning L - ^� A�/•' <br /> Horizontal Well ❑ '\ \` _ - r�' <br /> Destruction (Describe <br /> destruction materials and <br /> procedures in Item Li <br /> i (I) PROPOSED <br /> Domestic <br /> Irrigation- ❑ <br /> Industrial ❑ _ - <br /> Test Well ❑ l - <br /> Stock <br /> Municipal <br /> WELL LOCATION SKETCH ,Other ❑ - _ <br /> 3 EQUIPMENT: (8) GRAVEL•PACK:Roof-ing I - <br /> R,tart' Reverse ❑ Yrs No ❑ Size #aye l - <br /> C..hle LJ .air ❑ )31aZter of bore '�tt - _ <br /> i <br /> Other ❑ Bucket Pmcked'fiom _to• fC _ - <br /> CASING INSTALLED:,' (8) -PERFORATIONS: - <br /> Steel ❑ Plastic X Coneiete L;v Type of perh>i tion or'size of screen. '; - <br /> Froin To Dia. Ca,-Or Froom:._ To l�Slaty <br /> ft. ft.; in. Wall ft.\\.\ ft. i'; \�si7� - <br /> 0 1 0\11 160 130 - 1 ,-sete en I - <br /> 9) WELL SEAL: - <br /> '.t'ms surface sanitary seal provided? Yes.1 No If yes, to depth 50 ft. - <br /> -Vre strata sealed against pollution? Yes ❑ No Interval ft. - <br /> \leuhod ,f sealilw Cement 7 ork started 19 Completed <br /> io) WATER LEVELS: WELL DRILLER'S STATEMENT: <br /> Deoth of first water. if known n- This tnell utas drilled under my ,'urfsdictfon and this eport is true to the best nj m% <br /> Jtanciintr level atter well compled 1 n ft. krwwledge and belicj. <br /> 'I/ WELL TESTS: X <br /> '.t•is we 11 test made'? Yes = No 'A If yes, by whom? (Well Driller) <br /> T,., ,f test Pump Bailer E: Air lift ❑ NAME Kennings Bros . Drilling Co. ,Ine. <br /> Depth to water at start of test ft. At end of test ft Petsmn R nr cojpoz tion) Typed or printed) <br /> ""4arge al/min after hours Water temperature Address �52 5 p a na a e Ave . <br /> .:cal analysis made? Yes ^ No If yes, by whom? City Modesto' C a .If yes, attach copy Zi 9/- 56 <br /> iv.m_s electric lots made? Yes ❑ No to this report License No. 2 081 1 Date of this report 8-12-81 <br /> � py <br /> DWR 188 (REV. 7.76) IF ADDITIONAL SPACE IS NEEDED, USE NEXT CONSECUTIVELY NUMBERED FORM <br />