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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, 085319 <br /> ,f Intent N.>. WATER WELL DRILLERS REPORT state Well No. <br /> 'Permit No. or Date Other Well N,iG� 6-G — Z- �Y <br /> ( 1 ' OWNER: Name California Welding Supply (12.) WELL LOG: Total dcpth8o ft. Depth,J�..uwpluted well 80 it. <br /> A,ture,s 817 S• Center St• from ft. to ft. Formation (Describe b, slur, character, size nr material) <br /> t„tv btockton, Ga. Zip 0 - Topsoil <br /> '_) LOCATION OF <br /> WELL (see j �tructiutu>: r - 1 Clay <br /> Gntv San Joaquim —Owner's Well Numbe1 Gra <br /> e <br /> 40 <br /> Well address if different from above - 2 Cla <br /> Too•nship Ranee section 62_ - rave <br /> Distance from cities, roads, railroads, fences, etc. California - 80 <br /> a <br /> Welding Supply . 1000 E. 11th St. - v <br /> Tracy <br /> (3) TYPE OF WORK: <br /> New Well X Deepening ❑ <br /> 1 Reconstruction ❑ _ -O <br /> Reconditioning ❑ <br /> I <br /> Horizontal Well ❑ �•. - <br /> Destruction ❑ (Describe <br /> destruction materials antl <br /> procedures in Item LZ< - — _ <br /> (4) PROPOSED US - <br /> Domestic _ <br /> Irrigation ❑� _ , <br /> Industrial ❑ _ <br /> Test Well ❑ _ <br /> Stock. Q` - <br /> Municipal Q - <br /> WELL LOCATION SKETCH Other ❑ - <br /> EQUIPMENT: (6) GRAVEL PACK: - <br /> R,tan Reverse ❑ Yes [ No ❑ Size birdseye I _ <br /> C..tnle11 Qt _ <br /> L Air ❑ IZiameter of bore <br /> Other ❑ Bucket `Packed-fion, 50 0 ft- - <br /> CASING INSTALLED:.— (8) PERFORATIONS: - <br /> Soteei L—„ Plastic jo Conciate\C Type of perPniaW)n or%Aie of screen�^:' - <br /> From To .,Dia. Gari FrOM\\,\ �' To - <br /> ft. ft.:,'� in. Wall ft`s ` ft. \size - <br /> 60 60v % � • Breen - <br /> 9, WELL SEAL: <br /> Was surface sanitary seal provided? Yes No ❑ If yes, to depth 50 ft. - <br /> tXere strata sealed against pollution? Yes 7j No Interval Ft. - <br /> Ntethod ,f sealin^ e te Work started— Cumpleted 19 <br /> 10 i WATER LEVELS: WELL DRILLER'S STATEMENT: <br /> Depth of first water, if known • Thit well was drilled under my juri:rdiction rind this report is tote to the best of w, <br /> Standing level after well completion 8 ft. krwtu;ledge and belie/. <br /> WELL TESTS: SIGNED ��%_(! JLl `r"t`�llt� C�E.f <br /> Wit, •.ve11 test made? Yes ^ No.11 If ves, by whom'? - : t (Well Driller) <br /> Tvpe "t test Pump 7— Bailer ❑ Air lift ❑ �- <br /> JL4 t> Hennings Bros. DriAing Co.,Inc. <br /> Death to water at start of test ft. At end of test—ft P o firm,gr cgm��ati. (Typed or printed) <br /> Address 525 TelanQ/a're A�e. <br /> I)�• '-roe gal/min Ater hours Water temperature ^MOd e S tO Ca. 9 53 0 <br /> ,,.1 :modysis made'? Yes � No If yes, by whom? City_ ' n Zip r� <br /> •Icatnc lug made? Yes ❑ Nu If ves, attach copy to this report ucensa.Vo. 290 1 3 nate of this repo 1 1 X27- <br /> DWR 188 'REV. 7.76) 1F ADDITIONAL SPACE IS NEEDED, USE NEXT CONSECUTIVELY NUMBERED FORM <br /> C_ <br />