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CftIGINAL STATE OR CALIFORNIA <br /> ,� THE RESOURCES AGENCY L� Do not flU it <br /> Fits with DWR DEPARTMENT OF WATER RESOURCES No. 145680 <br /> If Intent Y,,._ R WATER WELL IL <br /> DRLERS REPORT <br /> ,+.• Nrnit ''to. or Daze�8_= ,0_L Stale Well Yo, _ <br /> Other Well N� <br /> ( I: OWYER: Name_Gonzales Transit Mix <br /> i<idrrss (L) WELL LOG: <br /> 8181 W Business s s Loo 20� Total depth_ t2ft. Depth.,f co,npletetl w" <br /> • Front ft. t. <br /> to ft F <br /> ra cormation i Desc <br /> ribe by color, character. size or material) <br /> Ca. Z;p 0 - Fill <br /> (?) LOCATION OF WLL (See iwnsntructiom): <br /> _ 1 Sand <br /> C1111n <br /> andC.,Itn ry—_SinyTo" Eri's WeINumber 1 1San d <br /> Cla <br /> Well addrm if different from above 19 <br /> 21 Cla <br /> T„wztship —Range Sectioq_ - an <br /> Distance farm cities, road,,:aiiro", fenm, etc, T 20J. 'Lmf le <br /> Vest of Chrisman Rd . south side 77 ` lay `pan s tea s <br /> _ x <br /> r <br /> 2 y 1 la <br /> r a TYPE OF WORK: 107 .� .�• Gravel __ <br /> New will 3t Deepening C] 1 1 1 1 Cla <br /> iReconstruction c 1 1 1 G r <br /> Reconditioning �2 - avel <br /> 11 <br /> Horizontal Wen I t - . W L d ve <br /> Destruction C "Describe G Ci $ <br /> i destruction materials and - <br /> !ptncedum in Item 13y <br /> (4) PROPOSED N'�` <br /> z <br /> ! Domestic , <br /> I i Irri¢atton - <br /> Industria) <br /> Test 'Xetl C - <br /> i I S t.,ck _ <br /> i Municipal <br /> WELL LOCATION SKETCH �Other ❑ j _ <br /> 5, EQ(IP'IE"T: 6' GRAVEL PACK: _ <br /> RutaR' Reverse L; -1'G5 ;a[ No D- Size v T Z - <br /> C.,hie L Air �^ `�t�i:euteter of bore `. <br /> Other U Bucket nm �0 +p 142 c� _ <br /> CASING INSTALLED: 9'r-PERFORATIONS: <br /> �reri ,—f <br /> Plastic •$ Co9Cme1 !Tvpe 4 oerfamoon„r•s&e A Kneen/..� fu <br /> Froin I To. Dia. I' _ <br /> ft. Gaper Fes.. .� Ta <br /> `l is Wail 1t:\':. <br /> 0 ' 1 �f G. d 160 1 2•- 1 � _ <br /> ---------- <br /> '9+ WELL SEAL: - <br /> ti:, ,uxfac= sunita*' srsi provided? Yes NU _ !f es, tc. depth_ "fir _ <br /> Were strata sealed ,raainst pollurion? Ye-, = N'., Inten•a? st• <br /> �Niet_h,xi of sea" } <br /> «Work stur'.ed <br /> 10) WATER LEVELS: <br /> Depth of first ..aver- if Known «'ELL D17U1.1-ER'S STATEMENT: <br /> 4 <br /> xandmq level her oel! completio <br /> This well ,cat drilled under my iurttdjcti,nr and thjiv ",,rr r.r (tyle to rhe hest c} n•; <br /> c : n rt, knotrl¢dke arta belie}- <br /> 11, WELL TESTS: <br /> "V:ta well test made? ;'� CYes SICKED -t_�,./ <br /> 'rt r +rf test Pump Yo ¢ Bailer"21 whom' (Well Driller) r t , <br /> Ai` lift :ray A n s Bros. Drillinr Co, Inc. <br /> Depth to water at start of tes�,� ,•1t arta of rest h •-� <br /> U. <br /> n` '4e mai:rnfa after ti.yz; Water temperature Address <br /> Y 2 e�an�aTe-"T 'IvPed Or pttntcd) <br /> f analysis made? Yes = No 2 If res. by whom? City Modesto• a • yp 95150 <br /> A. rkcrnC mY +"roar? Yea Sox If+•es• Attach COPY m this repnrt License�Iw; 29© i � ��1 7�7$ <br /> LL nate of this report O <br /> OWR 288 (REV. 7-761 IF ADDITIONAL SPACE 15 NEEDED. USE NEXT CONSlrCUTIVELY NUMBERED FORM <br />