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LOUJI` 'ON DOo Na���' OE[g �,�L_ <br /> ORIGINAL <br /> WATER WELL DRILLERS REPORT <br /> fde original Duplicate and Triplicate with the (seotsens 7076,7077,7078,Vater Code) <br /> DIYISl011 OF WATER RESOURCES State Well No � r <br /> F <br /> 0 BOX <br /> 1070 STATE OF CALIFORNIA—DEPARTMENT <br /> IA�D�ti6rylP/itATlRTDbtEDNr}T OIF'PUBLIC WORKS it W�i1 No Ort 7��31 — <br /> s,z.CRAL16NT0 9 CALIFORNIA f! 7 DIVISION ISION Of WATER ER RESOVRCES <br /> Rcg,on — <br /> LOCATION OF EM Fr O <br /> _) DRILLER (person, firm, or corporation) (8) ' <br /> Name <br /> County <br /> -Quontin Y. <br /> Address P .O. Box 35 R F U er Street No of Loclre Rd and.—Cr <br /> Lockeford, Calif <br /> OWNER: <br /> Name 04--o ge dame-S <br /> Address P.O. (9) WELL LOG <br /> Loekef ord, Calif. Total depth of well 210 it <br /> Formation Mention size of water gravel— <br /> to it <br /> (2) Proposed Use {Check} Equipment <br /> Domestic Industrial ❑ Rotary <br /> Cable 45- 93 <br /> Irrigation ❑ Test Well ❑ Dug Well ❑ _ — <br /> Municipal C] Other ❑ Other ❑ T <br /> lh-VoTrn <br /> (3) CASING <br /> ft of in lb/ga rising left m well <br /> Type and sae of shoe or well ring --. LT8- Home Uade� <br /> 4) PERFORATIONS <br /> Type of perforator usedlie f <br /> Perforated it to it holes per in <br /> Diameter of perforations in length sa <br /> (5) WATER LEVELS. _ _ — <br /> Was electric log midi of well? ❑ Yes�'j No If yes strath copy <br /> WUR UFFICIAL U OKI <br /> Depth at which water was first found 60 £c — <br /> Standing level before perforating it ' <br /> Standing level after perforating ft <br /> Yore your observation of any change in waxer level whsle dnlhng no <br /> u at a wrface,anitary seal provided? Yes Casing was eemen a �{ <br /> (6) WELL PUMPING TEST Werk......a rch 10 I9 2 Completed Marc !f 19 <br /> Gp3city gal/min NO7T ft draw down Date of Repore �/� 71 1Q�]7 19 <br />' WELL DRILLERS STATEMENT <br /> V t well gravel packed This well was drilled snider wy furisdsction and ibis report is HIM to the best <br /> strata sealed against p0lli111400 o/nsy knowledge igad belief <br /> Attach / <br /> I eutperature Was s chemical malysu made? copy "~ —___ a — — —�-- _ <br /> 1SIGNEDL <br /> �p f try <br /> If abandoned war well capped? Quell 1 • Thayer <br /> By <br /> (7) TYPE OF WORK (cbeek) License No 11f2j- Classificatton <br /> New well j3t Reconditioning of well ❑ �t1G1 <br /> Datcd....._._�_ — --—a+G <br /> Deepening existing well ❑ 41370 7 31 soar pu,N0 SPO <br />