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ORIGINAL WATER WELL DRILLERS REPORT Do Not Fill Yn <br /> File with ®WR (Sectsens rocs,7020,Toe 1,70e2,Water cede) N9 43088 <br /> THE RESOURCES AGENCY OF CALIFORNIA 0rt4--s <br /> State Well No'¢ - L <br /> LOC DEPARTMENT OF WATER RESOURCES <br /> T;a-�er Cede See. 13752 Other Well No <br /> {1) OWNER: (11) WELL LOG: <br /> Name Emersan FerrickTotal depth 480 ft Depth of cam leted well it <br /> Address Street Fonnatioa Describe by color,rbererfer size of marnsel,sed tirvefere <br /> ------- Ton soil ft <br /> (2) LOCATION OF WELL: -----fie <br /> Count? Owner s member if an ----- ZS <br /> Township Range and Sectice --T4 72�+—��— <br /> Dsatsace from guar roads railroads et ---- —'" <br /> — <br /> J <br />— By-nRA tt RA ---- <br /> 7 I <br /> (3) TYPE OF WORK (check): 117--- —= K <br />' New Well tX Deepemng ❑ Reconditions ❑ Destroytng ❑ ===--� <br /> I destruction,drrcnbe Material Mid oeedart rn Item I i <br /> (4) PROPOSED USE (check)• (S) EQUIPMENT. 1173--- -E-1172i " <br /> 1 Domesuc ❑ Industrial ❑ Mumc>;pal ❑ Rotary ❑ I !ZZJd hrQWM 01 ay <br /> —==--? r <br /> [Id a <br /> Imgauon M Test Well Other ❑ Cable [$ —•-«- <br /> Other ❑ ------- vnri nua haTistingsq hrn nlays <br /> LS <br />' (6) CASING INSTALLED: --"�"- <br /> 8TB6L OTHER <br /> If gravel packed <br /> 13IN6LSX DOU13L6 ❑ — — — <br /> t <br /> u <br /> Gage Diameter <br /> From To or of From To —=—=== <br /> fc <br /> it Dtam Wall Bore ft it <br /> s"i----_1 y} <br /> Size of shoe or well ria n Stu of rtravel — --L� <br /> Describe joint 'Meld-ad <br /> (7) PERFORATIONS OR SCREEN: 3.9A <br /> __ro-»= <br /> Type of perforatiom or name of screen <br /> _�. <br /> Perf Rows <br /> From To per per Size -----Y' <br /> it ft roar ft <br /> In X to r___...r41 A M <br /> - d <br />' pp ------ an <br /> 9a gray2j , <br /> 428-------435 `-- brom clay, <br />' (s) CONSTRUCTION: 43,5 S142--- <br /> Was a surface sanitary seal provided? Y*aja No❑ To what depth <br /> Were say strata sealed against pollunoa? Yes Q NM if yes note dePVrTairua <br />' From ft to it ---- <br /> ft to it Wotk sty if ,Cam fated TIB 0 30 l9 <br /> Method of sealta WELL DRILLER'S STATEMENT <br /> Tho well was ehet under my lurrsdtc&t7n and tiny report is tree t9 The best <br /> (9) WATER LEVELS: o;my A owledge and <br /> b <br /> Depth at which water was first found if known 28 ' <br /> Standing level t ft NAME r" f <br /> (Parson firm,or corporation) (Tyted oe peered) <br /> Standtn level after rfaratsn and devele to fr <br /> (lo) 'WELL TESTS: Address <br /> utn cast madt? Yes ❑ No if es by whom? <br /> ,old <br /> not/min with it drawdown after hrs SIGNgp [C, e, '� �- �-�� 'E <br /> / Wrll Driller) <br /> Temperature of water Wu a ch}e�mical analysts mads? Yn ❑ No /r�^ {y <br /> Was electric log made of well? Yes ❑ No,dl if yet strath copy License No...24.R9 �] n,L , 19w�y, <br /> SKETCH LOCATION OF WELL ON REVERSE SIDE <br /> DWR 188 {REV p 6S7 wast osoea as sots roup(D Aasp <br />