|
i p
<br /> sT4rr,�s. Do Nat Fill IA
<br /> ORIGINAL THE RESOURCES AGENCY �
<br /> tile Whit DwI1 DEPARTMENT OF WATER RESOURCES N_ 115197
<br /> WATER WELL DRILLERS REPORT State Well`a__
<br /> Other Wrll No
<br /> (1) OWNER: (1 I) WELL LOG: C°J
<br /> Name
<br /> Address
<br /> v —�♦�L- 3orm,u•n: nnnrFr f r rola.,rbrurrq uv s/ru•,uf.•d,Irrrra.r F
<br /> (�) LOCATION OF WELL: — S 1^a t _ to.k 1 "r-
<br /> E Cernr,Ssl t +Tn nr1•I1- n. an.,t - � 1 '.`I ^;ir .rT n7
<br /> T„.erAin.R••er, nJ Sr. T-.._ 1• _ T7_—`LJ_
<br /> � p9,• •fn ..Jar „r, 1r'':_:�' ,.i .a,� n- T, •.1- �J •- ��� E'en"QZ '��,
<br /> • s,,
<br /> 3 41
<br /> 1?- h i tar^
<br /> 1Ier'COt•�a �� rFr-r . �.a z: — '� in
<br /> i
<br /> y (3) TYPE OF WORK (rhrrk). 17741.
<br /> I'��!•a
<br /> [ New Weli Q derpeninP j� Rteandrtmue briroYrnr
<br /> �'h,-,'J 71 dnlrwrfi�n,drrrribr...lc.++i cxJ TrrNrJrrr ir.fir•rt I1. � .. Y d
<br /> '•' (,) PROT'OSED USE (check): (S) EQUIPMENT: — z!1 ':mw C' Iq
<br /> Domestic © Industrial © Municipal ;� Rotary [� r J i ') r � n
<br /> ZByC�..
<br /> `'r'•
<br /> Irrigation Q Test VIell f1 Odicr iD Cahle3417 Drtcked Sard - +
<br /> Other _
<br /> )cher :1;11 brnum -t4
<br /> CASING INSTALLED: 3= tr1 ttZc --layc
<br /> r
<br /> Ild packed l v
<br /> racae �c —
<br /> STEEL: OTHC:c: I Fi P C .�.5��'.d:S CI.:
<br /> CNQLElOV9.•E �r:t+Ze C Ry ..
<br /> .. — .,o SE 71 1 no Ck3 ice'
<br /> Gare Dirmete'r ,-
<br /> y
<br /> = From1.• .r f ur From To
<br /> ft. Diant. "a!! I Bore ft. Et. --
<br /> +::,:
<br /> l'
<br /> 6 7 7 t
<br /> (7) PERFORATIONS OR SCREEN:
<br /> :,�w+S•i if perf. 1 Row. -
<br /> From I To per prr Size
<br /> j M
<br /> ft. I k. row• ft. :in.
<br /> G __ a?i1LM1,I� Well Sy9lw.n.'.q...I•i1G/}}4,�'QII ed DIn
<br /> T it 1't T:ti _ t"•� s17 h C i.iir,�.�' fr ar y s i
<br /> :r.. ,7 + r-.»1-.n r, `+r-a'^.1.J f-Ir
<br /> r +1ZeR .r: 31II
<br /> on
<br /> (s) CONSTRUCTION: �
<br /> '� :.•y V.. mf.•r meq•.•rnl pn••id.d 1 Y.t I, Ne ra.Are d.nrh k.
<br /> _�..� 'Ree•.n....,r r,nld,rnnn ao9.,,iaul Yr. N•.[I t!,r w JrorR•f wen• - :
<br /> tru fr. Tom^ ft,
<br /> ft. ,ear►.,.ee 7 �"1 1, r ,Coe. C•—1 Q r] ^Jtyy
<br /> alnh,d.+��,I.ne a VI'ELL•DRILLERS STATEMENT: ' u
<br /> (s) WATER LEVELS: Thr. rrrr was JrdleJ rider my jrrrsdirtion acrd tha report it tree to fbt brat
<br /> +! r.n of cry knnwledSr ced hellrl. F I`
<br /> -. !'txf+•r.]r➢d.wr. ....:.r rand•.r cea f,,
<br /> i auelinr 4•.1 h.;an pe•fc.rine. if 4nr.n Fe. NAVE v
<br /> -)hr
<br /> a.
<br /> Yt —
<br /> s•,ed;ne Ierrl,1,rc v,rws:;n. .rad errrinp•,• rr. ,Y...en•Srm,..corp.,.<..wl [7rfrJ••►•,rrrJl
<br /> (10) WELL TEST'S: A idteu 11935 c Itin A1I c':I t=
<br /> vi [�
<br /> - tr...wacert ro,arl Yr,L7 No If,r.br wl.oml ..�C'?ln�]f �i 2
<br /> Yield. to 1.i..rh _ f+.J.r-Jf." hn, iStcNEo1 J
<br /> Tmvn....of.cern 7.,t rhero,e.i...I r.�.m.dal Yre fJ' 1e I"'I f Trfl UrJlnl
<br /> :•e�.' �,.elrca;e lir m.d.ul.rl]1 Y.i Ne-1 fl.n..nark c•.•. .. I T0721- Dat e��
<br /> - - License Ne._
<br /> ,- SKETCH LOCATION OF WELL ON REVERSE SIDE
<br /> i
<br /> DWR Ian -z• r.60. rr,n•rr.�u aor r.t►oreu t
<br /> 6
<br />
|