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VKwIIVAI, of ^ , ° "e �"L1e1HN : ^ DO not fiil in <br /> THE RESOURCES AGENCY <br /> File with DWR tPARTMENT OF WATER RESOUR tS No, 060032 <br /> Itd Infant No. 148159 WATER WELL DRILLERS REPORT slate well No, <br /> I tonne No. or Data 78 -1588 Other Well No iPr1l <br /> ( 1 ) OWNER : vou,a_D 1 A C Co s Nt Co ( 12 ) WELL LOG : Tour depth 81 ft. Depth of amnpleted well a It, <br /> Addros. _ 1369 Lincoln B1Vd o-01 rt: rs. it. Famnume to <br /> ascram by color, character, size tie matermn <br /> Ont.., Tracy , Calif , zip 95376 - <br /> ( 2 ) L CATION r WELL 0 — 3 fine sand <br /> U ( See instntetinnr ) : <br /> cony_ an loaquln OwmoesWeflNumber 3 - 10 sandstone <br /> n`cn address if different from above 766 E . Frisbee 10 - 14 sand <br /> TowmhilsRange Seath,n Lot #21 14 - 50 gray clay . crown san y c ay <br /> Ufstaava fronn eines, reeds, railmadr, fences, etc. – <br /> 0 - 58 our * and <br /> 58 - 7Y-\ 19 ght ` dark ray cla <br /> `small rock <br /> ( 3 ) TYPEOFWORK: 7173 ftne and course san <br /> Now Well IJ Deepening ❑ 73 (/4 79 gray e 1,ay <br /> Reconstruction ❑ – <br /> 24NN-�i ,[2a Reconditioning ❑ <br /> Horizontal Well ❑ <br /> .p Destruction Q ta(Desctihe <br /> q <br /> destruction <br /> dAli cool <br /> procedures in Item Lire <br /> �(/si re ( 4 ) PROPOSED USM) — <br /> Domestic _ <br /> ,q Irrigation <br /> 0 Industrial <br /> IR <br /> Test Well ❑ <br /> , Stack_ ❑. – <br /> Municipal' ❑ <br /> WELL LOCATION SKETCH j Other ❑ – <br /> ( S ) EQUIPMENT: ( 6 ) GRAVEL ,PACKi – – <br /> Rotary CI( Reverse ❑ 'Yes [X No ❑ Size — <br /> Cable ❑ Air ❑ Diameter of be n _ <br /> Other ❑ <br /> Bucket ❑ Pocked Fmm .ri0 . hs Rl ft. – <br /> i7 / CASING INSTALLED: ' tH ) PERFORATIONS: - <br /> Steel ❑ Plastic Concrete ❑ Type of perforation or size of screen – <br /> From To - Dia. Gage':or From. - To Slot — <br /> ft. ' ft: . ' in. Wall ft. ft, size <br /> 0 61a _ <br /> ( 9 ) .WELL SEALiWas surface sanitary sent Provided? Yes [7)( No, ❑ If yes, to depth 50 R. – <br /> Wero strata sealed ago ns[ pollutisln? ❑ Intervat R. – <br /> tifeWud of ,actin • bentonite cemen `amx Werk started l9Completed 19 78 <br /> _ <br /> ( 10 ) WATER LEVELS : WELL DRILLER'S STATEMENT: <br /> Depth of first water, if know IL Thisc ll was drilled undo mu inr tdiction d this <br /> Standing level after well completion EC knowledge and elef_ report is true <o the best of mg <br /> ( ll ) WELL TESTSt SIGNED .�I <br /> Wes well test made? Yes K7 No ❑ if yes, by whom? Capada ( e .Driller) <br /> Tspe of last Pump ❑ Bailer ❑ Ale lift <br /> NAME <br /> Drptb In water at start of test ft. At end of lest_ =n ( Person, fimr, or corporation ) ( Typed nr Printed) <br /> Discharge.19—=A9i�saifmin afeer_J.__hours Water temperature Addross P . 0 Rox 990 <br /> q . A analysis made? Yes C] Nob if yes, by wham? CityAntioch . Calif , zip 94509 <br /> Wits electric Ing made? Yas ❑ No If rex, attach copy to this rennet License No, 342893 Date of this report 11 / 16 /78 <br /> DWR 168 1REV. 7.741 IF ADDITIONAL SPACE IS NEEDED, USE NEXT CONSECUTIVELY NUMBERED FORM <br />