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ORIGINAL STATE OF CALIFORNIA- DO not fill in <br /> THE RESOURCES AGENCY <br /> File with DWR " EPARTMENT OF WATERRESOURCES No . 060030 <br /> t(y of Intent No._1ABIU WATER WELL DRILLERS REPORT State Wan No. <br /> C amdt No. or Date Other well No <br /> ( l ) OWNER , Name Del Auch Con ' t . Co . ( 12 ) WELL LOC : Total depth-7 it. Depth of completed Wait«. <br /> AddresSIL 1369 Lincoln Blvd , from «. t.. ft. Fomratinn ( Describe by color, character, size or material) <br /> cit,._ Tracy , Calif , ZIp95376 - <br /> ( 2 ) LOCATION OF WELL ( See instructions ) : <br /> CountySan Joaquin osr a w6I Ntr bar <br /> Well address if different from above - h sand <br /> Township Ranee Seattn O 22 clay mix <br /> Distance from cities, reads, railroads, fences, etc, S d d y <br /> 57 - 76 11 !j )!nd dark gray claX with <br /> two grrlCKS Of fine sandstone <br /> Wit Al <br /> Aj ( 3 ) TYPE OF WORK : <br /> 94 New Well 1 yy1 Deepening ❑ <br /> fon(Iff7 efug I Reconstruction ❑ _ < <br /> I Reconditioning ❑ <br /> �i Horizontal Well ❑ \ - ��ii <br /> '1 71 s <br /> Destruction ❑ (Describe <br /> destruction meerials arW <br /> p Procedures in Item 1,2'1 ' - - <br /> A v ( 4 ) PROPOSED HSE✓ - <br /> 4 Domestic ' . : • _ -- <br /> �e reµ d Irrigation ❑ <br /> Industrial ❑ <br /> Test Well ❑ _ <br /> Stock ❑:, - _ - <br /> Municipal 13 _ <br /> WELL LOCATION SKETCH Other ❑ - <br /> ( i ) EQUIPMENT: ( 8 ) GRAVEL, PACK: _ - - <br /> Rotary CI Revere ❑ Yes d( No ❑ Size 1pea - <br /> Cable ❑ Air ❑ Diameter of have <br /> Other ❑ Bucket ❑ Pricked from�to t. - <br /> ( 7 ) CASING INSTALLEDt ( 8 ) PERFORATIONS: - <br /> Steel ❑ Plastic IX Concrete ❑ Tylw of perforation of size of screen <br /> From To Dia. Gage: or From.. . - To . Slot <br /> ft. ft. - in. Wall fes ft. Size ' _ <br /> 0 57n57 ffix2p _ <br /> ( 9 ) WELL SEALi ,,yy <br /> Was surface sanitary seat provided? Yes LN No ❑ �1iLff yes, to depth .90 ft. <br /> Were strain scaled against Pollution? Yes ❑ ' No P Internal ft. <br /> Methud of sealln Work started 13_ Complete 19_ <br /> ( 10 ) WATER LEVELS : WELL DRILLER-S STATEMENT: <br /> Depth of first water, if know k• This well was drilled an cr rap iurfsd(cp'q, and this reparc is true to the best of me <br /> Standing level after well completion k. knowledge 4wollef4 <br /> ( 11 ) WELL TESTS : SIGNED <br /> u•a, wen test n,;rde? Yes k" No ❑ If yes, by whom? Canada ell Driller) <br /> Type „f test Plain Cl Boner ❑ Air Bk NAME_ Tae . <br /> Death to water at start of test k. At end of test ft ( Peon, Jim, corporation ) ( Typed or printed) <br /> Die�harao cal/min liter../..hours Water temperAddress P . n . rsRox 990 <br /> t .at analysis made? Yes ❑ No KI [I yes, by who temperature? Cloy Antioch . Calif , Zlp 94509 <br /> Wits electric log made? Yes ❑ No if s-es, attach copy In this report Llceme No. 342893 Data of this rep) Nov . 14s If <br /> DWR 188 ( REV . 7.76) IF ADDITIONAL SPACE IS NEEDED. USE NEXT CONSECUTIVELY NUMBERED FORM <br />