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ORIGINAL STATE OFCALIFORNIA DO notll in <br /> THE RESOURCES AGENCY n' fi <br /> File with DWR DEPARTMENT OF WATER RESOURCES NO. 053694 <br /> of onent Nn. WATER WELL DRILLERS REPORT Steric Well No, <br /> . <br /> Permit Nit. or Dnte - Other Well NrI,D I $, O' ) � <br /> ( l ) OWNER : Nauru ( 12 ) WELL LOC : Totalde depth l/5l /� <br /> 1 p -__,It. Depthof completed well [t. <br /> Address_ _ from Ft. to k. Fn,mnti n no by color, character. size a material ) <br /> City 0.0 .--_. _ 'Lire ' ` �J ^ GLU <br /> ( 2 ) L OF WELL ( See in.strncti( n.$ ) : – <br /> County IL 4 ,4g O net's 1Vell Nu her—�—' fr ` 3 L <br /> Well address I s If rent fro above C z,Q r iL,hJL ,iCO /e rra — <br /> Toun+hit Rnnue Sectio — � of <br /> Distance front cities, mads, railroads, fences, etc. <br /> `J C� <br /> — /124:.. ;,, I <br /> ( 3 ) TYPE O�FjW ORK : J ,? / f / <br /> ,New Well ❑/Deepening ❑ �// <br /> Reconstruction ❑ _ <br /> Reconditioning ❑ <��. _ �• _ <br /> Horizontal Well ❑ _ -- <br /> Destruction ❑ (Describe — _ <br /> destructionm tedels d <br /> procedures in Ren, 1Z) — <br /> � Cl/ ( 4) PROPOSED USE • _ <br /> I LLf Domestic <br /> Irrigation ❑ _ <br /> Industrial ❑ -- <br /> Test Well ❑ _ <br /> gyp' Steck ❑ <br /> Municipal ❑ <br /> WELL LOCATION SKETCH Other ❑ — <br /> ( 5 ) EQ T: ( 5 ) CRAPL PACK: — <br /> Rotary L7 Reverse ❑ Yes �.Ya ❑ Sizeazz — <br /> rable ❑ Air ❑ Diameter of here.— <br /> Other ❑ Roeket n Packed knmfl a <br /> m — <br /> ( 7 ) CASING INSTALLED: 18 ) PERFORATIONSn <br /> Steel ❑ Plasti� Concrete ❑ Typo of perforation or size of .screen <br /> From TO Dia. Cage or From. To Slot — <br /> ft, ft, in, Wall ft. ' ft. size _ <br /> ( 9 ) WELL SEAL:Was surface sanitary seal provided? Yes a � o If yes, to depth `-�� k. — <br /> \i'ere .strata sealed against pollntjnnn? Icy' ,moi' ,j Intervnt ft. — — e: <br /> Method of senllnii ,a7 -t•/�C4� Work start L 1H Complet 19_ <br /> ( 10 ) WATER LEVELS: WELL DRI L R'S STATEMENT: <br /> Depth of Ars[ water, if known k• This welt was Illed der I iudsd and lh�d it true m the hest of mu <br /> Standing level after well completion Et. knowledge a pel I y <br /> ( 11 ) WELL TESTS : SIGNED (� � � <br /> \\'ns well test made? Yes ❑ Nn Er If Yes;.by whom? ( Well Driller ) <br /> Type of test Pump ❑ Bailer ❑ Air lift ❑ NAMEcrahili �_ <br /> Depth to water at start of test ft. At end of test ft '!V - pg <br /> f gtlY!)f11n^,� rn r prim edE ) , <br /> D: tiara al/min akar hors Water temperate Address (ydpCk-CA�Q{Q5�3Ei0 – — <br /> analysis made? Yes ❑ No c�if yes, by whom? City _ Zip <br /> Was electric tog made? Yes ❑ Na • z2 (ff yes, attach copy to this report License No. 3�) /'� Dote of this repo is <br /> DWR 188 tagv. v.yes IF ADDITIONAL SPACE IS NEEDED, USE NEXT CONSECUTIVELY NUMBERED FORM <br />