Laserfiche WebLink
URIGINAL STATE OF CALIFORNIA <br /> THE RESOURCES AGENCY Do not fill in <br /> File with DWR DEPARTMENT OF WATER RESOURI.eS No . 106275 <br /> Ft( intent N..• WATER WELL DRILLERS REPORT <br /> l iialndt No, or Ont. 78 - 1185 state well Nn. <br /> Other Well N,, <br /> ( I ) OWNER : ( 12 ) WELL LOG : <br /> Andressti99 E Watters Rd Tram doptl R. Depth of completed well _ft. <br /> [rot ft. to ft. Fnm,atlon ( Describe by color character, size or material ) <br /> cityFre�CaMp California zl <br /> p - Sand Leam <br /> ( 2 ) LOCATION OF WELL ( Sec instructions ) : 3 - 14 <br /> Cmmty San Tna = 1 n owoere Wml Nmnber14 — <br /> Wall address if different from :nova 461 Watters Rd . 22 - 34 Sand w <br /> Township Range cls streaks <br /> section 34 - 40 Cla ' ' <br /> Distance from cines, made, mnmads, fen , ate 40 . 70 C1a. w Sand streaks <br /> 70 - 98 Course sand w CJ av streaks <br /> 98 - 134 Brnp & Blue clay w san <br /> ( a ) TYPE OF WORKt Streaks <br /> New Well C& Deepening ❑ _ <br /> Reconstruction ❑ _ �4` � \ <br /> Reconditioning ❑ �; _ <br /> Horizontal Well ❑ \��, <br /> DesWaet <br /> tfon ❑ (Describe <br /> deatmianmaterials and <br /> Procedures In Item 13). — <br /> ( 4 ) PROPOSED USE: — <br /> Domestic <br /> Irrigation p _ <br /> Industrial ❑ _ <br /> Tort Well ❑ _ <br /> Stock ❑ _ <br /> Municipal O <br /> WELL LOCATION SKETCH I.Other ❑ . . <br /> ( 5 ) EQUIPMENT: ( 5 ). GRAVEL PACK: <br /> Rotary Reverse ❑ YWM No ❑ Size _ <br /> Cable ❑ Air ❑ Diameter of bore 11 _ <br /> Other O Bucket ❑ Packed From 50 it, 134 _ <br /> ( 7 ) CASING INSTALLEDt ( 8 ) PERFORATIONS: <br /> Steel N Plastic ❑ Concrete ❑ Type of perforation or size of screen <br /> From To Die. Gago'or From . .: To Slot <br /> ft, ft. in, Wall ft, ft, size _ <br /> ( 9 ) WELL SEAL:; _ <br /> War surface sanitary seal provided? Yes ❑ No ❑ If yes, to depth h, <br /> Ware strata sealed ngmnst pollution? Yes ❑ No ❑ Interval rt, <br /> Method of semin Work started le__ Completed 19_ <br /> ( 10 ) WATER LEVELS ; WELL DRILLER'S STATEMENT: <br /> Depth of first water, , if known R• ThisIl was drifted under cop Ilteiadiction and this report is true to the best of my <br /> Standing level after well completion - ft, knncledge and belle). <br /> ( 11 ) WELL TESTS : SIGNED <br /> W'•aa well test made? Yes In No ❑ If Yes, by whom? ( Well Driller) <br /> Type of test pump ❑ Hailer ❑ Air lift ❑ NAME NOAC1c Pstm <br /> Depth to water at start of test ft. At end of text ftp 1Po p,Oflfl$ urOAs,mtton ) tTyped or printed) <br /> Discharge vI/nun altar mune Water teutpemmre Address V t5 UCS <br /> Let analysis made? Yea ❑ « Clt,• Stockton , California 95201 <br /> No ❑ res. hr whom? zip <br /> .. olectrie Ing made? Yes ❑ No ❑ If yes, attach copy to this report License No, Date of this report <br /> DWR 188 ; REV. 7, 791 IF ADDITIONAL SPACE IS NEEDED, USE NEXT CONSECUTIVELY NUMBERED FORM <br />