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ORIGINAL STATE OF CALIFORNIA <br /> THE RESOURCES AGENCY Do not fill in <br /> File with DWR No. 060034 <br /> 4.1 <br /> bEPARTMENT OF WATER' RESOURi. eS <br /> e eltnNt No, 1te 78 WATER WELL DRILLERS REPORT <br /> Pen'It No. or Dote 78 - 1563 sane Well N... <br /> Other Well No. <br /> ( i ) OWNER : N,,,,,e Del Auch Cons et Co , ( 12 ) WELL LOCI Total do h 81 �g <br /> Address 1369 Lincoln Bivel p ft, Depth of completed wel <br /> from ft h, ft. Form ( Describe by Color, character, site a material) <br /> t ky. :: Tracy , a 1 f , <br /> zip 9 - <br /> ( � 1'eL�Ofie') ��'Ulf WELL, ( Seeinstructions ) : - d <br /> `f owner's Wull Numher - 10 S <br /> Well address if different from nla9e 550 Rd , 10 - 14 soft brow Cl a <br /> 'c,aa,ashiliRanda section 14 — 31 hard ra <br /> Distance from clues, mads, mnnnaas, fences, etc. 31 — coul.sal andYa small roc <br /> 53 59 1"1 roil <br /> 59 11 1 <br /> ( 3 ) TYPE OFWOREt 1111111 JE I IIIa a tree roots <br /> Mall rock <br /> Now Well XJ Deepening ❑ <br /> 80v 5 rdr cl tri <br /> of <br /> Reaonstroem,n o - fine sand . <br /> Reconditioning ❑ ti\ `��,,, <br /> 00.6 Horizontal Well ❑ _ •`1 <br /> Destruction ❑ (Describe destruction materials :-�•. <br /> f <br /> procedures in Item <br /> p/ . 5 ( 4 ) PROPOSED eSEr' — <br /> Domestio <br /> Irrigatio <br /> U 0 Industrial ❑ - <br /> I Test Wellv 11 ❑ • _ <br /> Stuck ' ❑'- _ <br /> Municipal 0 - - <br /> WELL LOCATION SKETCH Other - ❑ _ _-_ <br /> ( 3 ) EQUIPME.YTt ( 6 ) GRAVEL . PACK: <br /> Rnfar (� Reverse ❑ � Yes t(I No E) size -14 ea _ <br /> Cubic ❑ Air ❑ Diameter of here 1V <br /> Other O Rocket ❑ Pirked . frnm D m 81 <br /> ( 7 ) CASING INSTALLED: ( S ) PERFORATIONS: <br /> Steel ❑ Plastic Concrete ❑ Type of perforation or sizeofscreen - - <br /> Frmn To Dia. Gape:or From. To Slot - <br /> ft. . ft. . in. Wall ft. ft, size <br /> n <br /> fil <br /> ( 9) WELL SEAL: <br /> Was surface sanitary seal provided? Yes IN No ❑ If yes• to depth_5J] ft, - <br /> WeN strata sealedagainst ppllutinn2 Xes ❑ No IntenaI k. . <br /> Method of testing <br /> Work started ' 19_ Completed Iq_ <br /> WATER LEVELS: <br /> Dept WELL DRILLER'S STATEMENT: �f <br /> Depth of first water, if known WELL <br /> This wall was dritied unde p huisdiction are is report i, true to the hest of m <br /> Standing level after well onn,pletinn ft. knowledge and . Ilei. t <br /> ( 11 ) WELL TESTS : Y�fSlcsEn <br /> Was well test made? Yes OI No ❑ If yes, by whom2 Canada Well D [or) <br /> Type of test Pump ❑ Railer ❑ Air lift ❑ NAMEI <br /> Depth to water t start of test ft, At end of test k P r D . e�Ox ,rp pf cv,rpurn iva yp o print<J <br /> Duvhatgn_1�2Qgdimin rdt<r�_Iwu Water wauperature Address 7 U <br /> ( ' r zip94 09:ai analysis Corder Yes c Ne If yes, by wnm„ nt och Caf <br /> Was electric log made? Yes ❑ No 00 1f yes, attach copy h, this report I License No. 349893 Data of this repo.? 11 / 17 LIA - <br /> DWR 186 ( REV. 7.76) IF ADDITIONAL SPACE IS NEEDED, USE NEXT CONSECUTIVELY NUMBERED FORM <br />