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ORIGINAL STATE OF CALIFORNIA <br /> THE RESOURCES AGENCY Do Hot fill in <br /> Pile with DWR DEPARTMENT OF WATER RESOURt;ES No . 060031 <br /> .V 1 „f Intent No. 1411158 WATER WELL DRILLERS REPORT <br /> Permit Not or Date - 7R _ tSAfi slate Well x... <br /> Other Well No. —_--- <br /> ( 1 ) OWNER : Ninon Del Auch Conset . CO . ( 12 ) WELL LOG : 81 <br /> snares. 1369 Lincoln Blvd . Tnmlaepnk_�ft. Deptbnfem,rplowdwell78 <br /> From ft. tie ft. Formation ( Describe fr. <br /> Cif Tracy , Ca 1 f , e by t„ler. ehnraeter. .A e : material ) <br /> City, Zip <br /> ( 2 ) LOCATION O1:' WELL ( See itrstruetions ) : 0 — 3 fine sand <br /> c„aafy SA Joaquin o, tiro W 11 Namber - <br /> Woll address if deferent from :rbnro 652 E . Watters Rd12 fine Sand \ <br /> . — <br /> r:,w„sh+p Ihsnge need„p <br /> Lot—W- 12 - 50 araii calm a brown sandy cls <br /> Distance from cities, rands, railroad°, fences• ata, 50 58 c r and and small rock <br /> 58 - 79 1init. p' dark gra clay <br /> ;small rQc tree roots <br /> N ( 3 ) TYPEOFOF W ORK: ` ` \ <br /> New Well (9 Deepening ❑ �' ` `� __ <br /> CReconstruction ❑ _ <br /> tit <br /> y Reconditioning ❑ <br /> HHorizontal Well ❑1 .•re �aDestruction. ❑ (Describe N:destruction aterials any <br /> Procedures In Item 12k,( d ) PROPOSED US os Domestic Irrigation Industrial Test Well ❑ _ <br /> Stock Cl _ <br /> Municipal ❑ <br /> WELL LOCATION SKETCH _ : Other ❑ _ <br /> IS ) EQUIPMENT: I ( S ) GRAVEL PACK, _ <br /> Romp, of Reverse ❑ Yes d( No ❑ Size + <br /> Cubic Cl Air ❑ Diameter of here 14 _ <br /> Other ❑ - Bucket ❑ Pncked from_c0_tn t. _ <br /> ( 71 CASING INSTALLED: ( B ) PERFORATIONS : <br /> Steel ❑ Plastic IM Concrete ❑ Type of perforathem or size of screen <br /> From To . Dia. Gage or From. To Slot - <br /> ft, ft. in. Wall ft, ft. size61 81 <br /> ' _ <br /> 0 61 <br /> v <br /> . \t v, - <br /> ( 9 ) WELL SEAL: s� <br /> Was surface sanitary seal provided? Yes K) No ❑ If yes, to,depth_K1 ft. — <br /> Were strata .senlerl ;n' 1 ppllatinnl Yes ❑ Nn Lj( Interval ft _ <br /> hlethod of sealfn p�Den tlnote cement mTX Work .started 19 Complete <br /> ( 10 ) WATER LEVELSi _ WELL - DRILLEWS STATEMENT: <br /> Depth of But water, if known ft- This well war drilled ander nil/ inrfer fiction a this <br /> Stranding level after well compleeen ft, knowledge and holiest report it ryes rn the bet n/ cop <br /> ( 11 ) WELL TESTS : Slee <br /> Was Well test made? Yes No C If yes, by whom? } riller) <br /> Type of test Pump Boner ❑ so- eft Yd�IE pP p{y <br /> Depth to water at start of test ft. At and of test ft P . D ( Pf70X Nyy,prcomorenon ) ( Typed nr print <br /> Dlsehnrge� gftl/ min aftec_.�_V. hna s Water ternpernmra Address U <br /> t analysts made? Yes C] No k If ryes, by whom? City_ Antioch , Calif . Zip 94509 <br /> Was electric Ing made? Yes ❑ No XJ If Yes, attach copy to this repo; License No. 342A9:1 " Hata of this ram, <br /> own 188 ( REV. 7. 7451 IF ADDITIONAL SPACE IS NEEDED, USE NEXT CONSECUTIVELY NUMBERED FORM <br />