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/ ,T 'AaaY 9 10 <br /> °n'°uvnrShp <br /> WATER WELL DRILLERS REPOxT Do Not Fill In <br /> File wl[luDWR (sectlasa'76791 Tom, 7681 , 7682, Water Code) <br /> N60 6545 <br /> THE RESOURCES AGENCY OF CALIFORNIA t � <br /> DEPARTMENT OF WATER RESOURCES dWo iState well No `) ,..tI '% R -' t .1 <br /> f well N6 1416 (3 <br /> ( 1 ) OWNER: - ( 11 ) WELL LOG : <br /> Name F- <br /> A does Alma a E31 p resocpmpmwellyyfr. <br /> Address1ppFormation: Dmnib <br /> e by rotor, ehrrarrer, Ifae of morula?, end srr.cn. <br /> L31 ft. m <br /> tr. <br /> (2} LOCATION OF WELL: _ S <br /> - _ _ CountY Civnerps mughcr, if any re' , <br /> ded <br /> Township, Ranee, ed See n dy _ , <br /> ant <br /> Distance from cities, roils, railroads, etc. o4A1 II- <br /> 816 <br /> ( 3 ) TYPE OF WORK (check) : y <br /> New clw I q�Dee e�wng ❑ Reconditioning ❑ Destroying ❑ .f % D <br /> it destnecti�on, dersribe matninl and procedure in item ll. ad - 11 <br /> (4) PROPOSED USE (check) : ( S ) EQUIPMENT: JS- a <br /> Domestic ❑ Industrial ❑ Municipal ❑ Rotary ❑ .I - <br /> Irrigation ❑ Test Well ❑ Other ❑ Cable S— <br /> Other <br /> j ( 6) CASING INSTALLED : S <br /> STEEL: OTHER . If gravel packed �f _ <br /> SINGLE ❑ DOUBLET] < 33 — h <br /> Gage Diameter <br /> From To or of From To <br /> ft, fr, Diary. Wall Sore £a fr. <br /> e� 6tl <br /> ' � L <br /> Size of shoe or well ring: .14X 'f Size of graveh 7 <br /> De crihe i <br /> (7) PERFORATIONS OR SCREEN: y1id ppd <br /> - - Type of prdaladon or green of settee 03 r <br /> Perf. Rows 3 — q1tp d" d J <br /> From To per per Size p.p cto <br /> it, ft. row it, in. x W& � p,p , <br /> t <br /> s- L <br /> s l it so _ ss <br /> ( a ) CONSTRUCTION: S= <br /> Was a surface sminry eel pror?dedl Yes 94 No 0 To w62t depth fr.Were any strata ceased :game[ pollution? Yet N No C If yes. note depth of strataoiT.r— <br /> From d ft. to 41. it. <br /> n� Ztytpf <br /> From d it. to go Y It, Work named ?9 , Completed 19 <br /> hfaclrod of staling ' f WELL DRILLER'S STATEMENT: <br /> (9 ) WATER LEVELS: Thiswell as drilled under my jarisdietfon and this reportis true'!° the best <br /> Depth at which water was first found, If known ft of myAnmufedgeangtelief. 0 NMI L USE NL`� <br /> Standing level Wom perforating, if known it, NAME. <br /> Standing level after ponforating and developing [c leen g, Som, o porar on) (Tytrd o 6rinrr ) <br /> *77 <br /> WELL TESTS: Address Q„ <br /> \ ImoLL Yes � No ❑ I[ Trap by whom? / <br /> gotJad withit, drawdownafterhn, [SIGNED]are of water Was a chemical analysis made? Yea ❑ No ❑ (Weil Ir <br /> din) <br /> War electric log made of well? Yes ❑ No Cl If yea' attich capy License No qo ' aterl <br /> *t SKETCH LOCATION OF WELL ON REVERSE SIDE <br /> eDW]iwted (REV. 9.65) 30391-990 10-03 sor0TRip © A oat <br />