Laserfiche WebLink
o�a>erra�' <br /> 11110 with uwR WATER <br /> WELL <br /> DR <br /> ILLER <br /> S REPORT Do Not <br /> P:II Ix <br /> (9«tio-,'707p,.raso,.7081r 2'atz.W tm cad.) O <br /> N- <br /> THE RESOURCES AGENCY OF CALIFORNIA w� 47,'739� <br /> DEPARTMENT OF WATER RESOURCES' state Veil``r° `' <br /> Other Well No <br /> (1) OWNER: (11) WELL LOG: <br /> Name 1:. -._ _ Total depth <br /> Address - Ft. Depth 194 completed veru ft. <br /> Formatioa: Dnrrib,by rotor,etxrseltr,JJU of weltriel,arj rrrwrt-rr <br /> (2) LOCATION OF WELL: 7 7 _ ft.to tt. <br /> County 't"�''� t'�•-.�.'� Owner's number,if any '. _ - _ _ _ _ <br /> t <br /> Township.Range,and Scetioa _ i,.- C i �,� i r'L' r •r r - <br /> Distance from cities,roads,milroads. - <br /> •r.'r. <br /> (3) TYPE OF WORK u(check): <br /> Neto Well M Deepy g � ~ <br /> eoing © Reeonditioning Dattro w ;'!,-_ ._ _ _ <br /> It destruction,describe material and procedure in Item 11. <br /> (4) PROPOSED USE (check): (5) EQUIPMENT: - <br /> r <br /> Domestic 0 Industrial ❑ Municipal ❑ Rotary ❑ -Z <br /> k Irrigation ❑ Test Weil ❑ Other ❑ Cable <br /> Other ❑ - 3- r•� <br /> (6) CASING INSTALLED: <br /> STEEL: OTHER- If gravel packed - <br /> SINGLE © DOU13LE El <br /> Gage Diameter 7 ' <br /> From <br /> d <br /> orof From Toft. Diam. WaIE Bore fc ft. nr:-r <br /> r• <br /> Size of shoe or well ring: ' Size of zravele <br /> Describe joint <br /> (7) PERFORATIONS OR SCREEN: <br /> Type of perforation or name of screen <br /> Perf. Rows <br /> From To per per size <br /> it. ft. row ft. <br /> M.x M. <br /> (8) CONSTRUCTION: <br /> Was a surface sanitary seal provided? Yes ❑ do To what depth ft. r•— r•"r"•� r l ',•[_ ++, , <br /> t.'t <br /> 3'191919 any a[rau sealed against pollution? Ye ❑ No❑ 1f yes,note depth of strata i t Li <br /> From ft,to ft, <br /> From <br /> it.to it. Work starred � � ��'- ae-.{- .Completed �' r-9 <br /> Method of walinisWELL DRILLER'S�STATEMENT- <br /> (9) WATER LEVELS: This well war drilled under my jurisdiction and this report is true to the best <br /> Depth at which water was first found, if known ft. �' ,- of my knowledge and belief. <br /> Ssaadiug level before perforating, if known ft. 4'', NAME <br /> staisdial level afar J!!rforsting and devrloping <br /> it. (Person,[ism,or mrporaeian) (y'yprd ar prr:serdy <br /> (10) WELL TESTS: Addrm G <br /> tact made? Yea ❑ ?Qe <br /> � If 7-,by..ham? L <br /> gal./miss.with ft.drawdown after bra. . <br /> EPerAcure of water 'Was a chemical audi sin made) Y. <br /> Was eleetric log made Ofwell? Yea ❑ Ha ❑ >if 7a,attach -y - _7 . . - <br /> l9�` <br /> skETCH LOCATION" OF WELL OfV REVERSE SIDE <br /> DWR 1199 }REV. 9.w5i <br /> ecE91-ac0 l0-tE COM TR11-©Q pgr <br />