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ORIGINAL STATE OF CALIFORNIA Do not fill to <br /> THE RESOURCES AGENCY <br /> ,I� with DWR DEPARTMENT OF WATER RESOURC-5 No. 060033 <br /> it of Intent No WATER WELL DRILLERS REPORT St eta Well No <br /> Annit No or Date 78-1587 Other Well Nn <br /> )WNERNi"" Auch Consr /1�" WELL LOG <br /> tl p 1 � Tont dept 18L��,ft Depth of completed well 78 ft <br /> ldrers 1369 Lincoln Blvd From ft to ft Fun"Mon (Descriha by color Otracter sire ur material) <br /> t, <br /> Tracy, Calif Z,p95376 - <br /> _} T,%ATJON OF WELL (S« tii,titia.tl0l)y} 0 - 3 fine sand <br /> a n O q-U:l t.11 Number 3 - 10 sandstorR <br /> 1r11 uldress if different tnin, ibn,.e 508 F. Watters Rd, 10 A 14 soft bro and gray clay mix <br /> i,reship —Section31- hard gray &T.M <br /> Lot <br /> Di%hwei Farm c,hes mads riiln)ads fences etc s—allsm-all rock <br /> 5 - 52 arav\)044 <br /> 52 - 601\ ourse�,sand and small rock <br /> 4F h6e=iig. 1x— 60 - 71 Aray' rayClay <br /> 11)A (3) TYPE OF WORK 71 % 75 'ra clayand tree root and sm rock <br /> sew Well ❑` Deepening ElC} 1--,\80 gray ala <br /> 1 <br /> / Recrinatrucdon Q <br /> Reconditioning ❑ <br /> Horizontal Well ❑ <br /> QO �� Destruction ❑ (Describe �1 ` <br /> IY �� r destruction materials and - V <br /> (1 procedures in Itein 1S k\ <br /> t}\ (4) PROPOSED UStr - <br /> 4 Domestic — <br /> ,, Irrigation ❑ — <br /> 4 Industrial 0 — <br /> Test Well © - <br /> S tack CT - <br /> Municipal Q - <br /> WELL LOCATION SKETCS Other ❑ <br /> R) EQLIPMENT (8) GRAVEL PACK <br /> t <br /> not-try 6 He1er+e ❑ Yes KINoC3Sizeae -- <br /> ble ❑ Air ❑ Diameter of hore 14v —y = <br /> her ❑ Bucket C1Packed from 5-O—"'--8 ft <br /> 17) CASING INSTALLED (8) PERFORATIONS - <br /> el ❑ Plastic CX Concrete 0 Type of perforation or stze of screen — <br /> From To Dia Gage ior From To Slat - <br /> ft ft in Wall ft ft size <br /> 0 61 6 ' 61 81 1/16x29 - <br /> WELL SEAL. _ <br /> ' surface sanitary seal provided? Yes (A No C] ifyes, to depth 50_-ft <br /> ere strata sealed aisinst pollution? les C] No h Interval ft <br /> Method of sea ng bentonite/cement mix W,,rk starred 12=7=8= Complete 19 <br /> 4) WATER LEVELS NVELL DRILLER'S STATEMENT <br /> pth of first water, if know; ft This well was drilled under ii/ jurisdicrion thra report is true to the best of o y <br /> Standing level ,after well u,mpletto —ft ft knuuled9C d belrtf <br /> 11) WELL TESTS SIG\ED <br /> is well test mode' Yes r' Vis C If ,es bi nhoniy Ca __ ell Dnller) <br /> pe of test Pump ❑- Bnder ❑ air lift 0 N-kME Cana a Pu Sales and Service Inc , <br /> epth to water at st in of test --_ ft At end of test ft (Person�j firm, or�tcorpurutiun) (Typed or printed) <br /> Disrhura C- 9-1,min ufter�ha.i, eater temperature kddre'a gyp[A ❑ox 990 _ <br /> L&JectritL <br /> cal inal sis made' Yes i City antioch, Calif. _ _Zip 94509 <br /> y � Vu � if des, by whom 342893 11 17 7$ <br /> !or made-' Yes ❑ No If les ettich cups to this report License No— Date of this repo <br /> e9 iREV 7 >ai IF ADDITIONAL SPACE IS NEEDED USE NEXT CONSECUTIVELY NUMBERED FORM <br />