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ORIGINAL STATE OF GAL.IFORN(A Do not fill to <br /> THE RESOURCES AGENCY <br /> I with SWR DEPARTMENT OF WATER RESOURt.aS NO. 060034 <br /> + It( Intent N.r l$ 61 WATER WELL DRILLERS REPORT state well No <br /> t'cnuit No or Date--L8-1563 <br /> Other Weil Na <br /> ffipWNEII . 1110 1 Del Auch Const Co. r1� WELL LOG 81 7$ <br /> Total depth [t Depth of completed well it <br /> 1369 Lincoln Blvd <br /> \chna. lFnnn ft to ft Formation {Describe by rnlur churtutcr size or muter(l1) <br /> Trac t,--c-aTi f. lit, 95376 <br /> ) L ATbgq ,ujF WELL (Ste tnsttuct(uma)("1111t, n O'ners \tcll N <br /> umbcr _ <br /> n sandstone <br /> 1 tddress if dilferent farm tbove R 10 = 14 Soft tiro AW., <br /> Ia <br /> t1nshtp R.tns;e Section Lot #2 14 31 hard ray <br /> Dtitance from cthes midi railmnclr fences etc 31 — Jb cggfr sa—nd Ad smal 1 roc <br /> 53 59 ' cnurse�,sand <br /> 59 80 saft grayclay tree roots <br /> (3) TYPE OF WORKisnmll rock <br /> New Well Deepening ❑ 805 rd r claystrides of <br /> Retnnstruchoq ❑ - � fine sand <br /> Reconditioning ❑ �, _ �� <br /> a <br /> Honzantal Well ❑ — ` ��� <br /> Destruction Q (Describe <br /> destnictmn materials and <br /> procedures in item I.Z) <br /> Ui11 1 ry, (4) PROPOSED USE: ` <br /> 11 Domestic <br /> Irnt;ahan © - <br /> `T� Industrial ❑ — <br /> Test Well ❑ _ <br /> Stock ❑ <br /> Municipal ❑ <br /> WELL LOCATION SKETCH Other ❑ - <br /> EQGIP%IENT (6) GRAVEL PACK <br /> Rotar% Reverse ❑ Yes M No ❑ Stze 4tt pea — <br /> 9[e Q Air ❑ Diameter of bore 14t <br /> e ❑ Bucket 0 Picked from 50 tet 81 +'* <br /> (7) CASING INSTALLED (8) PERFORATIONS <br /> MCI 0 Plastic CX Concrete Cl Type of perforation or size of screen — <br /> roin To Dia Gage or From To Slot - <br /> ft ft in Nall ft ft N,ze - <br /> WELL SEAL <br /> surface sanitary seal pros ided' Yes fN No C1If yes to depth5.0 ft <br /> re strata sealed against pollution? Yes t❑ No pi Inter%%L. .,_ .,,ft — <br /> Vlethetd of seahg bentanitelcement mixNVnrk stnrted - -- __ 19 Completed___— 19 <br /> 00) W-kTER LEVELS 1VELL DRILLER'S STItTEMENT <br /> pth of first water, if know it This well was drilled it de y purtsdfc <br /> hon an is report is trite tit the best of mei <br /> nding level after «ell complettor� T .J—ft knouledke and efrcf <br /> 111) WELL TESTS y SIG`ED <br /> Ittwelitest made Yes [� No Q if Yes by nhom' aa W ell D er) <br /> of teat Pump ❑ Sader C] air lift ❑ MNIE Canada pilmn-SRI- and Sam inc. <br /> h to water rrat start of test it At end of test_ ft or, ¢{ j�(corpora nun ( yp ur Printed <br /> Uischu �� —.GiL <br /> rge�; tamu <br /> lii ufter�ours Mb iter temperature -kddress P.O. e,�ox 7 U <br /> -1L-- analysis made? Yes G No If yes, by nh+nn, City Antioch, Calif. ZIp94509 <br /> electnc lot( made' Yes ❑ No If yes tttach copv to this report License No 342RC)3__ nate of this report:— �7-8 <br /> D 9 (REV 7791 IF ADDITIONAL SPACE 1S NEEDED USE. NEXT CONSECUTIVELY NUMBERED FORM <br />