Laserfiche WebLink
ORIGINAL WATER WELL DRILLERS REPORT Do Not Fill In <br /> Fl It Original,Duplicate and Triplicate with the (Sictsons 7076,7077,7071,water ceder W <br /> DtYl110N OF WATER RESOURCESstate vticll No t N G� ' 1���l <br /> 4 sOk f0>>i STATE OF CALIFORNIA—DEPARTMENT OF PUBLIC WORKS <br /> '9ACRAM[NTO 6 CALIFORNIA DIVISION OF WATER RESOURCES 9 other Wtll No <br /> Rcl,io l <br /> DRILLER• (person, firm, or corporation) (8) LOCATION OF WELL <br /> Name l- 1 n County T ^ e 2 , <br /> sTR F D or Street No 1IT fi -1 ' --^', a <br /> Address Q7t E. C'2-irter' �ZT <br /> �t01+1rtr„� <br /> 7 , ,-- In I I q <br /> - <br /> OWNER <br />' Name lr <br /> Address (9) WELL LOG <br /> j T 0 Cert on C-1_1 f. Total depth of cell 0)1 ft <br />' <br /> Formal,.I` <br /> ormanan Mention size of water gravel— <br /> (2) Proposed Use (Check) Equipment 0 li to 1 O it <br /> ,l{,Ob�1 r <br /> Domestic ❑ Industrial {] Rotary © n 1 on j;l „r7 C7--v <br /> Cabe 1' Irrigation ❑ Test Well ❑ D$l Well El 100 13g j O <br /> Municipal Other ❑ Other ❑ 135 11.0 S i n rl <br /> 11i C� 1 s` Soft CI tits <br />' �_1, :k r F 7 ('7r' vr? <br /> (3) CASING T <br /> it of to Ib/gs caring left in aril 2 I`ri T31 11 A r l a-tr <br /> 0 21, h^rd n-in <br /> 2) =1r 7 r?'de1 <br /> Z1t' 1)x(1 t,^r3 t��n <br /> Type slid s,ze of shae or well ring , v 771_ e (7h, j�l f1�T <br /> L I L,- 1�1 StJ -.7 <br /> '4) PERFORATIONS 212 c -2 01 ^ r <br /> ,pe of perforator used S ti l_r - 297 301, -sr <br /> Perforated i A+ it to ILO It holes per in <br /> l 5 2 <br /> 210 <br /> I � 2 L,i 21..7 - -- <br /> 271- 2 7L <br /> t 227 <br /> l <br /> Diameter of perfonseons /8, `{ 1Zr nEth in <br /> (S) WATER LEVELS <br /> Was electric lug made of well? 0 yes M No If yes,$ttub cop} <br /> Depen it which water was fent found 47 It <br /> Standing level before parforsl,ng ft <br /> Sundtng level after perforstmj ft <br /> I Vote your observation of any change,n water level while dnlhng <br /> N ss a surface san,lary seal prodded? 1'0 <br /> (6)I WELLPUMPING TEST {� Fork started JJ0O r t9 ;:' Complettdt)^r 1 �_Or,P <br /> r�capacety (OC gs1.Jm,n 29.1 e1 ft draw down Date of Report cJ-n. 22 19 <br /> WELL DRILLERS STATEMENT <br /> Was wetl gervel paekel? NO Tbrt null seas drilled vin i r my lurisdrclron and This rrporl a lrar to lbs brit <br /> re any.it",sealed against pollt,t,oO 1\10 of nr� know lr,lgr and brier/ <br /> T Attach <br /> Trmprratu*e VC'ar r chemical analyses mode?+T 0 copy lStGNLD] 02-arl� T e3a DrI I �. � 00a <br /> ell Dr,l <br /> If abanJoned was well rappel? <br /> I 9 <br /> (7) TYPE OF WORK (check). License No {� <br /> � r12 CClaascation S C �7 <br /> New well n Recondusoning of well 0 Dated _ _ Jn n e 22-) 1953 <br /> 19 _ <br /> Deepening existing well Q 44310 7 51 roti ou,n 0 aro <br />