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ORIGINAL WATER WELL DRILLERS REPORT Do Not F:Ii lit <br /> File with DWIt (Sactaoaa 7079,7090,7011,7011:,Water God.) NO 44226 <br /> CONMErT AL LO(3 THE RESOURCES AGENCY OF CALIFORNIA State Well No I�741�w�' "` �� 1 <br /> 16tor Godo Sea. 7880 DEPARTMENT OF WATER RESOURCES <br /> Other Well No <br /> Mow <br /> (1) OWNER: (11) WELL LOG: Continued fao3R 44225 <br /> Name Total depth it Depth of completed yell it <br /> Address Formstaoa Desnibe by color,character afar of watrrrsl awl strticlarc <br /> it to ft <br /> (2) LOCATION OF WELL: <br /> County Owner i number if any <br /> ==- <br /> Township Range and Section = <br /> Distance from c.ties road. railroads eu <br /> (3) TYPE OF WORK (check) <br /> New Well ❑ Deepening ❑ Reconditioning ❑ Destroytng ❑ 770-780 B11; S=dStano <br /> 11 destructrors,desenbe material and procedure in Item I1 <br /> (4) PROPOSED USE (check)• (S) EQUIPMENT <br /> Domestic ❑ Industrial ❑ Mutvcrp21 ❑ Rotary ❑ <br /> Irrigation ❑ Test Well ❑ Other ❑ Cable ❑ <br /> Other ❑ <br /> (6) CASING INSTALLED: <br /> STEM OTHER If gravel packed <br /> SINGLE ❑ DOUBLE ❑ <br /> Gage Diameter <br /> From To or of From To <br /> it it Dtam Wall Bore fl ft <br /> )52 1 11, CID 9101 <br /> Sae of.hoe or well nng Sat of Ruvel <br /> Describe,oiat R43 tt <br /> (7) PERFORATIONS OR SCREEN <br /> Type of perforst,on or ntmt of screen <br /> From Perf Rows <br /> From To per per Size <br /> to it it row it in x in <br /> 1} 1! <br /> re <br /> f✓ <br /> (8) CONSTRUCTION. CO <br /> NMENTAL LGE; <br /> 'Was a surface uniisry seal provtded? Yrs ❑ No ❑ To what depth it a <br /> Vert any strats sealed against pollution? YesQ7 No ❑ If yes note depth of strata <br /> From 318 it to12it <br /> 69 <br /> From it to it 'Work started 19 Completed 19 <br /> 62 <br /> Method of walm MS WELL DRILLER'S STATEMENT <br /> rskwell was drilled noiuledgeandrr my lurtidretion and this report is true to the best <br /> (9) WATER LEVELS- of myd belief <br /> Depth at which water was fine found if known it <br /> Standing level before perfaratsng if known it NAME <br /> (Peraan Wpii firm or corporation) (Ty dor prrstedl <br /> Standing level after Perforating and developing it <br /> (10) WELL TESTS- Address <br /> +s perm tett made? yet No El If yes by whom? r.. R <br /> 2 ^ L <br /> t gal lmin with Q 11 drawdowa after hit [SjrNED] 4 <br /> Terri erasure of water fWel!Dn!!rr) <br /> P psi a ohrmical analysis made? Yet No ❑ n — s <br /> V7as slettnc log made of well? Yes n— Nn It yes attach copy License No 121653aiea 19—.._ <br /> SKETCH LOCATION OF WELL ON REVERSE SIDE <br /> DWR 18B iitEv 0 93j faaat 950 10 as aOM rav(2)A our <br />