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' ORIGINAL WATER WELL DRILLERS REPORT Do Not FsU Is <br /> File with DWR Lea (Stroaa 7079,7020,7011,7012, W-mr Cod1\l e) 0 44225 <br /> 6 � �oS� ocTHE RESOURCES AGENCY OF CALIFORNIA State Well No E t V E - d <br /> Cot Guar Sg°' DEPARTMENT OF WATER RESOURCES other Well No <br /> 44w1 <br /> (1) OWNER: (11) WELL LOG: $pO ft <br /> Name Fibreboa-d Co oration Total depth it Depth of completed well <br /> Address Q Bog 780 Formauoa Dnrrrbr by rola rb+reeter,sfar of sraterid,avoid Structure <br /> 0- b it to Adobe soiStinnkt,nn_ Calif- 95207L <br /> l +_ <br />' (2) LOCATION OF WELL: 6- 32 Er <br /> County San J a Owner t number if any <br /> ryt32-118 Mug 0 ay <br /> Tows,Bhip Rants end Section <br /> Durance from cities roads railroads ate 12 5-)87 P111A rJ;4V <br /> 187-19Q Gr ay sarlil WoQdy <br />' (3) TYPE OF WORK (check). <br /> New W00a Deepening ❑ Reconditioning ❑ Destroying ❑ <br /> If destruction,describe material and procedure rn item I1 _ <br /> (4) PROPOSED USE (check). (S) EQUIPMENT- 24q.97o <br /> Domestic ❑ Industrial EJ Municipal ❑ Rotary ❑ <br /> Irrigation ❑ Test Well ❑ Other ❑ Cable <br /> Other ❑ <br /> P, Pia =alzel <br />' (6) CASING INSTALLED: <br /> STEEL OTHER If gravel packed <br /> 293-999 R1 11A hqrd r_1 <br /> SINGLE ❑ DOUBLE ❑ <br />' Gage Diameter 305-IOA R-1110 r, Ay <br /> From Co or of From To <br /> 3M-3111 Sarxi <br /> ft it Dlam Wall Bore it it <br /> 3211-328 Tniiah bl,'P 03 AV- <br /> Sue of Thor or well ring Size of gravel '41,14 Gr <br />' Describe lomr <br /> (7) PERFORATIONS OR SCREEN <br /> Type of perforation or name of screen 374-382 <br />' Perf Rows -' <br /> From To per per Size <br /> ft <br /> it row it in x in SanA <br /> f <br /> —5 <br /> _cf <br />' (8) CONSTRUCTION <br /> Was a surface sanitary seal provided? Yes ❑ No ❑ To what depth it ? <br /> Were any strata sealed aga.nst pollation? Yes ❑ No❑ If yes note depth of strata <br />' From it to it <br /> From it to it Work started 19 ,Completed I9 <br /> Method of staling WELL DRILLER'S STATEMENT <br /> This well was drilled' unju <br /> der my jurisdiction this report is true 10 the best(9) 'WATER LEVELS of my knowledge and belie N* F�ENTAL LOG <br /> Depth at which water was first found if known ft Water Code S <br /> , 70aQ <br /> Standing level before perforating d known ft NAME a� <br /> (Person,5rm,or­11"".1­3 (Typed or Pro-led)' Standen level after rforatin and deveio ing it <br /> (10) WELL TESTS- Address <br /> A.pum test made? Yes ❑ No ❑ If yes by whom? <br /> A aa1 I— with it drawdown after bra [SIGNED] <br /> (Well Driller) <br /> Temperarvre of water Was a chemical analysis made? Yes ❑ No ❑ 19—'— <br /> Was elretne log made of well? Yes ❑ No ❑ If yes attach copy License No <br />' SKETCH LOCATION OF WELL ON REVERSE SIDE <br /> ae9e1 aa0 10 as DON TRIP'J yr O&! <br /> DWR 188 IREV 2 651 <br />