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ORIGINAL <br /> WATER WELL DRILLERS'1 REPORT Do Not Fill Y <br /> Fite Original,Duplicate and Triplicate with the W A <br /> DIVISION Of WAJER RESOURCES , {s.relene sora,Gln,song,ap.lee Codi) IJ �:• e 2 C.I ; <br /> a.o.box i079 STATE OF CALIFORNIA—DEPARpFT/g�/MENT OF�yP�/UBLIC WORKS State Well N _� <br /> lACHAMLfITO S,CALIFORNIA DIVISION OF WATER RESOURCES <br /> L ` Other Well No.�_____.,� <br /> -, ; � Region-_-----_—_----•__---� <br /> _ •)f DRILLER:' (person, firm or cor oration I <br /> (1?e r p ) (8) LOCATION OF WELL: <br /> NameClark We3 I Dx!i 111 riL7 Q61. County ;i ly ._San Jo n„=6n _ <br /> Address 20 E, Charter Way,• . . r' k,F.D.or Street No. <br /> Stockton 6, Calif.-,.,'m 3 00 ft North <br /> hasC m a <br /> 200 ft Tln :�thi, City of <br /> OWNER: Stockton <br /> Name San Joaa in Cemetr W <br /> Address Stockton Calif. (9) WELL. LOG: <br /> Total depth of weal <br /> Formation: Mention size of water <br /> ^, „I gravel- <br /> 0 ft.,to 2 fr. Adghe <br /> (2) Proposed Use (Check) Equipment 2 Had a <br /> ' Domestic ❑ Industrial Rotary ❑ 1 Yellow Irrigation ❑ Test Well E] Cable°' [ <br /> Dug Well ❑ 22 1621 _- Soft san_4y clay ' <br /> Municipal ❑ Other ❑ Other.; ❑ 102 1 2 Blue •clay <br /> (3) CASING: " ' <br /> 152 !! 160 , :: Hard blue c a <br /> 1 0 20 Blue cls <br /> (t. of in -16./g2, caring left in well 20 21J, •• -Sand - <br /> 218 12 #12, 214 i 218 Hard blue cls <br /> Type and size of shx or well ring 5=x 4 <br /> '4) PERFORATIONS: <br /> v. <br /> ype of perforator used ,�_ •• <br /> S l�Qp Gut ; <br /> Ptrfonted _ ft. to ft. •C holes per, in. <br /> 194 „ 214 <br /> .. • ., •• ,i •. <br /> •• ,• -- •• • •v �a I- •• <br /> Diameter of perforations X in., length +' � in. •, <br /> 4 <br /> L) (5) WATER LEVELS: <br /> L WIS electric log made of well? 0 Yes <br /> U [�Na If yes,attach copy. <br /> Depth it which water was first found I'; j ft. " •'r •• _ <br /> Standing level before perforating �� ft. •• - -. <br /> '7 Standing level after perforating - z• :�`_'+ "� ft. - •• <br /> `f Note your observation of any change is water level while drilling �li. i <br /> W39 a surface sanirary seal providedN - �{i�N <br /> ��y <br /> � <br /> , -.�J (6) WELL PUMPI - _TEST":-ice. [jWork rrs.ried 19 completed — 19 <br /> Capacity, _ gal./min. it.draw down Date of Report �� +e•1 9 3 <br /> Q -� WELL DRILI E&'S STATEMENT- <br /> Was yell gravel packed, This well?Yes drilled Hider my jurisdiction and ibis report is true to the b <br /> / lere any swats sealed aplipi��ollu[on3 of tssy kdowledge and belief. <br /> ;. EI� <br /> Temper.[.,# u-i a o -Was s eMtesill Asgylyrta ri"sade i' MY SIGNED Q--•_-�_�.----._- <br /> �. � - � � <br /> If abandoned was well capped? "•"` 's - 5 - r.=-t-. rra .. x <br /> {7 TYPE OF WORK (check).- E. <br /> 1 r License No.�602____.__ _Claasificatio� A7 <br /> New Weil$] Reconditioning of well, <br /> , 19_...... <br /> Deepening existing well 0 , iHtQSPO <br />