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ORIGINAL STATE OF CALIFORNIA SHEET 1 <br /> File Original,pup'_ale and Triplicate with the DEPARTMENT OF PUBLIC WORKS f y- <br /> DIYI510N OF 0REiOUR(FS <br /> P o Box 1079 DIVISION OF WATER RESOURCES <br /> SACRAMENTO S CALIFORNIA <br /> Do Not F:ll In <br /> WATER WELL DRILLERS REPORT state well No__ <br /> Other Well Noi!NJ-6 E L- <br /> (5ecuons 70769 7077,7071,'hater code) / Region-- ---------------' -- <br /> ------ — <br /> Equipment d <br /> (1) Driller: (Z) Proposed use or uses (check} (3) Eq iment use <br /> p <br /> Name___--stpcktQn__Armature_&_MQtor_WOrkS___ __ Domestic [ Municipal ❑ (check) <br /> ' Address 64-6 -2outh 0"--— 0r2],I.9L_____ -_ __________________ Irrigation ❑ Industrial ❑ Rotary Domestic and Test well r] Cable ❑ <br /> License No��5_Q__—__ ___Classxficatton__.._—C_5.7__________ Irrigation ❑ Dug well ❑ <br /> ' Other---- --- --- ----- - Other <br /> Owner- <br /> Name..._ .... Chi her --------_-_— _ _ (4) Type of work (check) <br /> Address_______ 9Z9_NOa"Gh CpIltel' ------- - __ -___________ New well 91 Reconditioning of well ❑ <br /> - At-Q4ton,-_ggUronnl$ _-------------____-- Deepening existing well ❑ <br /> (5) Well Iog. <br /> Total depth of well_170__ ___ ft Give details Of formations penetrated, such as salt, peat,muck, sand, gravel, clay, shale, sand- <br /> stone,hardpan,rock Include size of gravel (diameter) and sand (fine,medium,coarse), color <br /> Depth From Ground Surface of material,structure (loose, packed, cemented,soft,hard,brittle) <br /> 0________ft ---_ft TOR Soil <br /> -Yellow Clay <br /> ' _?1} __-= "__ _2__4______------" Yellow Sand <br /> �9 3�---------" Jellow Cl <br /> _—_3 -» „-42---_-------" Yellowy Sand <br /> lellow g1gy <br /> �g--_ „ „ — --" Gray Sand <br /> 61 --» .,- 68 - Blue <br /> Blue Q1&T <br /> Gra Sand <br /> 87__,• » 121 - Blue C <br /> 121_---,• „� ,• Gray Sand <br /> 12 _„ „ 166_--" Blue Clay <br /> 166---_-„ '• 170 - Gr Sand <br /> — _ to ,. <br /> „ Is ,. <br /> to n » <br /> -„ » „ If <br /> ,. » „ <br /> If additional space continue on DWR Form No 246—Supplement, and attach to respective report copies. <br /> (6) Casing left in well. <br /> LENGTH DIAMETER SINGLE DOUBLE,WELDED LOS PER FOOT OR SEATING BELOW <br /> ' FT INCHES OTHER GAGE OF CASING GROUND SURFACE FT <br /> ----------- ---_--- ------- ----------- ----------------"------------------ <br /> Type and size of shoe or well ring----------Welded points----❑ Yes ❑ No <br /> ' <br /> � <br /> D W R FORM No 246 REGIONAL WATER POLLUTION CON'T'ROL BOARD COPY ��,,,�SO•OM JLIN SIO <br />