Laserfiche WebLink
ORIGINAL STATE OF CALIFOANIA DO not fill in <br /> THE RESOURCES AGENCY <br /> File with DWR DEPARTMENT OF WATER RESOURCES No. 083141 <br /> (Of Intent No. WATER WELL DRILLERS REPORT State. Well No. <br /> l �..0 lermit No, or Date 0�r � {ether Well Nn.n C+ "Z,-,r r <br /> ( I ) OWNER: Namr Franklin C le I C . 12 WELL LOG: 2 <br /> D� ! Tot:d lcpth�i�ft. Depth of completed we1L 200 ft. <br /> Address P7C2 L aIle Rd from ft. to ft. Formation (Describe by color, cha=cter, size or material) <br /> City TLracy, CA zip 0 - -T—Otop s oil <br /> (?) LOAl <br /> TIQ�T OF WELL (See instructions): 10 — 20 clay <br /> Connry n oa un 0ner's �jeq Number. 20 - 0 r V <br /> Well address if different from above Chrisman Rd. 0 - clay \` <br /> T.,%vnship C-5 S Range C)5Sectio y" 34 - 45 ravel <br /> 2 \ <br /> Distance from cities, roads, railroads,fences, etc. between 2$0SG <br /> 2826 north of Linne Rd. 51 - <br /> 55 jzi46�3 <br /> cl <br /> 60 - Vol <br /> (a) TYPE OF WORK: � Qq lay <br /> New Well QC Deepening ❑ 10 115 ra ve 1 <br /> Reconstruction o 1 - W ela <br /> Recnnditiuning ❑ 0 - 1 <br /> Horizontal Well ❑ \ - 70 1 <br /> Destruction ❑ (Describe ��'� - 1 ravel <br /> destruction materials a,4 75 <br /> procedures in Item - 1 c <br /> (-I) PROPOSED 1 --1 95\-, jz raved. <br /> Domestic 195 -` cla <br /> 3�7- <br /> Irris4ation <. 1 `- 2(>5raveZ�, <br /> Industrial ``\ �`1 o -\,24520—. Cla v <br /> Tes \Fell `� ❑ <br /> WELL LOCATION' SKETCH '\.' Other ❑ <br /> f5) EQUIP\IE\T: (6) GRAVEL-PACK: <br /> Rotary 0C Reverse ❑ _ es.Q[ Nu a Size <br /> Cable ❑ Air ❑ \ IZt�aleter of bure <br /> Other ❑ Bucket ❑ \ckrdfr„m -� tir-��n 4t: <br /> (-: CASING INSTALLED..i.' �;\ {g)`-PERFORATtO�$: - <br /> Steel ❑ Plastic C C-"C C\ Type of perfi ,x'�-Le of screen, ' <br /> From To Dia. Gar Fr V To ll�s?as <br /> ft. ft.( in. Wall ft ft. /-/< <br /> 0 200 `. 16 0 16o Wa -s.ci�een - <br /> �� X v — <br /> i 9 i tvELL SEAL: - <br /> Was surface sanitan• seal provided? Yes � Ni ! if yes• to depth 50 ft. - <br /> Were strata sealed against pollution? Y ti ii \u Interval ft. - <br /> Nfethnd of sealing �entoni' e )-V,,rk started 19= Completed 19 <br /> lIl)I NATER LEVELS-. «'EI_L DRILLER'S STATE\f£\T: <br /> Depth of Brat water, if kiuia' - k- This well was drilled under my jurisdiction and :his rc•pi,Y is true to the best it mmy <br /> Standing level after well completion _ _ft, knuuledge and belie/. <br /> t1I) WELL TESTS: St�`e� '�' l �- ' <br /> W:ts well test made? Yes a No EX If yes, by whom? (Well Drillery <br /> ,I•ype of test Pump o Bailer [DAir lift ❑ �.�-NIE Her mings Bros. Drilling Co. , Inc. <br /> D*o %'-iter at start of test- ft. At end of test ft (Person, Firm, or corporation) (Typed or printed) <br /> �al:min after hours .Vater temperature Adclres.K 3525 PQlandale Avenue <br /> _ ,moi analysis math? Yes 0 No Q If yes, by whom? Ciry Modesto- f or nis _ Zip 95356 <br /> .. <br /> Was electric log made? Yes ❑ No If tes, attach copy to this report License \4-290813 _--Date of this rryw t': <br /> DWR 180 ttrev.7.701 IF ADDITIONAL SPACE IS NEEDED, USE NEXT CONSECUTIVELY NUMBERED FORM <br />