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<br /> �.oC�x1aln� �vvTm�
<br /> ` ECK
<br /> WORIGINAL WATER WELL DRILLERS REPORT —
<br /> " Da Not Fill In
<br /> File Original,Dupilcite and Trlpltceto with the (lectlaar r0rs,7077,7o79,Wan"code) 3436
<br /> or-IONAL VAM PoLlrvnox -
<br /> cai�xztnxr EOARD N STATE OF CALIFORNIA fir -
<br /> �•PPraprfa?a srtm8rr)
<br /> U Other Well No�u/
<br /> P"'T17 OWNER-. (1 I) WELL LOG:
<br /> Name CRI j_forni s3 WA p-P — Tyr 1-1-,6— _ - ------ —---
<br /> Address P. 0, Box 7250 San JOaQ Calif. 3ctmsrE,a Drsr,bra, r�,r. ,r„,=. ! r•,r, f,r
<br /> (2) LOCATION OF WELL. ��� IryU� Kull —
<br /> countrSM Joappin O,vae^r f numb:r,rE a y �; [73 !'�— 331u- S,)Irl - — -
<br /> R s D orSS,-,tNo L'r,lst J”afVette Se Lomas t St,3o —1 75-
<br /> J-9 d0 Ye low owed _
<br /> 205 W Gravel u band
<br /> 217, 230 B1.ue Oand
<br /> 2 OBlue C1a_y_ _
<br /> (3) TYPE OF WORK (check)• —308 325 C l.,sy
<br /> Now wall M Deepening ❑ Retohdictotung ❑ A6irfdon ❑ � ,1 �330 BIL 3rjg((j
<br /> ff uLandonment,durrrbe maeeroal acrd prneedxre r,pian ]!— - - __ 3C _ 3 57 _' D!116 �' _Z' rr
<br /> (4) PROPOSED USE (check) 1 I uo
<br /> Domestic [3Industual C1Munlilpat Q Rc"ary E _ -?`a0 P-1 lie ("l
<br /> Irrigation ❑ Test Well [I other E3C-ible � �3�4..____ C FL— Blue
<br /> ti Dug Well ❑ _.--_��.1'C�X10 Blue �?� 1 _ � _ _�
<br /> (6) CASING INSTALLED- If gravel Vacl;.d —1111 — .- ---E �etC1Cy Clfl u
<br /> 91NGt.E� I70llE3LE� ---.1-2Q / S ci
<br /> GDie D, mcue from
<br /> From 01, ro O fe 20D9am Gall ofAv,e
<br /> 0 500 16 --10
<br /> Type,nduze0f4h0e0r,re11—jr12
<br /> (T) PERFORATIONS-
<br /> type of peffor,to-wed JU 11 s Kn Lf
<br /> Size f perfar,nonr 2 -
<br /> From (r to fr 5 Puf prr row R.er,p,r fx
<br /> 195 23n
<br /> _ 325 --3-30
<br /> ---.355 J/ 365
<br /> ( - - - - ( -— --- --- ---- 1 7`
<br /> (s) ICOASTiau1LION --
<br /> 'T!q„urr fret mm�ry-1 prondrdE 02 Ye, Q No T 1,r
<br /> vete eay atnta re,lcd,t„att poflurroa? El Yrs f„] I•I, If ,d',0, (
<br /> I,roxn fr to ft
<br /> ?,f,thod 0(SL
<br /> TtmFuatuto o1 water was a chemlal aaslr-n mad#? ❑ Yes $1 No
<br /> V,,,IccKle 1011 road#of well? O Tia ON* i assegr7 Qa Sara QU)N Q APa DWR FORM NO 240 4RV.9-U)
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