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File Original,Duplicate and Triplicate with the (Sections 7076 7077,7071,Water Code) 0 r,(N U 50886 -
<br /> REGIONAL WATER POLLUTION State Well No!N
<br /> STATE OF CALIFORNIA �r t
<br /> CONTROL BOARD Na— 5 `/ OtEter Well No
<br /> n _
<br /> ..err j"rakrlalf arnber} ��
<br /> . OWNER- (11) WELT, LOG-
<br /> Name CM1 TotA depth 528 ft Depth of completed well_ _U0 it
<br /> Address P. 0. Box 1 150 Forrn.uon Detnrbr by rotor r6ararin tt_r of-aemal and structure
<br /> ' San Jose' Ca1zf. 0 _ft to 10 ftTop Soil _
<br /> 10 20 '+ellat r S!_nd Clay
<br /> (2) LOCATION OF WELL: 20 . 30 Brown Sandy Clay
<br /> County vac JO Llli1 Owncr.number 1f anv— _30 . - 42 r a neBx'rJW11a�',12�t1��t. O.L' Br l�1
<br /> 1 R F D or street No 1 ,i - 1w2— - 65 Erm n Cl., particles F:Lne Sar-
<br /> 175
<br /> . _1 T F of youth O�hsr St__on
<br /> the S f side of East Jaclfson St. tock+�n— ��-- 89 Fine Sand, pa�rtzcles„Brown Cl
<br /> Q ^' ro -r -Clay, uarta cies Fine Sa
<br /> ' Ini 112 Caar,se5pnd(Free,),,, ” Blue Cla
<br /> I 19 122 Blue Sandy Clay
<br /> 122 _ Izi FineSir_d (Free,), " Blue Cla
<br /> ' (3) TYPE OF WORK (check), 111 � � Soft, B1ue� Cava n Fame Sari
<br /> ',ew well ® Deepening ❑ Recandstsontng ❑ Abandon ❑ :1.74 -... 211 l03rSeSand(Ti ght) Ellie Cla
<br /> 1 f abandonment,describe matenal and procedure in Item 11 21] 2-13 CoarseS,-nd(Free), tt ., Blue Cla
<br /> (4) PROPOSED USE (check) (5) EQUIPMENT. 2.13 21: COAMSE and(ri's_ht�� n si rr
<br /> ' Domestic ❑ Industrial [I Municipal ® Rotary ® 23S X55 CnarsPSan0(Frr`e) _ n
<br /> Irngatlon ❑ Test Well ❑ Other ❑ Cable ❑ �' tr u n
<br /> Dug Well ❑
<br /> ' 291 299 Fime S and Fee n tr u
<br /> (b) CASING INSTALLED. If gravel packed 2-99 106 -Fine ori i T:Lt1 tr a it
<br /> SINGLE DOUBLE 7 GageCt! tl it
<br /> or Demeter from to ,� �'+ ,,,,: [1 (Fre
<br /> From Oft to go ft 103).. s1Wall of Bore (t ft
<br /> 128 339 ane Sand (T3.ght)
<br /> ' 0 520 ?8 0 - 903,)q 1 Q Qor s eS n ee it it u
<br /> '20 90 5.20 -- ?54 g66 Soft Blue. Clay,;a_rt-0oarseSa�
<br /> 1&6------ Blue C-1 -
<br /> 189
<br /> -11a?S9 466 Fine Sand (Free) r'r' ►'_. 11
<br /> W_ 46k 1278 H2C1 El lie, Clay, ttL1 QQarse. S
<br /> 1 vpe and atae of,hoe or well nog none size of gr:gel 1 $ Y,1/4 (26 J¢tom F'-1 ne SRrrf (Prep},. 57,1 a�•,A C1P
<br /> Describe Jwnt up 1-ti- 4rq 49(, Snf i 30 im Q 1 azz, Eine pr.
<br /> ' Jh 508 Hare Fi,ifr G1ai
<br /> 17) PERFORATIONS: 4 -_F,3�i� G'1 air
<br /> Type of perforator wed I oil yer 52.F3
<br /> S1Ze of perforutanr louver in length br sa
<br /> From 201{t t� 00 {c 8 Per( per rod Rawe per it
<br /> 1 _
<br /> ' (s) CONSTRUCTION.
<br /> %as a surface sanitary seal provided? ❑{Yas ❑ No To what depth 90 ft
<br /> Were an,strata sealed aguust poilut,00? ❑ Yee tiR No if yes aott depth of strata -
<br /> ' From Lr to ft J
<br /> Method of Sealing vork started Dec. 22, 950, -P-ted i,Jreh 29, y GC
<br /> ' (4) WATER LEVELS: WELL DRILLER'S STATEMENT
<br /> This cell zeas drilled ur.dr my Jurtsdzcl,on and tress ri poli is true to the brit o
<br /> Duch at+h��h,rarer.vas first found not ft my knowledgeerrandbeluf �� r� T+ /, rmr�r�
<br /> 5tand.ag level before perfor.nng it a ft NAME =ti sL.a�l�.lLly JMEU DRZ. l_ u CO. L1J.1.
<br /> ' 1 nic'eve'sfree perfont,ntt er }R nun a ^- ...tit .t
<br /> Address F, Q BDX 47
<br /> 0vc10) NVELL TESTS- San 40se 1, Calif.
<br /> ' s._pump rnrn,de, I; Yes 0 No If les b7 whom' driller
<br /> Y ea Aa1/[me with ft draw lows airs 10 his Wris pr!!e-
<br /> Tnaparature of gator tilos a chemtul analyse Mede? G Yet Xi No License No f, �12 Dated Ji . 19 60
<br /> ' T nectr,r lot made of well? 13 Yat ❑ Net
<br /> 51021 6 07 eoww auras A sro DWR 188 (FEV 3 54)
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