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WATER WELL DRILLERS REPORT rDo Not Fill In <br /> ORIGINAL 1\ O 7 4 6 n 4 <br /> qjGIONAL <br /> Onglnal,Duphtate and Triplicate with the (see=tent 7076,yoyy,yoyg,mato cane) - <br /> WATER POLLUTION State Well No— - -' <br /> STATE OF CALIFORNIA Other Well No <br /> N'Y'ROL BOARD No <br /> '-sert appropriate number) <br /> .) OWNER: (11) WELL LOG <br /> Total d h ft Depth of completed well 220 it <br />' <br /> Name R r� V4i Iiam ,] � p p Address 3820 Carpenter Road Formation Describe by color rbsracter sszr of malersal and sernrlure <br /> 0 ft to 8 ftblk to soil to dk cl <br /> Stockton Cox if. g bra to T wa br el <br /> (2) LOCATION OF WELL 8 52 br cl to br SS <br />' county San doaouin Owners number of any— 52 ,;.64 br cl to sandy br_ cl_ _ <br /> R F Dor street No 0 64 68 * br SS,sml grvl_ _ _ <br /> lei �r —Mariposa68 80 br cl t D SS & fime sand <br /> 80 88 soft cl to sandy br cl <br /> 88 96� sand & gryl to firm br cl <br /> 96 10 * sand & grvl <br /> �A3 114 semi firm br al to sand 8 RR1 <br />' (3) TYPE OF WORK (cbeck) 0 r -br al to T. br cl <br /> New well fI Deepening ❑ Reconditioning ❑ Abandon ❑ I,4,() ___ __ .150 br SS & br cl to T.grygry cl <br /> If abandonment,describe material and procedure in Item I I * SS dk cem sand & blk rvl <br />' (4) PROPOSED USE (check),- - (5) EQUIPMENT 154 377 Alt SS & cem sand to T. el <br /> Domestic [X Industrial ❑ Municipal ❑ Rotary ❑ SS-& cem, sand <br /> Irrigation ❑ Test W01E] Uther ❑ Cable DE 182 222 T <br /> Dug Well ❑ <br /> (6) CASING INSTALLED = 7 If gravel packed 225 230 hl 11 1-1 <br /> SINGLE C2 DOUBLEi 1 Gage Diameter f om to <br /> or of gore ft ft <br /> Ont f= to ft Sham — Walt <br /> 0 132 8 10 <br /> !r - <br /> Type and size of shoe or well ring x 4 sat of grnvet <br /> ' Describe joint welded <br /> (7) PERFORATIONS. <br /> ' Type of perforator used ' <br /> Size of perforations n length by in. <br /> From ft in ft 'pert per top Rows per ft <br /> i <br /> (8) CONSTRUCTION <br /> Was a surface smstarr$eal proVsdtdj [❑ Yes ❑ No To what depth <br /> Were any strata sealed <br /> against pollurcoa7 ❑ Yes ❑ No If yes note depth of straw <br /> ' From ft to ft <br /> Method of Sealing Work starred 8tr $ 1967 Completed <br /> May 3. 1967 <br /> ' {9) WATER LEVELS- WELL DRILLERS STATEMENT <br /> This urcll was drilled under my jurisdiction and this report is true to the best of <br /> th at which water was first found68 ft my knowledge and belief <br /> jiWaadt.g lewd before petfuratsng rtV ft NAME <br /> _ �'ury�ann Drillers <br /> ,ng lever after perforating ft (i ,Son dim . ` frCr.s-- T zth,d or t•.jrds <br /> Address P. 0. Box 64 <br /> (10) WELL TESTS- Linden Cjif, <br /> ' 3 Was a pump test mades [] Yes g No If yes,by whems [SIGNF�] 1 <br /> Ytdd gni /min with ft draw down after Well Driller ra n� <br /> Temperature of water was a chemical anal,..s mades E) Yes ❑1 No License No �-10 fs� Dated 5/5/67 <br /> 19 <br />