Laserfiche WebLink
OR�3iNAL srA'10E OF CALIFORNIA DWR USE 520L � L L V <br /> File with DWR WELL COMPLETION REPORT srnr�YfEti++o rs A110N _ <br /> .'r Refer•La IrrcrToorlorr PaAtpl7let <br />' L DET <br /> owner's Well me, W— A p/13 NA• q El. Date Work Began 'q , Ended LAMTubr= LONGITUDE <br /> Local Permit Agency w v•n+ �trd! y <br />' Permit Na Peanut Date <br /> CEOLOGIC LOG ty,.\_ .W�EL+L OWNER <br /> ORIENTATION (!: Yexncet —HDRIZOMIL —AN= —(SPECFY) Name` � W •'`Z a�5t~ s e P �@IST <br />' DRR'1"Fl TO MM WATJZ (FL)BELOW SUPFACE Inig Address )` _ � <br /> ' / e- <br /> DEPTH <br /> aW� DESCRIPTION `; <br /> c[rY STATE ZIP <br /> F1 to FL Dacnbc mm"d, calor ccs # W ELL,LOC AVO N <br /> "t t <br /> 1 ! ' a <br /> ON 9p_'0'1!5 7Rroel <br /> 1 y Y 3 7 a Town§f�p IZanix <br /> e Section <br /> lAtul tide_ _.._nam LongitudeU N <br /> EC. QST <br /> DELL MaL BDEG. sM <br /> LOCATION SAETCH TIVXTY (2�-) <br /> NORTH NEIN 1NELL <br /> Wt Sir ► 1N �' 6AUt71FICARroNr34EPAliT <br /> Deopm <br /> 1 <br /> o/.v N ' —DESTROY(MON&9r <br /> Mon/dleea eadAliferra4* <br /> • i 11/ i• G Sb � � Umlar'YJEOLDtirC40[i'7 <br /> s PLANNED USE(S) <br /> rt <br /> WATER SUPPLY <br /> 1 1 <br /> :14A, <br /> -TEW WELL- <br /> SO <br /> , <br /> 1 ► J J <br /> � 1 f • ��CA7liGoW PROTEG <br /> i i W Q 7'• 1Hurerafs or ZUsctllas DBeanc of W411 from Isndnwr*s OIl1EA i8Px'M <br /> 1 d11Ch m Rand;& mzwrly ar <br /> tCOMPLETE BE ACM <br /> /' s +-.► • r I• METHOp OM <br /> • ����, ��FLt11Cr <br /> WATER L YEL a YIELD OF COMPLETED WELL �r <br /> T ` WATER OF E YEL�C�2 rZ�J�onj a DATE ME'ASIJAED ,7 <br /> 1 1 ESTimmm YIELD` (OPM) &TEST TYPE A <br />' TOTAL DEPTH OF BORING Z• (Feet) TEST L€NGIH 1L0*3)TOIAL DRAWDOWN&A_(Ft.) <br /> TOTAL DEPTH OF COMPLETRD WELL –Zef(Peet) •May rax be nprgwwatwe of a aawa}longterm ydd <br /> R <br /> DEPTH CA9ING(S] DTH <br /> EPANNULAR MATERIAL <br />' FROM SURFACE HOLE TYPE r FROM sURFACE TYPE <br /> DIA. ,� r� tAJITF.RtAL! INTERNAL (iAtl6'E SLOT 917.E <br /> 4.c OL J! C WAMLTER OH WALL IF ANY ENT �L FILTER PACK <br /> Ft to FL Ap a a � f}leeasl TFIICKNESS OeegW FI to T T_ (4) (r) (j) (TYt' ""n <br /> A 4W <br /> ' ws <br /> 1 ' <br /> 1 1 <br /> l � <br /> ATTACHMENTS (z�) Ci3RTIFICATIONI STATEMENT <br /> GR O100� I,the underwgned, 3 that this report is(ccamplete and accltrat <br /> Lng <br /> wmto the b stat my knowledge and belief <br /> Sdygau Oaft ctlan okoffila AMM F on ) DR d iFD1 p <br /> tma�A 32 <br /> 9ozatWafar(9rmltalAasHaus o <br /> t:TSY <br /> ATIACN ADMnarIAL AW;Ca 1/ATAX IF fT E7?8Tr) Sboad 4rElL pIt pEp fM ED Cbt EH51 NDI1nFS <br /> D%VRINREV i-M IF MA <br /> ADDITIOL SPACE is NEE ED, US CONSEC Y NUMBERED FORM 177? <br />