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ORIGINAL STATE OF CALIFORNIA Do not f&U sn <br /> File With DWR THE RESOURCES AGENCY <br /> DEPARTMENT OF WATER RESOURCES NO. 47975 <br /> Notice of Intent No WATER WELL DRILLERS REPORT <br /> r� W Stats Well No <br /> ocsl Pe <br /> Lrmit No or Date_ /Tri-- !7r7n..( s <br /> Other Well No <br />( ER Nam Melvin Bartoo 12 WELL LOG. <br /> 22$00 99 ( Total depth �ft Depth of completes well.- �ft <br /> Address S• H from ft to ft. Formation (Describe by color, character size or matenal) <br /> CiTop soil <br /> ty Ri on Calif p <br />(2) LOATIT OF WELL (See instructions) 28 <br /> '" <br /> County an J as U1 n <br /> Owaer s Well Number g sr. <br /> Well address if different from above 15'21 le & s and <br /> Township Rang Sectio 21-2 ' <br /> Distance from cities roads, railroads fences,etc Hwy 99 & Ja cktone 28-34 <br /> 01a <br /> Rd - a sari <br /> an <br /> 4 9±51 NX Clay <br /> (3) TYPE OF WORK 51455 NSand <br /> New Well X Deepening C] Cla & shale <br /> Reconstruction ❑ ?- and <br /> Reconditioning Ll 70-78v <br /> 1B <br /> Horizontal Well ❑ 1 -Sind�7 <br /> Destruction ❑ (Describe — Sha <br /> destruction materials <br /> procedures in Item - <br /> (4) PROPOSED - <br /> Domestic _ <br /> Irrigation<O _ <br /> Industrial ❑ <br /> t Well ❑ _ <br /> i <br /> S - 0 <br /> Munici <br /> WELL LOCATION SKETCH Other ❑ <br />(5) EQUIPMENT (6) GRA PACK - <br /> Rotary ❑x Reverse ❑ NoT-jSize <br /> Cable ❑ Air ❑ ter of bore(. <br /> Other Q Bucket ❑ <br />(7) CASING INSTALL£1) (8 ERFO S - <br /> str�l ❑ 1'hisui [ i et Type of pe a o- of scree <br /> }'ruin Ti Dia r F To I <br /> - <br /> ft > in Wall R VI-1 _ <br /> 9 1 - <br /> 9) WELL SEAL 50 - <br /> Was surface sanitary seal provided? Yes No ❑ If yes, to depth _eft - <br /> Were strata sealed against pollution? Yes ❑ No ❑ Interval ft - <br /> blelhod of sealin Work start IV <br />'10) WATER LEVELS WELL DRILLERS ST'%J k"-1N\T <br /> Depth of first water if known, R This well rwr dirffrJ w.s#. ..r ,road.#%,. s+af #fou ,ri„er a rr� r. l)” br+r v1 .ry <br /> 5tanding level after well compled (t knoufcdeo, and briwil <br />,11) WELL TESTS Sit\Lr,__ <br /> ryas well test madO Yes 0 No 5c If %es by whum+ <br /> rype of telt Pump ❑ Batter❑ Air lift Q Henn i n �]x"pg ri l l i n- Co. , <br /> I <br /> _ —� _...�L <br /> Depth to water at start of test— Ft At end ..1 int - _ —tt [ �+ . T.s.rl..y yrs#rwi� <br /> 17rschur{;r—..,_,_�gal/tion ,ifter hour %l,strr tin.is#ui.#r.,,. -- ���� ,. <br /> "Modoz 4a " Calif. 50 <br /> ru - <br /> Meinil anal>sis uwder les ❑ \u�' It ♦es br whm. -- _ + '_-_ — ` ,.y 3 �+ <br /> _ _ t.:._:.._'i.....,...,-....._L.-��,...�.'w ti...-. VV ,r,►�+ i s.� ..•.v...�=.....«.•' ,.....,... <br /> no <br /> wcv > 76 IF ADDITIONAL SPACE la PdLLDLD Ljs( tiaexr eo►tat CllTtva Lr NNYr[IIrQ 1G*IY .a.r. -+r.. «*a•.� w+ <br /> MGyn <br />