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BTATE OC CALIFORNIA Do Not Fill lis <br /> ORIGINAL THE RESOURCES AGENCY <br /> ! FRO with OWR DEPARTMENT OF WATER RESOURCES NO. 116720 <br /> I <br /> WATER WELL DRILLERS REPORT straw wat N._ <br /> j Other We11 N,71L—� <br /> 1 <br /> (I) OWNER: (11) WELL LOG: <br /> Address d. e KNam= fc ,h.t-.plavd) 190 1,. <br /> ( g d <br /> Fom-a : De....I,b, p/er.<aw+<ar.m..l <br /> LathrflD, Calif. h. <br /> s (2) LOCATION OF WELL: Lne <br /> m..Y San J'oa u -n .n.mt.r.Sf .yci-8 TOP soil <br /> > TOYGablp A+uq i:id 5<[tiM <br /> B-26 <br /> Clay & Shale <br /> n«fmm<,ri<a.m aa,<adm d,u 1p Onta e d 8c Tatbrnn26-12 Sand <br /> 1 <br /> Frontage Ed.-Eouth -of RothEd.-off hxy 12-951 Shale/soft <br /> (3) TYPE OF WORK (check): - 1F <br /> New Mdi j{] Deepeuin8 E3 Reconditioning❑ Det[roYine ❑ 10"106 Sand <br /> IidlSly>CfiOnrdrIC116f MnfC lllfl nllli ,n,d.,,in lit.fl. 106-113 Soft Bandy Clay <br /> (4) PROPOSED USE (check): (F) EQUIPMENT: 1_ 4-1?1 Sand—fair <br /> Domestic ❑ Industrial ❑ Municipal ❑ Ro[ary 91 — <br /> Irrigation ( Tes[Well❑ Other❑ Cable ❑ 128-1�5 Sand <br /> Other <br /> (6) CASING INSTALLED: <br /> BTEEL:x OTHER: If gravel packed I �• _ rl w_enfi: <br /> SINGLE Ig DOUBLE❑ 1 {l.-1fi R1 all Cl a'y' <br /> 1 (Zj Rrnwn Clay <br /> From "!b or of Fxom To nd <br /> — <br /> ft. it. Diam. W.11 Bore it. ft. *'—ryeC {✓t'(aar rpr, Q]IA ZR�••� <br /> 190-1 3 11 pn a ion 215-217 Rand <br /> _ -5L9 <br /> i-r.Z= Pl� A,r 4halpa <br /> 211_2,t'4?�—_P7 a� - <br /> h,udahwwrdl:.a . Siasnt a.rd, <br /> a....iw i <br /> welded- <br /> (7) PERFORATIONS OR SCREEN: <br /> Trw of p<ebr+.:mer mine of mmm <br /> Pntf. Row, <br /> From To per per Su <br /> ft. f, rov ft. in..in. +i. <br /> Alft <br /> 94 Igo i /A <br /> ti <br /> (S) CONSTRUCTIONS <br /> Yaa uorLc<,wimay xit mvid<dl Ya❑ k-30 To rU.dipa f<.. <br /> W.rc my vuu waled aiau polineim) Ym No 1f yu mac dw,b of xea+ <br /> tmw ism !.. <br /> tmm fe.e. h. Wort.nrtd 19 .Campi.aed is <br /> Sk.hed o[,.d;e WELL DRILLER'S STATEMENT: <br /> Tbh well w.irilid(9) WATER LEVELS: oI tty knowledr.and bdlrfdtr wy jarhdlrffon and this rrporl h few to the 6a[ <br /> awah.t rhkh wam<,e..A-.f.n.d,,f <br /> Snadi.e i.rd tdpm ..!.maim,. if kaova fr. NAME Hennings Bra.s DMIjin co, inc. <br /> p le<ron,6tm.wmrywaeien) ITrhdorlvW! ) <br /> Samdinx 6re1 afeer -!engin apd dmda in 22 C7 fe, <br /> (IO) WELL TESTS: Addren 2-990 W. Rumble Rd, <br /> tya,v ma.mw.l Y!a No , ]Fru.hyrh.m> P.G. & E esto C if. 9 3 <br /> c.l/m:....i,h51f..dcardarn afar hn. $[oNEb] { <br /> T.M...of r.,- ...iw mad.) Y.O No 11 <br /> gpnQ� 9 <br /> wa d.ao-ic bd made of rdl> Ynf1 Ne If yn,,.tmh My License N,--al!V_)_J. <br /> SKETCH LOCATION OF WELL ON REVERSE SIDE <br /> Own IBB i.C,pnm eaa+nvo p.ra aan rnty nr mp <br />