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01 =zr/ /.i-/f • • NOV 7' 1907" <br /> DRMINAL WATER WELL DRILLERS REPORT Do Not FM In <br /> File Original,Oaplitata and Triplicate with the (Src[i.na 1011,707,7071,mame Cod.) NU 5528 <br /> REGXONAL WATER POLLUTION <br /> CONTROL BOARD NDS__ <br /> STATE OF CALIFORNIA <br /> f eplre)rran aawbar) �j JG�' other Wdl No -- <br /> 1} OWNER. v (11) WELL LOG: <br /> Name �'�(r{/• Lin. +��{ijy{,et Toeal drprb "122 f <br /> _V Dmx6 f PI a It ��� p <br /> Address fjOJ/ )/ f,� /�r3 fL P.[ma[mn,...runes1 by r.ro,.rm.ren.n:r./wwnf.l.and afrwNarr. <br /> (2) LOCATION OF WELL: .0l f w <br /> 0..P.a.or SneeYNa <br /> 7 _fir — <br /> (3) TYPE OF WORK (check): <br /> SIJ " / •%. <br /> New well D«peeing ❑ RecaadadDninB ❑ Abandon ❑ •`K.Z._�t�sp ..-_/ <br /> fJ nbundanmen1,desrr:be malorki andedwefutlem 11. w� <br /> krDe <br /> (4) PROPOSED USE (cbtck): (5) EQUIPMENT:. <br /> Domestic [] Tnd=rfal 0 Municipal 0 l Ratar7 ❑ _ _, <br /> irrigation ) Test Well [] Othu [) Coble O - <br /> Dug Well (] <br /> (G) CAqS�ING INSTALLED: If gmyel packed <br /> 51Non.¢y"a DouaLE o <br /> Di111 from <br /> From &.m !r. Diam. m'.¢ Pan h, fc .. .. <br /> Trp.ana Dm.1 d,..m+df rine X Sd <br /> ikaeei6e pinx .. .. <br /> (7) PERFORATIONS: .. <br /> T7D..f parf.ritm and <br /> size .IPc[f.nd.mlen eh by 201111• ID, <br /> Frei h,m ,N'f..vr <br /> (9) CONSTRUCTION: ' <br /> Wes. am4«nnr.......I pr.ria.dr 0 Yea 0 Nn T.*ut d.Pah fu ,• <br /> mer raY rw auzird agrin,cpella[i.o) Af Ya ON. if Yar;mmMprhsf atea[a <br /> Froin. r D fr,,. <br /> Mcchod of Scaling . n Wma am[rrd Ld 9 , iP 6O cm rP .>I <br /> (9) WATER LEVELS: WELL DRILLERS STATUI£NT: _ <br /> .wu[vu ku[f.md R TbThi,weft au Pr drfiled nndn wy jurfrdiclion and 1I report is Imf fo flu bI o/ <br /> Drpxh II,+hkb <br /> a� .`r mykaowledgedud btEfej. <br /> ;nes keel Nf.[e pnf.rmi.a !r. NAME <br /> � a teed cies..ywf.arrinR fr. I/O�`^'�(Y+rmn,firm,nr rarpnnx.,nl f I rbd n b.:.bd) <br /> Address <br /> (10) WELL TESTS: <br /> messes P.mP nn mrd.; <br /> Ry. OT. IfYeohY+hemi > a + <br /> Yirldr fA f aal.lMe,d[6 f[.tl[av doves ahm here l$1eNnD) '^", We¢IN1¢rr _. _Y•..�4. <br /> Trmsnarvr ofvmr Wares ckrmialanalYrir mrd.i %T. ON. X.ianae No._ 19— <br /> W.rd¢uk7.amade.fNit DYn �N. Iwaa e-n.muDDmA aro <br /> DWR 108 rngv.F941 <br />