Laserfiche WebLink
� <br /> TRIPLICATE1C 11 <br /> 57ATE OF CALIFORNIAGALtFRNIA Do no;fill to i <br /> cwnees;opy THE RESOURCES,AGENCY fl <br /> i <br /> i DEPARTMENT OF WATER RES <br /> LF� O. 14J{}.7{� <br /> ?4O i <br />€ Ip WATER WELL DRILLERS REPO 1 01 1q87 <br /> Notice of Intent No. 4 <br /> State Well No, F <br /> Local Permit Not or Datc <br /> ENVIROMENTAL4EAUW, All <br /> EM <br /> Iri-Valley Growers �' R I <br /> (z) OWNER: Name (12 j WELL L� Total de atl �j� <br /> aft. Depth of completed well <br /> P.O! Box p Gd. ft. <br /> Addres F front ft. to ft. Fonnatinn (Describe by color,Y character, size or material) <br /> � :s r <br /> Cit - ` <br /> zip R 8 <br /> (C2)t I'%�J*Ajj WELL (See instructions): - <br /> ). w�gllrNtexrlf-r Bark brown sandy silt, 5-10% fine <br /> Well address if d€€ sifferent front above i iCU da soft <br /> Terwnship Rang¢ Sectio _ - ' <br /> Distance from cities, roads, railroads,fences,etc - <br /> alst, softY <br /> (3) TYPE OF WORK: 3+ - IRO f st soft <br /> New Well A Deepening ❑. - <br /> 'Reconstructionnet, Medium dense <br /> .❑' _ I <br /> Reconditioning ❑ :`.! _ <br /> Horizontal Well22 Dark naraylsh hmwn- sand- met <br /> ❑ E <br /> Destruction ❑ (Describe t.LL r <br /> 'i destruction materials and <br /> 6 procedures in Item 12)' <br /> 1 4 <br /> (4) PROPOSED USE` 26E26.5Liaht brownish gray, clay -wet. <br /> - Domestic (] V _ stiff <br /> CIf - <br /> Irrigation ❑ <br /> Industria] ii'4 ❑ - <br /> i <br /> Test Well r ❑ 'w - <br /> i�i Stock ❑. ! - r <br /> 4€� - Municipal ,,, ❑_ - <br /> WELL LOCATION SKETCH Other Mori}Wrap ] f - - <br /> L (5)'-EQUIPMENT: (6) GRAVEL PACK: - <br /> Rotary ❑ Reverse ❑ Yes ❑ - No ❑ r Siz2/12 <br /> - <br /> Cable L] Air ❑ Diameter of b. 75 - <br /> Other [3Bucket ❑ Packed from 25 to ft. j - <br /> (7) CASING INSTALI.ED: (e) PERFORATIONS: - <br /> i <br /> Steel ❑ Plastic ❑ Concrete ❑ Type of perforation or size of screen <br /> From Ti Dia. Gage or From To Slot - <br /> ft. ft in. Wall ft, ft, size t: - <br /> 25 r - <br /> (9) WELL SEAL: r - <br /> Was surface sanitary seal provided? Yes No ❑ If yes, to depthT_ft. <br /> i <br /> Were strata sealed against pollution? Yes C] No ❑ Interval Ft- - r <br /> Method of sea'I Workt.rte 39 'Complet 19 <br /> (10) WATER LEVELS: 17 WELL DRILLEWS STATEMENT: <br /> Depth of first Nater, if known _ ft. This well was drilled under-ney jurisdiction and this report is true to the best of my y <br /> Standing level after well completion`., _ ft. knoule4,e and belief. <br /> (11) WELL. TESTS: SIG' <br /> Was well test made? Yes ❑ No [j� If yes, by whom? ? e y, Well Driller) I <br /> Type of test �� Pump ❑ Bailer ❑ Air lift E] NAf�1E Exceltee�l, nc. k <br /> Depth to water, at start of test ft. -At end of test ft- fi (Person, firm, or corporation) (Typed or printed) ' <br /> Discharge_�E gal/min after hours eater temperature Address 41674Christy St. I <br /> Chemical analysis made? Yes ❑ No G} If yes, by whom? City F^l�l'Ront C 9.452-8 Zip <br /> Was electric log�lmade? Yes ❑ No ❑ If yes, attach copy to this report Liccnse No. 464124 Date of this report 9 IQ 187 <br /> Y 7� <br /> DWR 188 (REJ7-7e> IF ADDITIONAL SPACE IS NEEDED, USE NEXT CONSECUTIVELY Nll'MBEREE) FORM' <br /> Il <br /> I <br />