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IRIGINAL STATE OF CALIFORNIA DO not ldt in <br /> THE RESOURCES AGENCY <br /> File with DWR DEPARTMENT OF WATER RESOURCES NO. 153493 <br /> v of Intent No WATER WELL DRILLERS REPORT State Well No <br /> Penna No or pate Other Well N <br /> p WNER rN imr J 3-m (12) WELL LOG 'Total depth. ft Depth of completed well 2GOdt <br /> d, �O• Bo; 045 from ft to ft Formation (Descnbe by color character size or material) <br /> Ripon, Ca. - _. zr b6 - 33-- Clay,sand streaks <br /> �} L CATITON OF WELL (see instructions) <br /> unty San11— Qaquin Owners Well Number <br /> Mell addresb if different from above 2 6 <br /> Imnihip rt 1" "; Range Sectio 4 – Ca <br /> tbtanci. from cities roads railroads feneeb etc – 2 S <br /> 72 - 92 C1 sand streaks <br /> 2 - San <br /> (3) TYPE OF WORK <br /> New Well I Deepening ❑ <br /> Reomstluction ❑ `Z <br /> Reconditioning ❑ <br /> Horizontal \4 ell ❑ g <br /> Destruction ❑ (Describe 3 <br /> destructionm,tenals�y� <br /> prucedures in Item YY`` 1 3 <br /> (4) PROPOSED 14 Clay <br /> Domestic 152 3 Sand V <br /> ❑ 15 3 7 Cla <br /> Irng ition.\ <br /> ]ndustrial \� © � 5 Sand <br /> TE�Vi ell ❑ – <br /> Nfuntup <br /> \SELL LOCATION 51c6TCf! S Other ❑ <br /> ) EQUIPMENT (6) GRAY ACK RoC3fi�In <br /> t - <br /> ,yy �[ <br /> rotary {� Reverse la e�bt 10 Stxe <br /> Coble ❑ Air ❑ �I�\et�r of bore— <br /> ,N <br /> )ther ❑ Bucket C3 \` it in \ – <br /> 7) CASING INSTALLED (B) ERFORATI <br /> Steel [3Plastic C3Cu a Th pe of pe a' 4 ur a of scree 'tel <br /> Frohn To Dia Gaffe-or F191111'\\ To <br /> ft ful in Wall f�``y ft ♦ Si - <br /> 0 206, \ N 60 N> - <br /> PUC <br /> s� – <br /> 9) WELL SEAL - <br /> Was surface sanitary sea[ providedO ]es ❑ No ❑ if yes, to depth—ft <br /> te,e strata sealed al ainst pollution? Yes ❑ No ❑ Interval ft – <br /> ethod of seabn Work started_ ^19 Complet 19 <br /> (10) WATER LEVELS WELL DRILLER'S STATEXIENT <br /> Depth of first Nater if known ft This well was drilled under my jurisdiction and this report a true to the best of m. <br /> t indinK-level aper well completion,,... <br /> f# knowledge and belief <br /> 11)WELL TESTS SIGNED— _ <br /> Was well test m-tde° Yes ❑ No ❑ If yes by Thom' (Weil Driller) <br /> Tlpe of test Pump ❑ Bailer ❑ Air lift ❑ NAME <br />'Depth to water at start of test ft At end of test ft (Person firm or cnrporatto (T ed r tint <br /> Address 30053_ K- 1 roy <br /> D• Marge^�_ea]/rmn after Lours Water temperature City Turlock- Calif f_ 7..p <br /> iea] analysts made' Yes ❑ No ❑ If yes by %hoar? �� <br /> iiiiiiiiiife9538 <br /> Aft lectric jog made' Yes ❑ 1`0 ❑ If yes attach copy to this report License ho Date of this repo <br /> DWR 188 (REV 7 70) IF ADDITIONAL SPACE IS NEEDED USE NEXT CONSECUTIVELY NUMBERED FORM <br />