Laserfiche WebLink
ORIGINAL STATE OF CALIFORNIA DO not fill in <br /> THE RESOURCES AGENCY� �!e with DWR DEPARTMENT OF WATER RESOURCES NO. 22618 <br /> N"It,t -of lutant \o WATER WELL DRILLERS REPORT State 'Aell No fj <br /> t'enmt N,s or Date :7 7', _ _6, Other Well No — a l <br /> WNER 111e aA!! (12) WELL LOG Total depth ft Depth of completed well r a o rt <br /> 0L-')) <br /> l i from ft to ft FomNttann (Des(nbe b> color character size or materia!) <br /> VO—CATION1OF WELL (See Instrttetlorts) _ <br /> C,mnt} Ovtncrs Nvell NumberJQ <br /> �11 tddress if diflcreut fnmi ab„ <br /> to+hap Rang Section 36 — <br /> Dutdnce from cities roads rtdroads fence,,etc <br /> - s <br /> (3) TYPE O WORK <br /> %ee 11 ell Deepening ❑ <br /> Recnmtmctmn ❑ — <br /> Reconditioning 0 Q — � <br /> Honzontal NN ell ❑ <br /> Destruction ❑ (Describe <br /> destruction m ttenals <br /> prmedures in Item <br /> 6- �oU'yt (4) PROPOSED <br /> aAd <br /> 7. Domestic q -7 _ <br /> 3 V I Trig'tmmn�� _ <br /> Indtastrtcl ❑ <<J-pa <br /> we'd{ t Slrll ❑ <br /> V l 1 <br /> h00�;oe �� Mumca - <br /> 111 I L i OrATION SKETCH / Other / ❑ — <br /> LIPIIENT (6) CRA PACK <br /> Ratan ia� Ii,N�nr ❑ Y`S �'�o Saze e )41 nc <br /> hlt ` <br /> I„ au ❑ \ 3aturreter u! bore ' <br /> h,r 13 Bin kit \Ct11`rum — S <br /> (,I (ANIM J\srAIII.1) (\�\ (ti PERFOR S <br /> al I'1,+ta, }t/t Ali t1 r x. [of — <br /> C7 1 )1 nc o tem u ze of scree <br /> Pruitt Iu-` Dta C't};C r F \ To - <br /> ft ft III Wfl] �� ft �� \ stz - <br /> K <br /> (9) WELL SEAL _ - <br /> is uarftce sanatam sell prnNtded' ]es [t]/ No 01f Nes to depth�ft = <br /> err strrota sealed tt.un+t ttollution� lies No ❑ Intenil It <br /> Methrxl of seahrt \\ ,t trlyd _ 1V <br /> _ly <br /> g0) WATER LEVELS 11 LLL DRI IJ I ti I III I X11 \ 1 <br /> pth of brat NNater of knoo, ,T It , , ., <br /> !ha „ !1 t 1 Z_c <br /> w t f Na 1..aJ o,ay <br /> tnd ngr le%el tftcr Ntell completion _tt <br /> (11) WELL TESTS .t t & j L `t_G7_�+- <br />[pth <br /> well trT,t mode' les I: 10 &,-ItNes b, N,h ma ___ �,,], Iepe of te,t Pump ❑ Bulrr ❑ a r L11 �, a — C.t N+ tier it +1.rt f teat tS \t a t ' , n�'G CI !� •1 <br /> Do,ch u-, __1) u.,n tit,r 1, a N a <br /> I „ I+ , :, I, 1 ♦ tf , r 1,.'1 Ci <br /> 1 C IL Q l 7�—AL2_S1_ <br /> p t <br /> IF ACL. T .A 1'A 1 •1 ( 1 - aL •.i l S <br />