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In <br /> ORIGINAL WATER WELL DRILLERS REPORT N� 101Do Not Fit!In <br /> li <br /> File Original,Duplicate and Triplicate with the (s.etaant 7076,7077,7071,Water c,da) <br /> 742 <br /> REGIONAL WATER POLLUTION State Well No <br /> CONTROL BOARD No 5 THE RESOURCES AGENCY OF CALIFORNIA ILiOkOther We11 No�— 00 <br />' (!nein appropriate rxwber) <br /> (1) OWNER: (11) WELL LOG: <br /> aneOle Sands Total depth 100 It Depth of completed reit 100 it <br /> ddress Ht. <br /> is—Ripon <br /> " e.L Formation Describe by rotor character size of materiel,and straciare; � BOX .r8$Cal:i.f. it to <br /> it <br /> JZ s and <br /> (2) LOCATION OF WELL. 12 16 Sant~ a <br /> ' County Sari JO Q u i ll Owner a number ,f any-- 16 24 San <br /> R F D or Street No 24 36 roma clay <br /> 6/1C nile Nortn 99 H.'1 . an; H1 e �6 sin <br /> 'QS r of PTorth Hixon road - 40 gray c ay <br /> 48 <br /> T+l _ :.' Sec. 19 T- N--SHS- E � roRrn c ay <br /> 72 30 sand coarse <br /> $0 96 brown c ay <br /> (s) TYPE OF WORK (check) 96 100 s an d <br /> New well 6 Deepening [] Reconditioning ❑ Abandon ❑ <br /> If abandonment,describe material and procrdure in Item ]I <br /> ' (4) PROPOSED USE (check) (S) EQUIPMENT. <br /> Domestic ❑ Industrial ❑ Municipal [] Rotary <br /> Irrigation © Test Well [:j Other Cable ER <br /> Dug Well <br /> (6) CASING INSTALLED If gravel packed <br /> SINGLE RJ DOUBLE ❑ Gage t Diameter from to <br /> or <br /> ' From It It D..in _ —V .111 of Bore it It <br /> C p4 10 12 <br /> Type and site of shoe or-ell ring x �Z Sat of gravel <br /> ' Deacr,be joint 'Rut .Feld <br /> (7) PERFORATIONS. <br /> Type of Ferforator used Factory ❑❑ <br /> Size of perforation U in length by in <br /> From it ao it pert per row Ito.?per ft <br /> e <br /> ' (8) CONSTRUCTION <br /> Was a surface sanitary sea] provided? [] Yea ❑ No To what depth it <br /> ' Were any strata sealed against polluoona ❑ Yes ❑ No If yes note depth of strata <br /> From ft to It f <br /> Method of Sealing Work started 5_4-65 19 completed --6 <br /> ' (9) WATER LEVELS WELL DRILLER'S STATEMENT ~ <br /> n This well war drilled under my tstrirdiclion and ibis report rs true to the best of <br /> Depth at.latch water was first found 22 it my knowledge and belsef <br /> Stand,n level before perforating ..+ fe z <br /> 8 NAME Jahn �a,zero i,., and—Carl :iScLeister <br /> and,ng le,d afitr perforating It — eo firm or o too (Typed or printed) <br /> Address Rt.# '� fox �`��-`� <br /> WELL TESTSStockton Cala_tB <br /> ,*11. <br /> aump teat made? ❑ Yn No If <br /> Its by.homy <br /> [S16NED] r�JfjJ�---f�(--L-1� ....� <br /> Yield Bal�m a w,rh ft draw down after his An / Weil Drdler <br /> Temptrarure of water Was a chemical analysis model' ❑ Yea ❑ No License No 215-489' Dated_5— �Waa eleune log made of well? ❑ Yes ❑ No <br /> 5764a 5 63 aaaa QUIN Q A aro DWR 108 (AAV 3 64) <br />