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ORIGINAL WATER WELL DRILLERS REPORT Do Not Fill In File with DWR (Sections 7079,7090,7081,7082,water code) NO 2_814 9 . THE RESOURCES AGENCY OF CALIFORNIA "� = r - DEPARTMENT OF WATER RESOURCESSite Well No` Ocher Well No (1) OWNER (1 1) WELL LOG- Name :,_L1Int-i c Ric-llfleld ^ toward T�-11 .� Toeal depth 540 fc Depth of completed well r,1 it Address F.0 30:{ jo Formation Describe by color cbaracter srze of materrat and sNucture e�edrilci'1 Calif. t �J -IIS71s s 7 ft to fe (2) LOCATION OF WELL• P�'"�-�3�'� �� Ri7 0- s l county c`a-,Li T Q a g u Z j j Owner s number sf any f_— v L-I.ay r zp Townshep Range and Section f;}OJ 4 �, T'e 5 G G� Tn �' , �� '� - P r Si e 1 Distance from cues roads railroads etc ar r anYI ] I'+ a t- r,T onante 1-0 7t, N T4ansen - _ 41 - ' nark rown (dl_-r ' Sand (3) TYPE OF WORK (check)• Chan to '; -- S a New Well Deepening ❑ Reconditioning ❑ Destroying ❑ —5 i- r z 7,raypl 11 destruction,describe material and procedure in Item I I T� r t ° k s (4) PROPOSED USE (check) (5) EQUIPMENT - ? Domestic ❑ Industrial ® Municipal ❑ Rotary - '3 f Irrigation ❑ Test Well ❑ Other ❑ Cable ❑ —_ _„ oand Other ❑ 1 -1 c) ; (6) CASING INSTALLED- STEEL OTHER If gravel packed 9tq-3n Rr nAm Cln3 - SINGLE ❑ DOUBLE © — 300—�20 _ 1 Gage Diameter From 1 To or of f From I To �riL.�ri �J ('� aV 4 rl R>, Rnrk gtronita ft ft Diam Wall I Bore fr. ft 3 1 OF0 p Or, f I ? 11;) and k 20 3 - and clav 390-3 92 t_ o c k Sere of shoe or well nnA Srze of gravel 'T y I T _3U2-3f363 Clav neserebr rotnt r:- 1 J— w O Ck (7) PERFORATIONS OR SCREEN ~9'E-L,00 flav Type of perforat tun or name of screen i-vtl�J-4�i r =mall =ra,.reii Perf Rows f=0 —L1_ ` l a v From To per per Size l i— 1 -Cia'a' `=ravel fr ft row ft in zsn L14— r07 ardl "lay 6 Id-7 20 'i `'ravel r_-QcI 5 3 20 2 - 515-52 s giard Clav 525-53113- Small 'ravel AIW T'ard cl av o tr (8) CONSTRUCTION ° Was a surface sanitary seal provided; Yea C No[] To whir depth it Were anv strata solid against pollunon s Yes ❑ No Cl If yes note depth of strata From it to ft —" From it to it Work started 19 completed i4 Method of seahne WELL DRILLEI7S STATEMENT {9} WATER LEVELS This well was drilled under my jurisdiction and this report is true to the best of my knowledge and belief Depth at which water was first found if known it Standra4 Icvel before g Lf-)T-Tt T i71T E a„ 2T I'0 �'It�IT ^i TT perforaein of known !! ft NAME Scandin level after perfonttag and devetopsnR 00 ft (Person firm or corporation) (Typed or pre need) �0) WELL TESTS. Address i ti tr 2 eMat �^ T V-) Pump tesr made? Yes ❑ No ❑ If yes by whom? I T v -1 T d at/min vetch it drawdown after hr. (SIGNED] ❑ (Will n!!rr) Temperature of water Was a chemical analysts made? Yes ❑ No Was rlrctnc log made of we][? Yes ❑ No ❑ if yes attach copy License No-210-5 r 2 -6 SKETCH LOCATION OF WELL ON REVERSE SIDE DWR 188 s HEV 9 rse l ad3or 950 so as Sam Tper r'A osp