Laserfiche WebLink
91- <br /> ORIGINAL <br /> ORIGINAL STATE OF CALIFORNIA <br /> File with DWR THE RESOURCES AGENCY Do not fi1Z to <br /> • f intent No DEPARTMENT OF WATER- RESOURCES No. 248089 <br /> ff� WATER WELL DRILLERS REPORT <br /> .rs <br /> ! tt,t No or Date_: 5 f – State Ws.11 No <br /> Other Well NoOZSC14 1' <br /> ( 1) OWNER ~line �uaTe�lh Sparks <br /> (12) WELL LOG Total depth-193 <br /> \ddTesti ,51 Buena Vista �Vr• ft Depth of cnmpEered we1L1�� <br /> from ft <br /> mat. L1vY rr,zore ft ft Form ition (Describe by iJor character ri <br /> size or mi, a 0 to a <br /> _ <br /> Zip <br /> (2) LOC6MQI OF WELL � <br /> C+nintv_. Jan JOaquLn (Seetnstnlcttnns} �t ay <br /> _Owners Well Number 4 :JI).3 <br /> T, e.� <br /> NN ell iddre5s if dilferent from shove Patt ers o 2 F s j " 3 <br /> „� �. x 5 - �e t San <br /> mhip fian_e 77 <br /> Di%tince from cges roadru]ruldfences ec acterSoPass ]:L' <br /> o -580 105 Ula- <br /> north Ir'rest sx e 105 - 114 Snael <br /> 11 1 an y ae <br /> (3) TYPE OF WORT{ � r ay <br /> Lew Well 1N Deepening Q 1 J <br /> Sha e-1 <br /> Reconstruction 0 155 – \T(6) C3a <br /> Reconditioning 0 "1 01_ – 1 92 Bok�'S;�-(1 <br /> Horizontal Well © 1 g r Ra--kDestruction E] (Describe <br /> destruction materials and <br /> procedures ,n Item 12), _ <br /> (4) PROPOSED USE _ <br /> Domestic _ <br /> Irngarion Q – <br /> Industnal <br /> Test Well (] _ <br /> Stock Q _ <br /> lfumcipif 0 _ <br /> WELL LOCATION SKETCH Other _ <br /> i) EQT IP%IENT (6) GRAVEL PACK )an 6 _ <br /> iota`~ lb IlererseQ Yes No Size t7I"' el <br />'able1 <br /> 0 Air Q Diameter of bore If <br />)ther Q Bucket C] Packed from_. 50 <br />') CASING INSTALLED r f8) PERFORATIONS _ <br /> tee] C1 Plasttc� Concrete 0 Type of perfoiahon or size of screen <br /> From To Dia Gage or' From.; r <br /> ft ft -in Wail ft\ to '`size i J <br /> 0 7 > 0 15 19-3-, s,c re e n <br /> a) WELL SEAL <br /> as surflce stintary seal provided" Yes [� No El If yes to depth--5-Ch_g _ <br /> ere strata sealed againsto11 t,on2 Yes D No EDEntervll- ; <br />'thod of sealin fe nt oni t e t - <br /> Work sttrted L e 19 Completed_ ^.19 <br /> pt WATER LEVELS of first water if know WELL DRILLERS STATEVfE\T <br /> � <br /> ft T'htr tell etas drilled under n, <br /> tnleve[ atter µe11 completion fl knowledge a belie/ Y Rursdieteon and this ret+nrt true to the hest of rn <br /> 1) WELL TESTS ft <br /> LS Well test m tde' �r SIGNED <br /> Yes � tin �-J� If yes by „h�nni <br />-+e of test pump1��N� ��� (1Ve11 Driller) <br /> ❑ II+,ler ❑ fir lift ❑ N AME r It 1 BIROS . DRILL G CO. , IIN C <br /> pth water et curt of test {t . <br /> At end nt test_. ft Person firm or,7co ration <br /> 11/min ifter_ hours Water temperature Addre,s ?� Pelandale Aveyped or punted) <br /> d inllysis made', Yes ❑ No (X If yes by whoma City Modesto Ca 9735 <br /> I LILc tnc lot; rn ides ❑ 7 Zip I <br /> Yes 14n If ces attach copy to thn report License No 9Q 1 10-24- 3 <br /> ate of this repo <br />/R ie& {Rev 7 7e, IF ADDITIONAL SPACE IS NEEDED USE NEXT CONSECUTIVELY NUM$ERECD FORM <br /> r <br />