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-07 t4 <br /> r GINAL 'PATER WELL DRILLERS REPORT Do Not Fsi! In <br /> ORI <br /> File nNAL Dupflcale and Triplicate with the I (Soct,Oai 7076'7°77.7078'Votef cede) N? 79361 <br />%REGIONALC<f <br /> ATER POLLUTION State Well NoSTATE OF CALIFORNIAO BOARD No.�— <br /> (1) OWNER: WELL LOG- <br /> Name <br /> 1 r� <br /> Name r g f Total depth 02 it Depth of completed well 2 it <br /> 5 { q Formarr <br /> .tsob D ,&by rotor,eboerter,"Z'Of"'serial,sud atrfcture <br /> Address r— <br />' , ret a _.._ <br /> 0 it to it 5011. <br /> ar- <br /> 3 56 Br <br /> 56 61TJ <br /> (z) LOCATION OF WELL- 61 0 Soft sand clay <br /> eo-nty SanToac Owner a number [!an>- <br /> 0 73 Coarsea <br /> R F D or Street No 73 1 C7 Brmm f-1 ay <br /> 0 y , <br /> 117 11Coarse brown 3and <br /> 119 -12�j Broun -1 ay <br /> (3) TYPE OF WORK (check)• 124 127 Silty packed sand <br /> 1 <br /> 'New-well ® Deepenmg ❑ Recondtt,ontng ❑ kbandon 12 r 1 3'0W2'] cls <br /> If aba+sdortmext,drscrrbc trtarr <br /> ttal and procedure on Item 1I 134 13 :yied.a.u.�n brow a <br /> nd <br /> (4) PROPOSED USE (check)- (5) EQUIPMENT• 135 137 - Brown clay <br /> Domestic Q Industrial E:1 Municipal F] able <br /> c 1 0 14,1 3 ue andy clay -- <br /> Cable ❑ <br /> Imgation ❑ Test Well ❑ Other ❑ Dug Well ❑ 141 1LL+ Coarse b e sand <br /> 14-IL 160 _ -Blue clay <br /> (6) CASING INSTALLED: If gravel packed 60 163 Hard blue. shale <br /> SINGLE DOUBLE i! Gage to 163 1 b'] y (j'1 ,r,, 6111a s'-:36 <br /> or llsatrtter E-em <br /> rOIIl Et ,e ft Dram 'Wall of Bore ft ft 162 <br /> y <br /> '172 28,9 <br /> 133 09 it i T qand and gJr' irel -"'-- <br /> 2 <br /> 227 _ 228 -1,riedilara s2nrl - - - <br /> 223 2-44 Flue a <br /> Type and a,ae of Am or well ring . d Sin of gra*r1 Well sand 2311- 2:11 _ Tec .� + a ---- <br /> Doerabe joint 3utt gelded 211 252 ' ue a <br /> 252 255 Fj o nPc:keci gand <br /> (7) PERFORATIONS. 255 225 <br /> Type of perforator used Factory clean-cut <br />' Size of perferatroer to length by ' m- 275 -,Bl p — <br /> FraTtl ft to i[ Perf per ram R.—per it 2D7 2Q4 <br /> L! 4 r 1r <br /> 11 14 n,edj.vlm sand <br /> 4 e c7lay <br /> 1r <br /> (8) CONSTRUCTION: Y 6 356 ne pa ked an <br /> '"rYea <br /> .L <br /> Was. ace aazury am p — i ea n .._ ro wt, d.A-1, €3 <br /> p, 0t fL .i ..r1 n_....-.. �.a _A .:.� <br /> rouse'r � u + <br /> Were any atrsts aealod against pollution? Yes No if yea note depth of meats361- � \\ <br /> Frain it to ft _379 83 ,zedi m coarse sanr� <br /> Method of Sealing ,cork atutad v Completed r� <br /> WELL DRILLER'S STATEMENT -r" OP." <br />' (9) WATER LEVELS: Thu well was drilled andrr my)uresdretron acid Ar,44v/rue to a. brsf of <br /> t,at whit,rater was first found 54.9 It my knowledge and Woof 0 <br /> [ fore perfontsos ft- NAME <br /> ~ - <br /> it {Pcram }firm or eormt1afr) rTYPrd or P""Jed) <br /> 'WX i. tet perfonung J 4' ^ <br /> Address So <br /> (10) WELL TESTS: ~, <br /> pia a Vuzzip ton msde? jo T. 11 No 1170,bf r,nm? Yom. <br /> Yields 570,q wnl/.ia wit, ft.drir dews altar3 Yea. I$ICNIE7P � ,�, r., Aru D.i � iY '>• +�+ y r�,�r <br /> Temperature*I watee. O ra a chM.Cal asalro,made? [3 Yea eg No License NIa �J3 y �LDated_ <br /> ti's'electric las=ode Of-iii:!? ❑Yes X Norj- _ ■rose a sr ser eusr b oro DWR 1Br3 (RS=Y. '3d1 <br />