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<br /> _STATE OF CALIFORNIA y
<br /> f ? a•�., s• t'�,r f{Y"{ �•r ,'' •1.�'1 [t�.''.iri l,I C"S Ytl%�(,+ (,.Ta :r-
<br /> ?.THE RESOURCES AGENCY _.:�
<br /> .!..iQIPLiCATH�f't•�'y`1F'e'tj v:�,t ..:. , _ , 7 0 � �4 �5119 9 -
<br /> �r,�yifliJ t�F,i ��< cf^�"�t' ,'DE ARTMENT.OF WATER' RESOURC ;• '�,. IN0
<br /> f , /, S a tt•t,� g 1' Iw+,. r.-.•, ` r' • _ {..: r''
<br /> Petain Ih1d to f�, ��,��,,,a :gipny ;f �3 r�7�.,J.�;i: a i iw' f•, /t'. •:. F�? S Y fs LrYF•;'a
<br /> pY `lt,f)?[ t/LW ATER•�;WELL DRILLERS 'REPORT y•r`. a" 8cate v7d1 Nq.-;v .✓ �:,,ft�: ,r�
<br /> 1;1 tlr''Yrtt�'" ?r >S
<br /> } .(, c , ,A ryl/,r Jt�,.f i! Irv'.• d .li•' .� -...,r...+. .,,1: P, f�5 {.I•• "r' - •i;,' 1 1' ?
<br /> a�i +4 :1! h'0h r i''�c + „t,.,.:•; -"I' ;t:'•-i, j'' Other Well No. �:"'
<br /> •r,,\'{f •q.` .;.•.!a+r' ,r:�rYYat:![rr' $'y"•.1LM. r4,'i+,tt `'•��l r' y•, 1. :f:l'F„ �, ,k.y.. . 1• L. ri '�I'.I ,
<br /> t:a'd "tet�t�'a ,�Y tisk �! } 1J p'fix R y
<br /> (I)
<br /> OWNER- ::,.�:'r�%'� "r';' 1r ,�' �,i t `; (11) •WELL" LOGt f r+ Jl Ya.i t
<br /> ;y'!.. 1. ,.r ,at-•T , r -1',•.,. .f ;/...
<br /> Namc`i'y 1 Simpson-Lee ,F'aper'rCo. ..`„1 L. .:.....__.,_ ,_;..2$
<br /> ,' 'f 1
<br /> Total depth It.•r Depth of completed-wdl ,fe. '
<br />��'Address 11' O� ti`•i P=?'-'- r%�l i i•" ''r i'"f''r'•'•' * Formations Describe b rotor,ebtntftr,Else a nrtfertel,and aNnr[rre
<br /> r / Vii ;
<br /> L
<br /> 1FOI�� Q �. • '!-t'•'•lt".'?i'}j.' R•J: • :.:,, ,;. .ens::{;vg�;:,.•#: 'j�4v+l}r. (t.to 'D:•• I .✓ ,r.aa[t.'...
<br /> 1
<br /> (2) LOCATION OF 1Y'ELL�.;; ' ryry• 9 ►. f• r I
<br /> SalaJoa iiin � r t:.5�,,, .f::-♦G;Y: :� . ,.•:,: - �:•. r san y .:c y
<br /> County' 9 Owner's number rf an -� ;
<br /> ;,Township;Range,ind Section •'M'
<br /> CII • %e'as Q IPi !:F7©u
<br />' r w:-:z>r town-c a
<br /> Divance from cities,rods,tailrotds,`eta en o .t• O C Un[ V�."— y
<br /> ml. ,.8ou 'i7 •'.pr V8 e-, Y' yeway.;1.f1. K:,i.!: :;,'.,yt. — -h::c'►.'.. ar •88n y.•:r; <,a`�.t. :�.r7•,
<br /> (3) :TYPE .OF WORK check):'.tC:" ,Y alj,»?,"y', f` �f +`�, + ;
<br /> n,, 1, .•', rtie ,. ,.•• t>n •,y
<br /> 'New Well [x A Deepening ❑ Recondtuoning ❑ �1�Desetoyang ❑ t
<br /> 'if destruction;describe material and procedure in Item 11. ' '- �• 'f "(''~ �I' t.'e '': n O 6:r f :
<br />,{,• .�\. ♦... r.Y V,;f'.::•r':' r� � ',{•rf.C',','Zl C y.t�tl'/ ,t': ',r'f•1:[ a r
<br /> ;:(4) PROPOSED,:USE (check): ; , (S)%EQUIPMENT: -
<br /> i" ). t — :" ,— r .4"-r. n '•fro 8 e j i
<br />.—Domestic ❑ Industrial 7�nlci pal ❑ =,`Rotarysa ;t' 'r"Irrigation'❑ Test Well 'Other ❑ Cable )t tsr "�•❑ !05 ar!4' C ,T r•tY 1•`;�y'¢.':pa'-...,- Others '� ;,Ys l,` ❑ ,:,1 .•w r ..t!n coarse V •.rrt.l Zi.�. ,! L. it
<br /> 1 (6) 'CASING INSTALLED 'a► .'•.1 e r 8 r
<br /> fl (
<br /> I :y�{ 1•r i.r.,•�, h j2 fry AK SJ If gravel packed!".,,, .:Zq. .coarse S t T.+�c�•.e alae J. �.-
<br /> 1 < STEEL: '', J OTHER , .� -160
<br /> y{}
<br /> �.ri ttr.�J.S,t'1'�i )• 1 y �''J r ::''J_I:.OMAN Clis
<br /> SINGLE •DOUBLE ❑ ... . !] n
<br /> !i:r71 M;�.y it l'r•Jr ! '• e ✓ 9-.160-179 .T.s -.,.sand G syr.
<br /> Ir ( •'Gage ;Diameter l s d. 1'r i; , "•. a-stir i t a ;L'.1•':.c rty,t
<br /> -�d a.,
<br /> 1-r �1+1,': i" •.. /` ♦ t, r ,a 4. it
<br /> From I o '� ! or ' j'of From "n To `
<br /> 3 �• it.
<br /> `ft
<br /> •.rRT OU
<br /> •50 ,,, n -. It.. �: _ �P1tV —1 u::.san s..•.r,.^"„Vr' ;. . :A La' ;
<br /> a3l .! I 1r, "t,' aw. f'.'Vo `•t :'f..r:. 't.'''•5.:c:.�r-
<br /> j:/ r. •,. •-u•,.t.;,, t. Cl° t '� ;.l:i 'a!_.;:. ,, e'J aa;_ i° '%,••Fr sand .-.7,
<br /> .'Sae of shoe or well ung: '' '�M' •Sire of Rnrelt''u C:x r ►�p+ a .. F :4
<br /> —'23.0 '•w'44.san - €; c ay77
<br /> 8 P
<br /> c ay g c.t7
<br />{. :�: . r•rr're ->,, tl�Cj';•e, l"• F-j•7;. ,• rr J .Y�s,+..��'• r , . ?gaan . s T s
<br /> Dertribe.joint r r C Y
<br /> (7) PERFORATIONS OR SCREEN 1`",� hSfti W C a g r B
<br /> t p,I.w1Jt�. ••1�� a- 7•d.Ntt)'r{I ^j,t+.!t rl,t'',i t.�i�:27 r r,'•1:'e:ball a �t;, )..r i :f�'•1,.•}
<br /> Type of perforation or name of screen` 1i '
<br /> Xti.✓�,1;' ^, a,..a 7 , ,• xaa:+•art ,.t,l. c' y .3 t���R'ttta:.��°'::.I j.
<br /> t r n' •, r a;r t "t u .Perf s}1 Rows " rz t y ,
<br /> t, .A t 3A1 -t r r �: `L. k” r• ♦ f } i.� i 7 a,�`:-M'�"�rtia 'y-,�, ,}
<br /> t ar �:rw IL' , ,.a SIle• '1I' ! i, i..- r Ni. !•.;y r t _ i"1'.
<br /> per +e i ,per ort'
<br /> ,e Frons,-,s- ,r To ,�S j.'� a�, �r.�,.� �,1•;:2� .:�t",1��y, t..�•- °.I •';. ^� 1 s'�Jrt�.{ i!
<br /> 1 ft. ft. row - '.ft. tn.`xin: .,.
<br /> �y5 •f'.,N:Y:r •�,'�. v r _ -} ._ _ -•�� '('•I:'"sats-i!y.'j,,.,,•,t , .S
<br /> 0 - r ; .� ,tib ,.,.•n .1+•ti,;',l,,.l ��, • er era ons con
<br /> i `Z�5 .. ..1 rj t. :C ,',' , ,=`•n .•.(..-',, ,r,..' r 4.
<br /> 465 - slot
<br /> 220
<br /> _45 55 .a -
<br /> lb 70
<br /> (3) CONSTRUCTION:
<br /> �.
<br /> Was s surface unitary teal provided? Yo [.�. No ❑ ''To•what depth' 50 ft. -
<br /> _ — !
<br /> Wert my strsts sealed against pollution? Yes❑ No If yea,note depth of strata
<br /> From it.to
<br /> 74
<br /> From - [t.co lt. - a''� •..f Work started — .it ,Completed .19
<br /> WELL DRILLER'S STATEMENT-
<br /> Method
<br /> of staling - - ,a 1 �• is,
<br /> • " : '"This well was drilled under my jurisdiction and this report is true to the bat
<br /> '(9) WATER LEVELS: ' .t -
<br /> <s ti ;`{},. r f w s p f my knowledge and btlief..z:; .tt.
<br /> Depth at which water was first found, if known ft. 1..
<br /> t : �iovr�: Well
<br /> *`.Equip. 'Co. -Inc, f
<br /> Standing level before perforating, if known it. r NAME
<br /> + (Person,firm,or corporation) (ry►td or)rin/rd)
<br /> 'Standinglevel after perforating and developing " '' ft. i +;�- i♦tt tC it ,:"i
<br /> '(l0) -WELL;TESTS: " `( •` ret,.^r�t I'., +n'• Address'1$25 Yosemite Blvd.
<br /> •'t S, , r n rt tri /t••�� Q
<br /> F�aayv , t, 'i } •�'t t •ti-t,CteO,t l)fat 13 t.V es Q, •
<br /> Wn Pumptnc made?' Yea l.lf>` 'No•❑ If yrs,by whom} _
<br /> Yield: sial./min.with ft,drawdown tfur '.•.• y hry. [S1GNE01 °.' t`• - 1
<br /> r : :..-.' Driller
<br /> Temperature of water '" '" Wat ehemieil analysis made} Yes ❑ No ❑ .�'3�`,•t 's'�1� . "^ ^
<br /> S4 /1 4'
<br /> s
<br /> W n dtctric log made of well? Yea ❑ ` No ❑' t' "if Ye 1,attach COPY ' License No. Dated
<br /> SKETCH LOCATION OF WELL ON REVERSE SIDE
<br /> r)WR 18R tare. 9_a8, rs,nnao a-aa so,♦Ten AD oer
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