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STATE OF CALIFORNIA Do not;fiU sit <br /> IGINAL THE RESOURCES AGENCY <br /> DWR DEPARTMENT OF WATER RESOURCES NO. 129428 <br /> N 160902 WATER WELL DRILLERS REPORT state Welt No p2No7E3t D501 <br />�a o Intent o _ 0 <br />�'` enrol[No or Date W M Other Well No <br /> OWNER- Name ' � i ob' le orne k (12) WELL LOG Total depth-1-9-0--ft Depth of completed we1L190 ft <br /> 3907 E. Erem- ont from ft to ft Formation (Describe by color character sue or matenal) <br /> s Stockton Cal2.f .. ,p 9520 0- o e <br /> Q 3 ay <br /> ri SanTI�o�QLFt1 WELL <br /> (See 32- Sand <br /> Owners Well Number 3 a �rS+ <br /> 3 ay am s an Y <br /> address if different from abase San \\ <br />«nsbip Rang Sectio { <br /> agile as ress - <br /> nce from cities To railroads fences, etc <br /> 800' No. of road <br /> (3) TYPE OF WORK <br /> l� New Well iDeepening ❑ - <br /> �7 Reconstruction on ❑ I-T <br /> + �l L Reconditioning ❑ <br /> Horizontal Well Q n <br /> Destruction ❑ (Describe <br /> destruction materials <br /> procedures in Item <br /> (4) PROPOSED y <br /> Domestic \ ` <br /> Irrigation�� ❑ ``` V v�1 v <br /> Industrial <br /> Test Well �� Q \\A\_proper,w ell. cover was installed <br /> �3�jo �•��n� SX <br /> \ `ten js, and, am no <br /> \\ esgo sIe for any artering or <br /> /> Municipal' ❑ <br /> Q or casIng. <br /> WELL LOCATION SKETCH Other <br /> 5) EQUIPMENT (6) GRAVEL PACK <br /> OW <br /> an Reverse ❑ Yes [ N.)0 Size e - <br /> le ❑ Air ❑ Diameter of bore _ <br />)tht r Q Bucket ❑ Packed from <br /> CaS11G I\STALLED (8) PERclwlffut <br /> ❑ 1']lan, 1)[ CfinCTCtG ❑ TNpc cif perforation nr size of screen = <br /> 1 null lo Dia Cage of Froin To Slot <br /> it ft )n Wall ft ft sze - <br /> 0 1,00 0 T , 150 90 3 <br />� «ELL SE 4L <br /> , ,uriicc %irotIM se-1 pnoideda les 'X No ❑ if )es to depth ft <br /> N1 ere ctrita sealed 'igainst pollutionP les ❑ No 9 Interval ft�jr <br /> thud of sealin Work start 1 Complet 19 <br /> 0) WATER LEVELS WELL DRILLER'S STA'TEME'NT <br /> th of first water if knot• ft Thu welt w ed rt <br /> sdiction nd i repo is a to the best of my <br /> Standing Iecet after Nell completzo EL knowledge nd <br /> s <br />�1) WELL TESTS SIGNED <br /> 11 test made' Yes © No If yes b ( Driller) <br /> of test Pump ❑ Bay wham? <br /> Bader I❑ Air htt ❑ NAME Panera Well Drillin -dnc . <br /> water at start of test_�L , At end of test ft (Person,'firm or corporation) (Typed r printed) <br /> cal r hours;g' yZ" Water tempera Address T 1 <br /> -A- tet° s ; Oakdale Calif: —Zip 61 <br /> 'f City <br /> analysis made? Yea ❑ No C3,If 1-. by whom? 114-t, -- i'rlZ f ��1 78 <br /> e c log made? yes`❑ '` No ❑ If Ses,'trach copy to thss report License No aid pfitliia report <br /> pWR s88'(aEv 7 let "' !F ADDI"FIpNAL SPACE IS NEEDED. USE NEXT CONSEGUTIVEtY L BEFZ1= <br />