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Division of Resources Planning <br /> Water Well Construction and Sanitar Sure <br /> • k ;I2 4) <br /> State No. 25 J 5E 21 M.D. County AN <br /> Investigation S• J. CO. WELL 57D5. G.W. Basin an Joaquin Valley "Zoo. <br /> Region U.S.G.S. Quad Scale <br /> 0-�mer Cit of TracZ Address City' Hall <br /> Location <br /> Use Municipal Depth 880 Diameter Method of RotaryGravel <br /> const. - - Packed <br /> 1. Distance from contamination none Log Source <br /> Source <br /> 2. Drainage toward casing Log no Source <br /> away <br /> subject to flooding Casing type <br /> well pit Casing seat <br /> 3. Type of platform wood Casing depth <br /> concrete <br /> metal Type joint <br /> pump mounted on casing <br /> not on casing Annular seals Depth _..� <br /> 4. Height of casing ? Conductor pipe Depth <br /> above ground surface <br /> Casing Reduction <br /> S. Seal between casing <br /> and platform Yes Perforations type <br /> b. Seal between pump base Yes remarks <br /> and platform <br /> 7. Seal between casing <br /> and down pipe <br /> (pump off-set) ` <br /> Nhneral Analysis <br /> 8& Well vent IIO if so Date <br /> screened <br /> 9. Measuring hole Yes <br /> if so, capped yes Bacterial Analysis <br /> Date <br /> 10- Evidence of oil leaking <br /> into dell no <br /> 11. Can bacterial sample be <br /> taken at well Yes <br /> 12. Sample Point Tap at well <br /> Remarks <br />