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a. ORIGINAL STATE OF CALIFORNIA SHEET 1 �a 5 <br /> �'!'Orly,.el,"Duclicatr and Triplicate with the DEPARTMENT OF PUBLIC WORKS <br /> P o BOX <br /> ,079 1f1or+ REsoaltcEs DIVISION OF WATER RESOURCES <br /> o�g <br /> SACRAMENTO S CALIFORNIA <br /> Do Not Fall In <br /> WATER WELL DRILLERS REPORT State Well No-P►m4-==' =1 _ <br /> Other Well No ______ <br /> (Sectwas 7076,7077,7078,Water Cade) Region-----------________ _--------------- <br /> (I) <br /> _____(I) Duller: (2) Proposed use or uses (check): (3) Equipment used <br /> Name__1j0ffU=_Well lri33AU9__S4.,t__l+tc, Domestic Municipal ❑ (check) <br /> Address _522_T..._SanLta Irrigation ❑ Industrial ❑ Rotary ❑ <br /> _------Sr--fit- ___ ________________--_ Domestic and Test well ❑ Cable [ <br /> License No — �_—___.—Chssification_______L'_ '�—_—_ Irrigation ❑ Dug well ❑ <br /> Other-------------- ------------ --- Other--------------- <br /> Owner: <br /> Name Traay._3SenJaw M emeatax7__ lchoa---- -- (4) Type of work (check) <br /> Address____' mfr__ `'40 J f._— _______—_______ _______—_—__ New well Z] Reconditioning of well ❑ <br /> ----- ------------------------------ -------------------- Deepening existing well ❑ <br /> (5) Well log: <br /> Total depth of well____— _ _ ft Give details of formations penetrated, such as salt, peat, muck, sand, gravel, clay, shale, sand- <br /> stone,hardpan, rock Include size of gravel (diameter) and sand (fine, medium, coarse), color <br /> Depth From Ground Surface of material,structure (loose, packed,cemented, soft, hard, brittle) <br /> -----------Q----_ft to ---12-------f t Trard StAcki D017 �. <br /> •- f, n ,r v <br /> 41j a �S1 Q6--,r n-------{ifF------- <br /> rr Sand <br /> ay <br /> v r <br /> large Nater, Bou'lelers & Sand <br /> LL ,r » ' <br /> a, » n <br /> It <br /> " Gr av9t <br /> - -" Sam & araval _ <br /> _A - --" �e11 aw sty r r M OY <br /> -------19?- " ,. --2%--------" SQ TIA & t'rny"i , <br /> ------204-----,. ,. - __2J33-------" SltickY &rd Gras MAY -- <br /> - 283L-----.. I. <br /> ---- " R't»w t'1 uy <br /> Sand <br /> - ., „ <br /> -- ----- <br /> ------- <br /> -----------44L ., <br /> A11,101 Rimi Sand <br /> 41fx -- -----428 - ., <br /> 428 -A43-5-- -„ <br /> 1. „ 1� „ <br /> If additional space is required, continue on DWR Form No 246—Supplement, and attach to respective report copies <br /> (6) Casing left :n well <br /> LENGTH DIAMETER SINGLE DOUBLE WELDED LBS PER FOOT OR SEATING BOLOW <br /> FT INCHES OTHER GAGE OF CASING GROUND SURFACE FT <br /> ai ---- ----------1b - - -DQnhln 22-- - --- - 92 <br /> - -- __----- --- ---------- --- - ----------- <br /> -------- - _ ---I3nnhle 12 403- <br /> ---- -- ----- -- - - ------------ -- - ------ - <br /> --=------- <br /> Type and size of shoe or well ring- -__ Welded joints---o Yes [Z No <br />