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r <br /> STATE OF CALIFORNIA Do Not Fill In <br /> ORIGINAL THE RESOURCES AGENCY N� <br /> Filew1th oWQ DEPARTMENT OF WATER RESOURCES <br /> 146807 <br /> Well AT <br /> i -7 s <br /> - Co "FIDii�lTIAL LOG WATER WELL DRILLERS REPORT State o � =�ty�- <br /> "" - <br /> water Code Sec. 13752 OtherwellNo-75-999 W_- <br /> (1) OWNER (11) WELL LOG- <br /> Name Martin Totsl depth ft Depth of completed weli 144 it <br /> AddressT:CqCY—B Formation Describe by color character r1zc of me#rrel end succi err <br /> 0-4 it to Top soil it <br /> (2) LOCATION OF WELL Clay ` <br /> County , San jnaQ1jjnOwner r number it my 0 Sand—f e <br /> Townsk.p RanSt end Sraeon 20-24 Clay <br /> DiftaAee front el-et toad. railroads etc I 1 Sand <br /> 12 0 Clay_ <br /> (3) TYPE OF WORK (check). 2and <br /> clay- <br /> It <br /> New Well R Deepening 0 Reconditioning 0 Desttoytng Q <br /> drsirrietsois,describe material and procedure in Item 11 1 51 -161Sand <br /> (4) PROPOSED USE (check) (5) EQUIPMENT161 -168 Clay <br /> - <br /> Domestic ® Industrial ❑ Municipal ❑ Rotary ® C <br /> Irrigation ❑ Test Well ❑ Other ❑ Cable ❑ 169-1-72, Clay <br /> Other ❑ 173-18;> Eand-sot lip <br /> (6) CASING INSTALLED <br /> STEEL OTHER If gravel packed <br /> SINGLE Q DOUBLE[] ZLaSt C <br /> Gage Diameter <br /> Frain t o or of From To <br /> ft ft Dram wall Bore ft ft <br /> bow 11 100 144 ` <br /> Sue of shin,-e well ring Sue of erarde <br /> De.enli,w of glued <br /> (7) PERFORATIONS OR SCREEN- <br /> T pt'of tri-iii. ar name of screen hand cut <br /> Perf Rows <br /> Front TO per per Size <br /> ft fir tow ft to r in <br /> 126 141+ <br /> (8) CONSTRUCTION- <br /> War asurface sanuuy re:I prorsded) Yes No Ll To what depth 50it <br /> Were any stents sealed ag.rist po410etn0 Yes❑ No❑ If Ye, noes depth of strata <br /> Fro ft to (t <br /> From it to Ir Work started 7-28 19 75 Corn Ieted 19 <br /> Method of snitax Bentonite WELL DRILLER'S STATEMENT <br /> (9) WATER LEVELS This well was driller!under my jurisdiction and this irport is trot to the best <br /> DI my knowledge and belief <br /> De th as wkech water ars first found if known it <br /> �isandtatt level Worc�perforatinl of known ft NAME Rennin S Bros Drilling <br /> �nnding terel -fresIPrrfoc-m and derelop-ng ft (Pmon firm or corporation) (Typed or printed) <br /> (10) WELL TESTS Address 2500 W. R e Rd <br /> L=! test made3 Yes❑ 110 if es by whom? IQde tC <br /> i <br /> 1 Fal/men with fr drawdown rfier her [SIGNED) Q <br /> empentun of water Was a chemical emlyn {Writ Driller}s made) Yes ❑ No Q <br /> Was eleeuie tog exude of.sell? Yes ❑ No If Yes atueir copy License No 2901913 - Dated ,—. 8-219 , 1�-�— <br /> SKETCH LOCATION OF WELL ON REVERSE SLOE <br /> ❑WR 180 SREV 9 66) ee 72303 --Rte Or osp <br />