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� ® <br /> p STATE OF CALIFORNIA <br /> ORIGINAL THE RESOURCES AGENCY Do not fill m <br /> %otice <br /> ie with DWR DEPARTMENT OF WATE=R RESOURCES <br /> WATER WELL DRILLERS REPORT No. 325308 <br /> of Intent No State Well Na <br /> Local Perrntt Na or Date- -89-2679 Other Well No <br /> (1) OWNER Name Frances Francisco (12) WELL LOC Total depth 200 ft Completed depth.1Z-51—ft <br /> Address from ft to ft Formation(Describe by color character size or materiel) <br /> City zip <br /> (2) LOCATION OF WELL(See instructions) 4 ` 60 Clay <br /> County San Joaquin Owners Well Number 60 - <br /> 65 FTn� Sand <br /> Well address IF differ nt Froin above 6 — 75 Clay <br /> Township Range `' Section '� — 79 Ein� Sand <br /> Distance from cities,roads,railroads,fences,etc r k W e c t Z — <br /> of TrA.ry 0 — 110 Fine Sand\\ <br /> 110 — 115 CI <br /> 5 — 123 n <br /> (3) TYPE OF WORK 123 — 200 G,1 8 <br /> New Well 1a Deepening ❑ — <br /> Reconstruction ❑ <br /> Reconditioning U <br /> Horizontal Well ❑ — <br /> Destruction fI (Describe — <br /> destruction materials and pro- <br /> eedures 1n Item 12) <br /> (4) PROPOSED us <br /> Domestic — <br /> Irrigation — <br /> Industrial ❑ <br /> Test Well O ❑ <br /> Munro © ,_ 0 <br /> WELL LOCATION SKCPGIt < Tpeiglbe) — <br /> (S) EQUIPMENT �GRAV CK S <br /> RoUry 00 Reverse © No e i <br /> Cable © Air ❑ C Qi cte f bore <br /> Other ❑ Bucks \end ram <br /> (7)CASING INSTALLED (8) PER ORA`TI _ <br /> Steel ❑ Plastle n et T of fo t vn or size of O <br /> From T Dt Gage or T t <br /> ft ft t Wall t size <br /> (9) WELL SEAL <br /> Was surface sanitary seatpmvided? Yes Q(1 No© Ifyes,todepth ${) ft- <br /> Were <br /> tWere strata sealed against pollution? Yes ❑ No ❑ Interval fL <br /> Methodofsm1ing BENTONITE Work startedWrit!- I t9 <br /> -8a CoiTtpleted 1eJ—.— <br /> (10) WATER LEVELS WELL DRILLER'S STATEMENT <br /> Depth of first water If known ft <br /> Standin level after wellcom lesson 1 Q ft This well was drilled under rn'/jurisdiction and this report is true to the <br /> 8 p Iiesl of yy knowle a and edte3 A <br /> (11) WELL TESTS Signed-ma ` - j <br /> Was writ test made? Yes❑ No)a( I F yes,by whom? (Weil Driller) <br /> 0 ype et test Pump 0 Bailer ❑ Airlift ❑ NAME H E N N I N G S BR 0 S . DRILL I NG C0__, I NC - <br /> Depth towater atstart oftest it At end of test it (Person firm orcorperatien)(Typedorprmtad) <br /> Discharge gal/min after hours Water temperature Address <br /> Chemicni analysis made? Yes 0 No)M if yes,by wham? City x'10 D E S T 4, f A zip-9-5-3.5-6— <br /> Was eleclno log made Yts 0 No i f yes,attach copy to this report License No 2 4 fl R 1 3 ._.D rte of this report AO V 9 <br /> AWR 188 IRRV 12 eni IP ADDITIONAL SPACE 1S NEEOED USE NEXT CONSECUTIVELY NUMIBERED FORM sa7s3 <br />