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MAY 1 l 995 <br /> LRIGI14AL WATER WELL DRILLERS REPORT Do Not Fill hs <br /> Filo with DWR (Sections 7079,700,7081,7092,Water Code) No 4 4 S 9 4 <br /> THE RESOURCES AGENCY OF CALIFORNIA <br /> DEPARTMENT OF WATER RESOURCES ate'Well Na„ TI6 <br /> WO 7-39 5/11/E7 r other Well No 164 <br /> l) OWNER (11) WELL <br /> 1 LOG' <br /> ame %oo abr?r--c _ Y zonmc Lodge Total depth 115 it Depth of completed wd! 110 it <br /> ddress n� �+ Formation Drserrbe b)color character nae of mrlerut amd strartsrrr <br /> Surface it to 0 5 it <br /> 2} LOCATION OF WELL: Br cla-y 5 <br /> count, J vin owner.number .fan, -Hard trittle gray elan* 11 13 <br /> owalbi Rang snd Section T Z 1,TR 6 Sec 3 grA�,, -IL;- la <br /> 16 <br /> 11hastance from cities road[ rcilroads etc +r s <br /> x -~ 1s 33 <br /> WTYPE} OF WORK (check): ” <br /> Well M Deepening ❑ Reconditioning [3 Destroying ❑ r 3 36 <br /> describe maferral and procedure on item 11 clay 36 48 <br /> E <br /> 6r, <br /> PROPOSED USE (check): (S) EQUIPMENT: 5 <br /> mesuc ® Industnal C] Mutumpal ❑ Rotary I] <br /> gatfon ❑ Test Weil ❑ Other ❑ Cable ❑ r — E <br /> Other ❑ 79 79 <br />�6) CASING INSTALLED: -- O;ft grpy C1 ny 79 B3 <br /> STEEL OTHER I£ gravel packed nnimqe -- rand 83 155 <br /> SINGLE ❑ DOUBLE ❑ / r r Soft -.re cl e 5 98 <br /> Course sand 92 98 <br />' Gage DiameterQ$ 101 <br /> From To or of From To Very soft grey cls <br /> It ft Drsm "ail Bore ft ft Course l i c r_- s and 101 108 <br /> 78 6t 12 Br:.tmle fl_ e = cl mar 13E 112 <br /> 112 135 <br /> Sass of*loos or well ring Stu of*ravel <br /> nbtat <br /> 7) PERFORATIONS OR SCREEN: <br /> T of ptrforsuoa of aging of[crew <br />' Perf Rows <br /> From To per per Size <br /> it ft row ft in z in <br /> CONSTRUCTION: <br /> k2a <br /> madam unitary seal provided? Yea M No ❑ To what depth 30 ft <br /> Were tit atrats arsled ' F <br /> sgotmt pollution? Yea❑ No if ccs nom depth of mann -% t � - 71 +SP 5 <br /> roes ft to ft <br /> Tom it to ft Work started 19 67 ,Com letad 541 2 19 6 <br /> Mnlood of 9"ling WELL DRILLER'S STATEMENT <br /> (9) WATER LEVELS' <br /> This well was drilled under sty Iurtsdtcttoe and ibis report is true to the best <br /> of my knoudedae and belted <br /> at which wsur was trot found .f known ft <br /> ' <br /> 5[aad+a incl before pertorcue SLn j0&elir, P•�^-�1T1 Co If kerowa ft NAME ---r <br /> --Sta&dlnx level after perforalLfir and dgre! as 19 it (Person,firm or corporation) (Ty}ed or jrhrted) <br /> WELL TESTS: Addrea 500 ettlerla n Ln <br /> test made? Yes ❑ No It yes by whom} � <br /> gal fmsn with ft drawdewo after Kra SIGNED -r <br /> rm ratore of-our Was a ehematal■naF tit mads? Yes ❑ No 0 #(WWI Drimer)/� <br /> a**[cetera Ieg mads of Vol l? Yea ❑ No ld If 7n attack copy Leense No 172051 nit.a 5/1 5/C7 _ 19 <br /> SKETCH LOCATION OF WELL ON REVERSE SIDE <br /> 10WR tea aRry s es, ssul_aso Io as sow Tletr Q�oar <br />