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SU0003307
Environmental Health - Public
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SU0003307
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Entry Properties
Last modified
6/16/2020 12:07:10 PM
Creation date
6/16/2020 11:47:02 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0003307
PE
2633
FACILITY_NAME
SA-89-23
STREET_NUMBER
2851
STREET_NAME
BOZZANO
ENTERED_DATE
11/7/2001 12:00:00 AM
SITE_LOCATION
2851 BOZZANO
P_DISTRICT
000
QC Status
Approved
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SJGOV\gmartinez
Tags
EHD - Public
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• JON <br /> ti A.7PL14rM,T�fi ':1� •�- •�•I:•�•c-�( •�•. �j� i-::Jr tiTATE OF GALIfORN1A:� .' !tk - •DO f10��in" <br /> OW1Fe.'fCOpy/ .r;: THE RESOURCES AGENCYftitti '^ <br /> };k:k :� . �! • ;<.:J?� DEPARTMENT OF.WATER RESOURCES. �,, y��ri r•;No 173122 <br />�rrwice of Intent No WATER WELL.DRILLERS REPORT..,' - <br /> wen No <br /> Permit No.or Date - 'r .Other Well No <br /> I) OWNER: . Nam UalIt Assured Parkin P18(lt (12).WELL:..LOG:!':T«.,depeh445 k_ Depth of compktedweml 9 5 jL <br /> Lkdd from ft 1 to i h. Formatloo (Describe by Dolor, characteq size or material) <br /> amity Stockton. CA tip _ 5 : Cla - ' <br />:2) LOCATION OF WELL .(Ste instructions):.' "' '"�� "is <br /> Dungy S A n J n A g L l n owner.Well Number _ <br /> 45 Clay <br /> Well address U different from a 4S - <br /> rownahlp Range Sectlo <br /> 51 -90 Clay <br /> r. <br /> 3(stance from cities,roads,railroads,fences, gn - <br /> (3) TYPE OF WORK: <br /> . New Well x) Deepening ❑ 1 rl .%v ' <br /> Reconstruction .❑ <br /> • .. - Reconditioning -.:y❑ - - . <br /> liorizontal Well ❑ n- <br /> . Destruction ❑ (Describe \N��_nrn mat 40 <br /> 92 fj7& <br /> procedures is Item 1R - <br /> (4) PROPOSED\ — <br /> .. Domestic - <br /> Irrigation ❑ <br /> . Industrial O X] - <br /> T Well ❑ <br /> ' Stoc - <br /> 322 �d <br /> • Munfclp _� . <br /> WELL LOCATION SKETCH Other ❑ iz n- <br /> S) EQUIPMENTt (8) GRA V ACK. - <br />.otary Q • Reverse ❑ Noti ,iu - <br /> ible C],' <br /> . Air ❑ 1ei�i er of bore <br /> v <br /> ther ❑ Bucket ❑ t70 <br /> - <br /> 372 San� <br /> rl) CASING INSTALLEDt (8) ERFORA'110r1$t r• -2 8-1 Clay <br /> cel Plastic ❑ Co a Type of pc or a of scrcene� -jag Sand <br /> From To Dig. Ga e r F To389 418 Gla <br /> ft f �in. Wall ft ft � s' A I A425 SAna <br /> — <br /> gal; <br /> -434 G <br /> \, - <br /> A32 Fine Sand <br /> 438-445 Clay <br /> 10) WELL SEAL: _ <br /> as surface sanitary seal provided? Yes D No ❑ If yes, to depth 5�,- - <br /> ere strata sealed against pollution? Y11es ❑ No ❑ Interval h_ - <br /> �thod of sea • Work start 19r Completed-19- <br />-0) <br /> ompleted 19-0) WATER LEVELS: WELL DRI R'S TATEMENT: <br />-.pth of fist water, if known - k This well was drilled under wry furisdia" and this report 4 true to th fest of m, <br /> rndLtg level after well compk-do knowledge n{f btliet ` <br /> 1) WELL TESTS: SIGNED \ I <br /> s well test made? Yes ❑ No If yes, by wbomt : 7. (Well Driller) <br />__�e of test Pump 0 34Likr ❑ Air lift Q NAM� U C V til T'Ing O D fl C <br /> mpth to water at start of test k. At end of test k y or Y a sm,or o don printed <br /> 7 <br /> v.; " Ad 1917r, DP AVF <br /> chargtt_ gal/tale after hours Water tempera 7 <br /> al analysis made? Yes ❑ No (X If yes, by when? City } p TC7�C5 6 <br /> electr(a madet Yes No If attach to this n K Lioerm NoiUu 140 ata of WV h <br /> Mrlt lea (Rgv,7.741 .. ' IF ADDITIONAL SPACE IS NEEDED, USENEXT CONSECUTIVELY NUMBE�.ED FORM-`) <br />
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