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' OR1GINgf_ 3 <br /> fife 4rogin�'�nplrq�;l7and Trlpiltale wllb Iha <br /> DMIS10N OF %7b 4�RFsbujgs SHEET 2 <br /> P o 13OX 107,,9 , <br />' SACRAMt0o 6 CALIFORNIA, � + <br /> WATER WELL DRILLERS REPORT Do Not P ll In - <br /> 11State Well No fL <br /> �(,f4tions 7076,7077,7079,Water Coda) <br /> Other Well No <br /> ' , �'"a►.alt +; •i'`f��fl,��ti Region- -- -- s -- <br /> (7) Perforations <br /> Type of perforator used <br /> Perforated_ -12-8--ft to 34---ft Ho s <br /> _168 �. 010 of holes-2,2.per_rt, <br /> 11 79 <br /> (8) Water levels: + (9) Well pumping test: <br /> Depth at which water Date of test-..__-_—-.By whom—_ _ <br /> first encountered - _.______ T _ -1r Depth to water when test started <br /> Depth to water G P M at beguvung of test_ <br /> _ before perforating_ _-_-__ _ _^ft Driwdown from standing level__ {t <br /> Depth to water G P M. at completion of test__._ _ _ <br /> after perforating ___—,ft Drawdown at completion of test... __ —__ _ _fc <br /> N ote Zny change in water level while drilling Length of time tested- <br /> 4 <br /> Temperature of water---- <br /> Was <br /> ater_-Was gas present in water? [] Yes ❑ No <br /> (10) General <br /> Was well gravel packed? _ _Y Size of rock— _.. _ _-Thickness of p-ick.__.-_- <br /> Was a surface sanitary seal <br /> Were any strata sealed against pollution? ❑ Yes ❑ No If yes, attach detailed description <br /> Strata <br /> Was analysis made of water? ❑ Yes ❑ No If yes, attach copy <br /> Was electric log made of well? ❑ Yes ❑ No If yes,attach copy <br /> If well abandoned, was it plugged and sealed?---.- <br /> Method <br /> ealed?—_ ._Method of plugging and sealing _ <br /> (11) Location / (12) Time of work <br /> 7vorfb Section No_.__ ff_ ___ _ Work started date -Completed date 6/3_oj4i <br /> in the Cot U Y 01 Township-1-1___ -_ Date of this report,_ /2_V_5.1_ <br /> $t0 ]it0 Range—i-6-1-- <br /> Base <br /> ange, i_-Base&Meridian-K 1)-- -___ WELL }DRILLER'S STATEMENT. <br /> Show location of well in Sec- This iveTT was drilled tinder tiny jurisdiction and this <br /> tion,thus (X) re-port is true to the hest of ney knowledge and belief <br /> d Distances tAtWanebes from [ e1 <br /> p well, 3Q or S_—�_ft SIGNET) "eels <br /> a. <br /> _ and ll or ti _100 ft r/•`'^1 w.rr,Qrihr, -- - <br /> �� � Show location of nearest By Ste+/--ir_ /fir/�/ <br /> known well, thus (0) License No 7b64z _cl-Issificatia SC 57 <br /> 1 MILE Distance to nearest known `��� 1_l <br /> well _ _ ft Dated_ _ ! I'9 / <br /> ;1 • /(s ,�r <br /> J <br /> 0 w R FOAM No 246 REGIONAL WATER POLLUTION CONTROL BOARD COpy 25971 3 10•OK _V,N tiro <br />