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' 0121GINA; 1� (fit•} <br /> File 1)nginaplltta:d and Trlplkate wiib the XU ]V` <br /> MVISION OF WAW;RESOUNES SHEFT 2 -t- '- <br /> P O Box rola. <br /> SACRAAI'£Nto S CALIFORNIA <br /> WATER WELL DRILLERS REPORT Do Not P/'11 In <br /> }(S Lona 7476,7D77,7078,Wirer Code) State Well No /�f- -ZL r <br /> Other Wel!No L-- <br /> Region- <br /> (7) __Region_(7) Per#orations: <br /> Type of perforator used �- <br /> Perforated _ _ --f t to-168f t Hole size_ 1/4—No of holes-22-per—ft.- _ <br /> H ,. PV It <br /> It <br /> (8) Water levels; a (9) Well pumping test- <br />' Depth at which water Date of test...^ -By whom-.._-__ <br /> first encountered- _�__ __ ..ft Depth to water when test started _ft <br /> Depth to water G P M. at beginning of test_... <br /> before perforating_ �— -_� __-:`ft Drkwdown from standing level_ . - _ <br />' Depth to water G P M. at completion of test----- <br /> after perforating_- _______ft Drawdown at completion of test-- __ �~^_ft <br /> Note-Iny change in water level while drilling Length of time tested__ - <br /> - Temperature of water_ <br /> Was gas present in water? ❑ Yes ❑No _ <br /> (10) General <br /> Was well gravel packed?_— __r_ Size of rock —__ _ .Thickness of p-ick..-'Was a surface sanitary seal provided?---------- <br /> Vere <br /> rovided?--_-------Were any strata scaled against pollution? p 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 /> ed?.-. -Method of plugging and sealing­ <br /> (11) <br /> __ <br />' (11) Location j (12) Time of work: <br /> North (12) <br /> No—, -__ _ Work started date__,.p ompleted date 6/3o/4i <br /> D Townships 1 Date of this report—�7,C��,��._ <br />' Std Itt0 <br /> Base&Mendian_K A__________ WLLL DRILLER'S STATEMENT. <br /> Show location of well In Sec- This well vas drilled under my jurisdiction and this <br />' I tion,thus (X) report Is true to the best of my Anowledge and belief <br /> D <br /> Distances to` #9nElthes fro <br /> well, m <br /> p well, X or S�.�_ ft <br /> and E or JW- --100 ft >9.0 rr <br /> AR Show location of nearest By _ <br /> known well, thus (0) 57 <br /> Distance to nearest known License No?6(002 Cllssificatio S - <br /> wC' <br /> 1 MILE (Q AiP 19cl <br /> cll __ _ ft D�tcd <br /> r- ” <br /> O w R FORK No 246 L'� ' REGIONAL WATER POLLUTION CONTROL BOARD COPY =,�,_ ,q pM _u,N SPO <br />