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Do Not Fill In
<br /> STATE OF CALIFORNIA
<br /> OR1d1NAL
<br /> THE RESOURCES AGENCY N2 157646
<br /> 1r11wwith DWR DEPARTMENT OF WATER RESOURCES
<br /> WATER WELL DRILLERS REPORT state Well No
<br /> other well,No 6- 21
<br /> "at.ei Vla� Jam., .c.�l��.
<br /> OWNER WELL LOG
<br /> Name George Uetherell Total depth 171 1 it Daprh of rornpkced well is
<br /> Address 17-717 S • Airport Way Form aeon D,,rrrbr h).ol.r rbuurrr [rvr of nrrrrrsl •wd,r—cl.rr
<br /> Manteca Calif. - 2 ft [n S@nrl ft
<br /> (2) LOCATION OF WELL IP-17 C.1 ay
<br /> Loontl San Joaquin Gwner,number ,f an, _
<br /> Towtnh,p Range and Sen on T 1 S R 6E
<br /> f,om c,,,r, raad, -1—ds r,. S . A xe p art Way-4,mi -
<br /> North fo Hwy 120 west side -
<br /> (3) TYPE OF WORK (check) —qciny
<br /> New Well ® Deepening ❑ Reconditioning 0 Destro)ing ❑
<br /> cznnei
<br /> if destruction,describe malrrral and procedure in Item I I —Q
<br /> (4) PROPOSED USE (check) (5) EQUIPMENT — I C
<br /> lay
<br /> Domestic PCJ Industrial ❑ Municipal ❑ Rotary ® 10-1-105 n
<br /> ti
<br /> Irrigation ❑ Test Well ❑ Other ❑ Cable ❑ 105-119 Clay & shale
<br /> Other ❑ 119-125
<br /> (6) CASING INSTALLED 125-151
<br /> STEEL OTHER If gravel packed 1 -1 71 Gravel sar)(i
<br /> SINGLE (:] DOUBLE ❑ • C
<br /> Gage Diameter
<br /> From 10 or of From To
<br /> ft tt D,am Wall Bore ft ft
<br /> 0 17C 6 160w 11 100 170
<br /> e ,hoe or well nng s—of .,Duel hirdseve
<br /> Dncn6r suint
<br /> glued
<br /> (7) PERFORATIONS OR SCREEN
<br /> Type of prrtun stun urn me of screen
<br /> Perf Rows
<br /> Front To per per Size
<br /> fr ft row ft in xin
<br /> 16Q 120
<br /> (B) CONSTRUCTION
<br /> Wr.a,urtaer s,n—ry seal prov,ded> Ye, No I] To what depth f,
<br /> VI'err�n> .,rata.sled.,mr,t pollue,on, Ye, ❑ N. If ves note depth of strata
<br /> Prom f, to f[
<br /> Krum
<br /> it to f[ Fork.tatted 6-15 1926 Comple,ed 19
<br /> tlethod o1 >caL.ng WFLL DRILLERS STATEMENT
<br /> This well was drilled under m_) )urrsdirlmn and I& report it true to !hr bis'
<br /> (9) WATER LEVELS of my knowledge and bellrf
<br /> Depth it -h-ch wale, was Snr found ,f known ft
<br /> standing L,rl hdurc perfarst,nF ,f known ft NAME Hennings Bros . Drilling Co Inc
<br /> (I'enon firm or eorporat,on) (T)prd ur p,,,rled)
<br /> NtandmF level aflrr perforat.ng and developing f,
<br /> (10) WELL TESTS Address 2500 W. Rumble Rd
<br /> W..pump test made? Yes ❑ No If yrs by whom? Modesto,,- a
<br /> t ul/min w,[h ft drawdown after hes 1$IGNEt)]
<br /> {Wrif Dnflrr
<br /> Arra curt of..ate, 1Y+ac a rhem,cd mJym made? Yr[ [] Ko r��
<br /> elec test log made of welt? Yet 0 No if yet aclach copy Lseense No Dated , 19�
<br /> SKETCH LOCATION OF WELL ON REVERSE SIDE [L —
<br /> �n
<br /> DWR 188 [REV 9 601 a 71 Dox Ttttr dr oar
<br />
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