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U/SUEaC �ran "r" <br /> t <br /> STATE OF CALIFORNIA Do Not D11 In <br /> I <br /> ORIt�INA! 13 l5Z THE RESOURCES AGENCY N2 157684 <br /> File with DWR DEPARTMENT OF WATER RESOURCES <br /> WATER WELL DRILLERS REPORT state Well No <br /> •t. <br /> Othcr Well No 76-483 W <br /> OWNER (1 1) WELL LOG <br /> Name Andrew Rossi T-1 depth 1 8 ft Depth of cornpleud well f, <br /> Address 17659 S . <br /> Airport YY`.r a y Form�c+on Drunbr 63 ralw rM eerie+ uzr of mauru! and rtrrrl:rr <br /> an eca a i . 0-15 1t to Sand " <br /> (2) LOCATION OF WELL 15-17 <br /> Loun[} San Joaauin t�.nrr,number ,fan. 17-10 B <br /> Tywneh,p Range and Section 30-12 <br /> Clay <br /> O,atmce from I-- road, r..],.ad, ,, .Airport Way 4mi North 2- 8 San <br /> o Hwy wes � sl e 48-1o4 1 <br /> (3) TYPE OF WORK (check) 104-107 Sa n <br /> New Well 2; Deepening ❑ Reconditioning ❑ Destroling © 107-1 1 Clay <br /> If drstruciton,describe material and procedure on Item 11 115-150 ha <br /> le <br /> (4) PROPOSED USE (check) (S) EQUIPMENT 150-174 d <br /> Domestic ® Industrial ❑ Municipal ❑ Rotary ] 174-185-- Shale <br /> Irrigation ❑ Test Well [] Other ❑ Cable ❑ <br /> Other ❑ <br /> (6) CASING INSTALLED <br /> If gravel packed <br /> STEEL OTHER <br /> SINGLE ❑ DOUBLE ❑ l <br /> Gage Diameter <br /> I-roin i u or of From To <br /> ft tt Dtam Fall Bore it it <br /> 0 175 6 160-4 12 100 175 <br /> t <br /> 'hoe— +yell r+nR Sirr of navel bird e e <br /> MR crib. ...,glued <br /> (7) PERFORATIONS OR SCREEN <br /> Type of pen--ion ur name of scrren hand cut <br /> Perf Rows <br /> From To per per size <br /> it it row ft an x 1n <br /> 1 1 <br /> Ec. <br /> (8) CONSTRUCTION 3752 <br /> Wa a Variate unitary serf provrded� Ye,M No 0 To.chat depth 50 ft <br /> weir xny,[rata.ealed agar net po11o„on1 Yet ❑ No E] 1f vee note depth of neat. <br /> From it to ft <br /> From f[ to ft Norl ,carted 7-1 i9 76 Completed 19 <br /> Vlrthod of secl+nR Bentonite WELL DRILLERS STATEMENT <br /> This urll uas drilled render m7 jurisdiction and this rrport is tsar to thr brit <br /> (9) WATER LEVELS- of my knoteledg[ and belief <br /> Depth at which water war !crit found if known ft <br /> ,[,riding Ir.r! hrfurr perfor..-n of 1,.— It NAME Hennl.n s Bros . Drilling Co. Inc . <br /> (Ferson firm or corporation) 1T31wd or prmird) <br /> ]nndrn level after Pelf oratmR and develop,rtR ft <br /> (10) WELL TESTS Address 2500 W. Rumble Rd. <br /> Was pump test made? Yea C] No lK 1f yrs by whom? Modesto. -Calir• 951'50 <br /> eat lmtn with ft drawdown afrer hrs [SIGNED] <br /> Iiii (Wrlf Dr+!!rr) <br /> eratore of water Was s ehem,eal aria lys+a made? Yea ❑ No ((��RR 4' <br /> elrcrr,r log made of wr111 Yn ❑ No 1f Yn ,teach copy License No 29Q81 Dated -1 , ;9--7-6/� <br /> SKETCH LOCATION OF WELL ON REVERSE SIDE r� <br /> DwR 1136 (REV 9 681 6 12 DON TRI.v, OSP <br />