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i <br /> ORIGINAL WATER WELL DRILLERS REPORT 4 Do Not Fill Ir, <br /> File original,Duplicate and Triplicate with the (stKe,aaa roc -7077,7079,Water coda N° 3 8 8 6 5 <br /> REGIONAL WATER PoLLLTTIO]*I <br /> CONTROL BOARD No- STATE OF CALIFORNIA/� (�� State Well No— — _� <br /> G` <br /> {larrrt a)}ro�r,.er■resrbrr) «1Other Well Na_ <br /> f (1) OWNER (11) WELL LOG.Ift <br /> me P-Y_-11kLen-q–Enrd G1 ass Ca. Total depth 202 it Depth of completed trtll 202 it <br /> ddress For"'"On DrImbe by rolor,cb—srtn,lox,of,w.rr:e! end slrrrterr, <br /> Talef o 5 Oha o0 it 10 10 ft 503.1 <br /> 14 Sand <br /> (2) LOCATION OF WELL 14 I —clay <br /> etmnq Owner It number it an*— 17 22 Sand <br /> R F D or Street No 22 39 Clay <br /> SCc. 35 R617 T15 39 5Q r e sand <br /> .5 n 62 rjay <br /> (3) TYPE OF WORK (check). e rave <br /> New well X) Deepenms ❑ Recondauontng ❑ Abandon ❑ d <br /> If abarxdonmeni,describe mstrrtal and procedure on Item 11 <br /> (4) PROPOSED USE (check) (5) EQUIPMENT. <br /> Domestic ❑ Industrial n Municipal ❑ Rotary ❑ <br /> Irngation ❑ Test Well ❑ Other ❑ Cable <br /> Dug Well ❑ <br /> (6) CASING INSTALLED: If gravel packed <br /> SINGLE® DOUBLE ,— Oar from to <br /> From ft to it D,am wall of Bore it it <br /> - . 202 14 hln NO <br /> i <br /> T7p•and nue of rhac or trill nng 5 5 Saxe of gravel None <br /> Deaera>K,.int W e I d e d <br /> (7) PERFORATIONS: t <br /> Type of perforator tired i i w <br /> Size of perforat,o_nr 3/16 as Itagmh by 2 to <br /> Frmn <br /> rr�� <br /> ft I. ft p Peri per tow Ro-a per it <br /> x50 I 8 <br /> 2 <br /> 190 <br /> rna <br /> (8) CONSTRUCTION - <br /> � u <br /> r <br /> Wu a surface unciaey real protxded? Q Yea X] *7o To wham depth it <br /> Were say heats sealed agaanst pollattou? 0 Yes ,X1 No If ya note deptta of Items <br /> From it to It <br /> Method of Sealing Work started 19 Compleerd 8/23Z61 19.� <br /> (9) WATER LEVELS. WELL DRILLER'S STATEMENT <br /> Ther well was drilled under my jurisdiction and this report as true to fbe best of <br /> Deptk at which water_.a tint fonad it my�Enowledgr and brllrf rp� <br /> itaaadu 11"al before perfor.rmng ft NAME Clark Well Or1IIlnQ CD0 <br /> a <br /> IyI Isrel after perlorauag 3 6 it - - - '—" '— <br /> lYrrwn firm or corptrauun7 rTYDrl or pr,wtrl) <br /> Address 2.024 E, Charter Way <br /> WELL TESTS: <br /> �T _r_ <br /> pYa0NoIfrl' by_hon'at !t drsv dots of tet bra Wrfj Dr161rr of raver VY'ar a ehemsnl sadyl,I medal Yn Cl No <br /> License No--T66G2— Dated-8/28/61 , s9 <br /> y� , <br /> VON e< <br /> e ttae leg male of weIIT 0Yea �] No mew 3 to a0N gVIN Q.►O OWft F'OR at NO 24 lR[V 3 541 <br />