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UGINAL STATE OF CALIFORNIA Do not fill to
<br /> THE RESOURCES AGENCY p�
<br /> e with t7WR DEPARTMENT OF WATER RESOURCES NO. 21469
<br /> ,+f Intent 'yrs WATER WELL DRILLERS REPORT Mate µell .n_ /�/ _ —
<br />„ Iennrt 'so ur Date Other Melt % 0��446V/
<br /> AI
<br /> Doc Mullican 12 WELL LOG h 135 _I�OtI
<br /> �'�ER 1\unr�� � � Int I dept rt iJrpih nt con pitied t
<br /> 1+53 Moffat Blvd. from ft to ft FonnZtion IDeccnbe h% color charcter axe or notion)
<br /> nteca , Calzf. L,,, --2 and
<br /> - - Blue clay & sand
<br /> LO�ATIT OF NVELL (Sit, Instnlction.%) .. 3 Sand
<br /> �� aA oaquln fla,nerc \\elf \ornhrr - ry
<br />„ addres+ [f d+fferu,t f,no „u,.. lap
<br /> T2 S n_ a n
<br /> 'LG'ti..7 ]t�tP R Ge[hnn -- - -
<br /> ,ce fmm rthe5 rn+d niln 3700 Hwy 120 —9 Gla ul, fence etc -
<br /> �TMjle Wesof Airport Way, —South side 96-101 Sand
<br /> 1 101,127 ay
<br /> an
<br /> (3) TYPE OF IN ORK f
<br /> New 1'l ell tX Deepeninc ❑ �f
<br /> Reconstn,ctt(In ❑ '
<br /> Reconditioning ❑ i` -
<br /> Honrnntal \x ell ❑ -
<br /> Destruction L De,crlbe -
<br /> destmcnnn initenllc and
<br /> procedures ,n Item 12) -
<br /> (4) PROPOSED USE -
<br /> D,nowt,( -
<br /> lrnl.ctt,n, u =
<br /> Indtistn'd ❑
<br /> Test It ell ❑ -
<br /> Stock Q
<br /> Mumc,pal ❑ -
<br /> \%ELL LOCATION SKETCH Other ❑
<br /> 1W1111MENT f6) GRAVEL PACK -
<br /> t1r, Revers {] Yes R NO 0 Size -
<br />,I+le [' 4rr ❑ Dr'uneter of bore—
<br /> h,r
<br /> oreh,r 1] 131Icl.et ❑ Packed from 100
<br /> i CASI\G INSTALLED (8) PERFORATIONS hand cut
<br />„l ❑ pllctu Concrete [ T,pe of perforation orsize of screen —
<br /> From To Dia Gage or From` _ To S16t
<br /> ft ft , )n Walt ft ft size —
<br /> 130, 160W 120'- 1 0
<br /> 9) WELL SEAL
<br /> IS surfItc sanitars seal pro,+ded° les IM No ❑ If }es, to depth�ft
<br />%co, strut, celled 't�-ainst les ❑ No ❑ Intenal------------�t -
<br /> ,th„ h
<br /> d nr sein Bentonite IN d 19 Completed 19
<br /> 10) WATER LEVELS NNELL DRILLERS STATENIENT
<br />,+tith of first „titer if kncr„ —ft Thu u.411 uaa dulled under n tonsd+ctic n rind the, rrl,r,rt r, torr to tht lies, of run
<br /> ridtns. lc,cl ,iter „ell tompltt , 12 ft Rnouledge and belrcf )
<br /> i I) Fi ELL TESTS
<br /> (Well D er)
<br /> c „ell te,t n„dea lieu r \I) [X If ,es b, %shorn,`
<br /> ,jw of test Pump ❑ Hn,ler ❑ Air fist ❑I 1\-0,1E Hennin s
<br /> >,pth tri eater ,t st,rt of fest ft At end of test ft (Periun fine or corporation) (Tspe[I or prsntcdt
<br /> (�'�,��
<br /> —
<br /> nsmm „ n
<br /> ri>chtirCr 1e,lrmtn ifler hours MiAddress 2500 Ir Rumter temperature Modesto C lif Zip ( 350-emlt.il anuls ode Sr, u 1. If ,c, b, ho °
<br /> Cit,
<br /> nY Ing made' les Q '\oX if ,ee �itt-ich cop, to th„ report License N, 290 D'ite of this retro
<br /> e (Rry 7 -7e+ IF ADDITIONAL SPACE 1S NEEDED USE NEXT CONSECUTIVELY NUMBERED FORM .,eic s.cr
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