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S �f�E <br /> MIGINAL STATE OF CALIFORNIA Do not rill its <br /> THE RESOURCES AGENCY n' <br /> ie with DWR DEPARTMENT OF WATER RESOURCES No. 190840 <br /> oI Intent No WATER WELL DRILLERS REPORT <br /> mut No or Date--16-401 Zr� — 4-0 Q — 0 J 3 state Well , <br /> Other Yi ell Nu <br /> I ER N rime Gonsalves & H o l l o w a (12) WELL LOG Tot i1 depth 2 0 2 ft Depth of completed well 2 0 0 It <br /> ldress P . 0 . Box 2034 from ft to ft Forination (DeScnhe by color character size or matenil) <br /> Manteca , Ca z,p 95336 0 - 6 Top Soil <br /> I LO(.'ATION OF WELL (See instructiorLs) 6 - 10 Clay <br /> Jan Joaquin Owners Well Number 10 – 13 Sand <br /> iddress if different from above Y o s e m i t e A v e . 13 - 30 Clay <br /> s nship Manteca Ilxnp a Sectio 30 - 90 Blue Sand <br /> 'a ce tmm cities roads railroads fences ete 1 1 5 0 E . Hwy 120 90 – 1 15 Blue Clay <br /> 115 - 130 Sand <br /> UO - 160 Clay <br /> 1 0 - 165 Sand <br /> (3) TYPE OF WORK Clay <br /> New Well EX Deepening ❑ 18(''-A 9 8 Sand <br /> Reconstruction 0 198 - 20 0 Clay <br /> Reconditioning ❑ 200 – 202 San d <br /> Horizontal M ell ❑ 202 – Clay <br /> Destruction ❑ (Describe – <br /> destmctmn materials and <br /> procedures in Item 12) – <br /> (4) PROPOSED USE - <br /> Domestic _ <br /> Irrigation [] » <br /> Industrial ❑ – <br /> Test Well ❑ _ <br /> Stock ❑ – <br /> Municipal ❑WJW ELL LOCATION SKETCH Other ❑ – <br />) EQUIPMENT (B) GRAVEL PACK Sand <br /> tary )b Rei erre E] 1 es Xi No ❑ Size a <br /> – <br /> u <br /> ble 0 Air ❑ Diameter of bore – <br /> her ❑ Bucket ❑ Packed from—_15 to 20 0--ft _ <br /> CASING INSTALLED (8) PERFORATIONS – <br /> el 0 Plastic Concrete 0 Type of perforation or nze of screen -From To Dia Gage or From To Slot - <br /> ft ft, "In Wall ft, ft s.Ze - <br /> 0 200 6 160 180 200 Screen - <br /> i) WELL SEAL �t C - <br /> 1s surface sanitary seal pmvided> Yes)b No E3 If yes to depth 95 ft – <br /> ere strata sealed against pollution" )es q No ❑ Interval_ ft – <br /> thud of seahng Bentonite Work started r. 19 Completed 19 <br /> 0) WATER LEVELS WELL DRILLER'S STATEMENT <br /> pth of first water, if knnwn ft Thu well was drilled under my runsdiction andthis report is true tha best of my <br /> inding level after well completion 12 k knowledge a d belief r_ 1 <br /> 1) WELL TES'T'S SIGN>n <br />-, well test made les ED \o ❑X If ves by whom" (Hell Dnller) <br />,,e of test Pump ❑ Mailer ❑ Air lift ❑ NAME— y B N N I N G S BROS . DRILLING CO . , LK, <br /> C . <br /> pth to water at start of test It At end of test Person firm or corporation) (Typed or printed) <br /> �hatge eal/iron after hours Water temperature Address 3 5 2� P E L A N D A L,E AVE , <br /> J, analysis madea YesCita -- M 0 D E S T 0-,A <br /> ❑ Na [X if yes by whom? <br /> is electne log made }es 0 No 3_If ,es attach copy to this report License No 2 9 0 8 1 - _ nate of this reportMAY <br /> B (REV 7 7e) IF ADDITIONAL SPACE IS NEEDED USE NEXT CONSECUTIVELY NUMBERED FORM <br />