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JUL 5 1F; 37 <br />ORIGINAL WATER WELL DRILLERS REPORT Do Not Fill In <br />N10 with DWR (Sections 7079, 7080, 7081, 7082, Water Costo) NO 8055 <br />y1J(^ o 5 <br />THE RESOURCES AGENCY OF CALIFORNIA State Well N��/�9' {5�' <br />ik DEPARTMENT OF WATER RESOURCES <br />M" t%�� Other Well No.� <br />(1) OWNER: <br />(2) LOCATION OF WELL: llf?v <br />C ... ty frIAl- owner's numrber, if any r�cG:/ <br />(11) WELL LOG: <br />'Poral depth t a 0 ft. Depth of completed well Zoo ft. <br />Formation: Dneribe by color, eboracler, si:r of rrsalerldl. Ona slrs 19'e <br />0 ft. to Blac k Top Soilft. <br />Br i <br />9 28 Brown Clay— <br />Towaship, Range, rad Sec oo N �J n/� t w t.% <br />8 <br />! 0 <br />_Mm San — rr"iypi 41 <br />Distinea from citiet, roads, railroads, etc. <br />0 <br />50 <br />Brmm Silt-& Clay <br />50 <br />52 <br />Brom Sand <br />(3) TYPE OF WORK (check): <br />New COelI Z Deepening ❑ Reconditioning ❑ Destroying ❑ <br />If destruction, describe material and procedure itt Item 11. <br />52 <br />6o <br />Bro-vm Clay <br />S - <br />(Sandy) <br />(h) PROPOSED USE (check): <br />(4) <br />Domestic ® Industrial ❑ Municipal ❑ <br />Irrigation ❑ Test Well ❑ Other ❑ <br />(s) EQUIPMENT; <br />Rotary 9 <br />Cable ❑ <br />Other ❑ <br />72 <br />76 <br />Gray Clay(Sandy) <br />76 88 <br />Blue Clay <br />88 92 <br />Dlue Clav(Jointe6 <br />92 <br />96 <br />ue Grafi Sand <br />(6) CASING INSTALLED: <br />STEEL: OTHER: <br />SINGLE ❑ DOU13LE M <br />Gage <br />Prom 10 or <br />ft. it, Diam. \Vail <br />If gravel packed <br />Diameter <br />of From To <br />bore ft. ft. <br />6 <br />100 <br />i1- <br />Blue C1aV <br />Sita of slave or well ring: i <br />Siu of erAr I: <br />\� <br />Describe iolnr I,u _ L 1) rd 17//' t <br /><< <br />(7) PERFORATIONS OR SCREEN: <br />'rype of perfutitfon or name of screen <br />From <br />fc• <br />Perf. Rows <br />To per per <br />fr. row ft. <br />Size <br />in. x in. <br />/ vux <br />(3) CONSTRUCTION: <br />`.9at a surface unitary sral prnvided? Yet Ll No To what de th ft. <br />'S'ere any strata Leafed against pollution? Yes W No n if yet, note depth of waca <br />From ) fc. to 0 ft. <br />From ft. to ft. <br />/ // <br />Work started -- I O 19 G (o , Completed <br />3-11 19 4 <br />J �• <br />Slethod of realioR V + .� - aL L t h- ' S !fl/lr' <br />NVELL DRILLER'S STATEMENT: <br />Z'his well was drilled under my jurisdiction aesd this report is true to the best <br />of my knowledge and belief. <br />NAMEt7L4E r? f 6i Lot -L L Qrlle Q. Y l'..O <br />9 WATER LEVELS <br />( ) <br />Depth at which water wit first found, if known fr. <br />StanJing level before perforating, if known ft. <br />Sundin 1-1 after perfontin , and dcvclo ing Er. <br />(Person, firm, or <br />Address P 5. <br />corporation) <br />(Tvpei or trinled) <br />(10) WELL TESTS: <br />'AMP ttsc madt? Yes ❑ No 1f yes, by wham? <br />G- K. 'F u <br />L <br />G 1" N .'S .ZD I <br />gal /min with ft. dnwdo— after hm- <br />�7 <br />(SIGNED) (" !Y , <br />(Wr?t n.?ffrr) �rli4 cL f jf �a > <br />Temperacura of water Was a A-1­1il analysis made? Yes Q Nal_ I tu(&_ I <br />Was eltctric log made of well? Yes C) No Tf yes, attach copy License No.I?./ D s 7_� atccl _ 19_ <br />SKETCH LOCATION OF WELL ON REVERSE SIDE <br />DWR 1E18 (REV. 0.83) <br />5639t-950 10-62 5051 Tnip n A OSP <br />