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Site Address: 16727 Brandt Rd Way, Clements CA 95227 <br />Date: 6/17/2021 <br />PHOTO # 1 New Well. Well Loq. Well Grouted with 10.3 sand cement from 100 ft. <br />110 M, <br />i 666 FAST 1-1AZl'LTON AVENtJL - STOc1<TON CA H`;205 -6'L'32 (2H'!) 46F,-Z�" �� �//,,% <br />Tf it C1 EXPIRES 1 YEAR F <br />ROM DATE(SSll 1.: 1_ <br />rxCFL Sll.E `� LANn 1JSE APPUGATION 7f P �`—� f<3 � G L/� <br />L PI10NC lin; ` <br />C\TY/STATE/ZIP. �n�O Lr'� `/ J <br />CQ <br />FA <br />G\TY/STATFJ ZIP y� / /'" <br />-7 � �� � EXPIRATION GATE <br />SUoc /-� <br />4Trc+Pana (43432) (4393) <br />391)/ nibroll,n<=t,loro4 <br />+a1 r) Winter CU„_,lilY Manlloring L1 Snit Son,Piin9/CharaGariza{fon -” <`_ � � �� <br />Rllon/Ma>U llicallo„ It c.l ,.o• .• +" rl Ciantacl,nlcat __ -�` j — �_ D � �` J/�+ � I _ <br />'9(s� Wo1� al I., C'n.>-s-Connoctio„ Repair y� /� y�j/r"Ly." <br />1 <br />fir•,•• --la• n r:lprn Bollnrn �C ravel Pack/6raval size y <br />�t r casing oapu, rt 7�7> % `�— j✓rV <br />Z� LI .`il<xc1 � -Ill, (-I Stai Wises to ai n Olt,e AClr m/x/7 Hal walar •--7 y1 / <br />I ,.vaf Pr) �•` ,tl C.e+nenl_.��� �> i c�/ti <br />ag/G/O l �- --� <br />Clll +e•r =-� - � ,r, C1 Cnrla ty L3o it Stove PIPo `3 �N �/4 f -',L/ <br />—."— <br />/I <br />11.11`i. I i<'ALStJVIG Gf CI I\(=Y TII/A-TNMY 12 C'a1U11iN OEL GEN BEA6 <br />r30/1R CT ANO TI -IAT I AM IN is r>M r•LIA NGG WI'I'li ALL <br />TIONS - PLEASE CALF-- (209) 9_16—=7�.L� <br />Francisco Garcia Ruiz, Environmental Health Specialist Trainee <br />Record ID: WP0042047 <br />Page 1 of 2 <br />