0900f48e8098b387 additionally, i have attached some ... · 3/12/2013 · from: bennett, jim to:...
TRANSCRIPT
From: Bennett, JimTo: Gungle, AshleySubject: 3600-12-005 Tierra Del Sol Solar Farm - Groundwater CommentsDate: Tuesday, March 12, 2013 2:08:00 PMAttachments: Doc1.docx
Tierra Del Sol Well Logs.xlsTierra Del Sol Well Logs.pdf
Hi Ashley,
Groundwater comments can be found at the following link:
http://webtop-dctm/lueg/drl/objectId/0900f48e8098b387
Additionally, I have attached some documents to go with my comments for use by theconsultant.
Thanks,
Jim
DEH Permit WELL LOCATION DEH DATE APN15149 TIERRA DEL SOL BOULEVARD 91905 23-Jan-03 658-090-05-0015555 38763 ALTA VEGA ROAD. BOULVARD 8-Sep-03 659-070-06-00
15997 MOON VALLEY ROAD, BOULEVARD 91905 25-May-04 658-090-49-0016051 TERRA DE LUNA, BOULEVARD 91905 21-Jun-04 658-080-52-0016446 38211 MOON VALLEY RD. BOULVARD 91905 30-Jan-05 658-090-03-0014728 TIERRA DEL SOL RD , BOULEVARD 91905 16-May-02 658-090-18-0014729 TIERRA DEL SOL RD , BOULEVARD 91905 16-May-02 658-090-18-004610 38663 ALTA VEGA RD , BOULEVARD 91905 30-Jan-96 658-090-51-004133 38709 ALTA VEGA RD , BOULEVARD 91905 3-Dec-95 658-090-52-003131 642 TIERRA DEL SOL RD , BOULEVARD 91905 21-Nov-89 658-081-06-003133 658 TIERRA DEL SOL RD , BOULEVARD 91905 29-Nov-89 658-081-05-004632 940 TIERRA DEL SOL RD , BOULEVARD 91905 30-Nov-83 658-090-36-008442 980 TIERRA DEL SOL RD , BOULEVARD 91905 8-Nov-77 658-090-34-008681 664 TIERRA DEL SOL RD , BOULEVARD 91905 13-Apr-86 658-081-04-009056 940 TIERRA DEL SOL RD , BOULEVARD 91905 22-Apr-86 658-090-36-0010598 961 TIERRA DE LUNA RD , BOULEVARD 91905 658-090-26-008418 928 TIERRA DE LUNA RD , BOULEVARD 91905 31-Aug-87 658-080-53-0014797 38511 ALTA VEGA RD , BOULEVARD 91905 22-Oct-00 658-090-50-0014727 TIERRA DEL SOL RD , BOULEVARD 91905 14-Nov-02 658-090-18-0012025 876 TIERRA DEL SOL RD , BOULEVARD 91905 22-Sep-80 658-090-38-005337 872 TIERRA DEL SOL RD , BOULEVARD 91905 13-Mar-96 658-090-19-00645 873 TIERRA DEL SOL RD , BOULEVARD 91905 9-Aug-94 658-090-23-0010399 38511 ALTA VEGA RD , BOULEVARD 91905 13-Mar-90 658-090-50-0010956 965 TIERRA DE LUNA RD , BOULEVARD 91905 21-Jun-82 658-090-27-0018495 38709 ALTA VEGA ROAD, BOULEVARD, CA 91931 3-Sep-07 658-090-52-0019614 639 TIERRA DEL SOL RD, BOULEVARD PRIOR A 31-Mar-08 658-081-07-0019019 38093 MOON VALLEY RD, TIERRA DEL SOL 15-Jan-08 658-090-24-00
On-Site Wells2157 805 TIERRA DEL SOL RD , BOULEVARD 91905 30-Sep-78 658-090-31-0015698 805 TIERRA DEL SOL RD. BOULVARD 91905 2-Dec-03 658-090-31-00Well AWell B
X Y DTB INIT_DTW FINAL_DTWWELL YIELD
RESIDUUM DATE
6536738.471 1802265.19 500 10 0 to 356543098.688 1803360.82
6537722.749 1803393.756535518.699 1802578.376537701.791 1803889.446537943.528 1802340.736537943.528 1802340.736541252.206 1803251.75 300 12 15 0 to 36 2/3/19966541729.587 1803255.72 620 3 0 to 10 12/13/19956535511.238 1800354.94 220 51 30 18 0 to 48 11/26/19896535511.027 1800705.61 260 80 25 16 0 to 18 11/22/19896539382.695 1802796.92 150 40 15 20 0 to 60 12/4/19836539333.782 1804140.156535510.854 1801052.73 230 140 50 9 0 to 96 4/16/19866539382.695 1802796.92 245 150 30 7 0 to 62 4/26/19866536263.826 1803139.656535519.079 1801909.11 375 150 30 5.5 0 to 30 9/4/19876540517.873 1803365.296537943.528 1802340.736538441.867 1801950.17 110 55 55 20 0 to 55 11/10/19806538129.786 1801953.58 500 5 0 to 5 3/30/19966542074.996 1801932.45 177 18 0 to 36 8/6/19946540517.873 1803365.296537109.182 1803145.326541729.587 1803255.72 700 8 0 to 25 9/10/20076535697.248 1799640.14 170 80 70 6 0 to 20 12/19/19756537051.826 1803715.97 9.5
32616 well logs
6538478.209 1800927.68 520 286 200 5 0 to 11 10/4/19786538478.209 1800927.68 800 3 0 to 18 12/15/2003
1000 48.45 61.3 1.8 0 to 50 4/4/20121311 29.45 44.9 75 0 to 11 4/25/2012
NOTES2 hour lift test
1 hour lift test1 hour lift test4 hour test4 hour test2 hour lift test
3 hour lift test3 hour lift test
15 minute lift test, 3 ft drawdown2 hour lift test2 hour lift test
2 hour lift test
2 hour lift test2 hour lift test
COUNTY OF' SAN T)IEGOÞEPARTMENT OF PUBLIC HE/\I i
' 600 PACIFIC HIGHWAY, SAN DiËGO, C;, .I OÍ a5E jo< /-07
(11) WtJLt [,oG:
3BLq9!l!!- i2þ-Jl'-[9pttr or co¡r piglecþelj::, .:r,:'.1_ / /__g__\r,. ,-rcprn or coì/¡tp¡cücct $'ell ft.ld,rtnati<¡lr: Deseribe by col.r, cl,iràcter, üã;i iltorinl .urd ,tru.tñ,
ft. to fr.
æ./
I.)o l,lol lTill It¿
. ! -'a, --{ t ¡- t')"!/ - jtttir , ír'- ç
T;î;;;;;;\ r. ., \., ì'V l\ Jr.tt :
l^ry:-&¿lM¡d!'ss.¿-zlL-
-{ä"t--/¿--2.
w/\rER *ELL DRTLLETì* REpoR-r + (tu! iïiliå:
O'rvnef'snunrber if an
\7) PLRFORATTONS OR SCREEN:\Type of perforation or nanÌe of screen
!'rorn ft. toMethcd of sealing(9) WATER LE\¡EI,S:Pepth at whiglr _water rvas- first founcl¡!-lrow¡lStanding level belbre perforating, if known
WELL DRILLER'S STATEMIINT:
or corporatíon)Acìdress 't 2 /;'.¡ ,<t
.-Th-ís we\ was drilled under my j_urísdiction and this report ís true tothe best of n1X hnowledge and [rtit¡ef.rne oest ol nll nnowledgc end
x4yn /t'o o Cara t
(/,) PROPOSED UStr (chech):Do¡nestic Él- lndustrial I MunicipalIt'rigation I I'cst Well fl Other
(6) cnstNc rNSfAtrÌ,]DSTEEL: oTHER:
srncue I rrouelr I
1bft. f)iam.
of shoe or u'ell ri
IPI\{ENT:,f/> fu
En
ut
(5) EQ{JRotaryCableOther
Gageor
\{allFrom
fr.
Size of\D*";ib. i.i"i
þ-romfr.
ft.fr.
SKETCH LOCATION OF WELL ON REVË:RSÍ: SIDE
OVER
Licerrse N".221-7¿-¿:
If gravel packed
I{ork started/A^ /1 L97,t.ç61¡¡p1sted7T-
sAN 52 (9-74)
D ate d -¡A==.AJ-- Ls ?.á^
COUNTY OF SAN DIEGODEPARTMENT OF ENVIRONMENTAL HEALTH
WELL PERMIT APPLICATION
1. Property o*^"rt /uLl.//e. a'r--,f¿/ ((K;
2. Well Location - Assessors Parcel Number
DEH USE ONLY
PERMTT {wEL lØ+gWELL
FEE:
WATER DIST
¿a/kf,?/' 7?e;r
Þ*o.(¿u, , ' ¿u ?rç.s rcity z¡l
aî2- y
Ma¡l¡ng Address
Private
Type of Work:
Type of Equipment:
Depth of Well:
Proposed:
Q lndustrial
O Reconstructionryñew
C-57#: êZZ2A Cash Deposit <tl.Ëond.Posted
O Cathodic tr Other
tr Destruction Time Extension: 1st O 2nd
Casing¡Type: 14(Depth: &QDiameter b/z ¡n.Wall/Gauge, tS'b
Conductor CasingOYes QNoDepth: ft.
Diameter t 1- in.
Wall/Gauge: _
Filter/Filler Material PerforationsOYes QNoFrom: _ To:
Type:
Wall/Gauge:
From:
From:
From: -
To:
To:
To:
9. Annular Seal: Depth: p_tt Sealing Material: 6. ^tr..t¿.-Borehole diameter: /¿ Ut in. Conductor diameter: / ?- in.
10. Date of work: start: ' qlf/o i t--v--
Complete:
On sites served by public water, contact the local water agency for meter protection requirements.I .hereby gSre_e t-o comply with all regulations of the Department of Environmental Health, and with all ordinances and laws ofthe County.of San Diego and fhe Sfafe of California pertaining to well construction, repair, modification and destruction.lmmediately upon completion of work, I witl furnish the Department of Environmeniat Ueaitn with a complete and accurate logof the we.ll. I accept responsibitity for alt work done as part of this permit and all work witt be pefformea'unaer m,y iiücisupervision.
Contractor's Signature: ,^", ry'zÁT
DISPOSITION OF APPLICATION (Department of Environmental Health Use onty)I ' -r--"-' tl
ff Approved tr Denied Special Conditions: Grading and clearing associated with access to, or thecònstruction, maintenance or destruction
_of water wells, may require additional permits from the County of
san Diego and/or other agen "ie" c*R â' . '";¿1- -qh;: í- "i;4"
;';;"" út--*
DEH-LU-731â (Rev. 4/02) NCR Page 1 of 2
s'-/¿ g ¡\ c
COUNTY OF SAN DIEGODEPARTMENT OF ENVIRONMENTAL HEALTH Assessor's Parcel Number:
LOCATION
lndlcate below the vicinity and exact location of well with respect to the following items: Property lines,water bodies or water courses, drainage pattern, easements, roads, existing wells, sewers and privatesewage disposal systems and other potential contamination sources, including dimensions.
eþl
4."ß "*ß
s*/r,
"-/-
C
DEH: LU 731 b (Rev. 7 12002)
lùJØt-,,\$tllsOR¡GINAL
Date Work Began Erded
Permit No. LvuÈ.L'töl}v3 Pemit Date u4 ùep¡emoer zUUl
GEOLOGIC LOG WELLOWNERoRrENrATroN ( vl -luent,co,-
-'oRrzol,Tt - Ar,rcr¡
- (spEcrtrl Machelle Greenl¡etd
BEitHðS e¡r nr!".v_r'uro.W"HDESCRIPTON
Ma¡ling Address 18709 Alta Ve9ÑCa 91905
sizq &L elc.LOCATION
DEPTH FROMSURFACE
ANNULAR MATERIAL
Ft. to Ft.cE-
MENTBEN.
TONITI FILLFILTER PACK(TYPÊ/SrZË)
U 1V x X
o 1 000 5r10 well rocK
CERTIFICAT¡ON STATEMENTl, lhe unders¡gned, certify that lh¡s reporl is complele and acÆurate lo the best of my knowledge and belief.
"n", Franks Well Drilling
(PERSON. F|RM. OR CORPORAÍON'
P.OBox310l53 Guatay Ca91931
IF ADDITIONAL SPACE IS NEEDED, USE ADDITIONAL FORMS AND
STATE OF CALIFORNIA
npru rioot& Pase jL- parcel-93:!jl__Township 17s Range 6 E Secfion-Latitude--J---J-ar,lo¡¡¡r Lo,EM"
õEã I üi: | ¡a:
*o
illustralo or Oeæibo Dislanæ ol Wsll loñ Rodds, Buíß¡nas,Fgnæg R'Ers, elc å nd atâch a map. Use addilional æær ¡lreæssåry. PLEASE BE ACCURATE ¿ COI¿ PLETE.
€+ò
tja-\
\\Vrr,l"
s^,
DEPTH TO FTRST WAIER_(Fr.) AELOW SURFACE
OEPTH OF STATICwereR levEr-9L (Ft.) & oArE rlrensuneo-ll}9EsnMATED yrELD .--9-cp-- (GpM) s rEsrTÉST LENGTII--J¡- (Hß.) ToTAL oRAWDowN------I,d
AL DEPTH OF BORING L F""t)DEPTH OF COMPLETED \ /ELL _ZL(Feet)
DEPTH FROMSURFACE
BORE-HOLEDIA.
(lnchss)
CASING (S)TYPF lvì
MATERIAL /GRADE
INTERNALDIAMETER
(lndles)
GUAGÉOR WALL
THICKNÉSS
sLoT srzEIF ANY(lncùas)
Yz5@
zuuÉfì
o
iiuÀEJJ
Ft. to Ft.
U 21) 1Z x s¡eet tr.5 .lcozt) /uu o.c(, /tu PVç 4" sDh( 121 .040
- Al lAUtlMtsNlli (l¿l-
- Geolog¡clog
- \¡1/sll Construc{ion Diagram
- Qsqpþy5ical Log(s)
- Soil
^/ater Chem¡calAnalys¡s
ATTACH ADDITIONAL ¡NFORMATION, IF IT EXISTS.
Dl /R 188 REV. 11-97 (REVISED 0&'03 BY www.Theoontfac{orscfoup.com TO BE FILLìN-ABLE)
lf"larrñúUof $rorptqgo. STORTWATER & DISCT{ARGE NAilAGEXENT PI.AN FOR TVATER TUF¡LI.S
' Iltforne tcshldü dlVdWÅ1rytu'tlsa Only
TLis forn e tc shtlH ü ú Yd W Å11tu
Wdl rermÊApptcdt¡n Numbec Ass€Éx¡od3'Farcd'ñftsnt¡e¡:
SECTIOil f. RGtHfued lnfumation ltorn contæbr or Gonsulüant
GPS mao OüþYEs 'Ñ)YES @YËæYE¡ bffiwYES T@YEs ¡v
2-3.4.5.6.7.8.
q
toogü¡ù&tü¡rle
- -
,.--. - . -ltoryoffired?l. A¡ê üsE dty Wrcouæes a rËr bodas rÍüh 5{t Ê€t düe ffi d sti ffiæ€ñ-Do€ üo FH tltor üa pqfect bonnrffi (A'dü hsef Ë acce@Þ fu a EgÞ perËÊú c bt).fba üle pht dtou Èoþ¡¡nûE dany cxhlütg sræü¡reg ad ffi lü¡fr fæ Ë€û oiüa ffir¡ posiUin?Doæ qe PbûCwloúnsûh€üÞ nmdrry enmr¡bmüralrq ffirage cqr¡æa¡Croræoerltü rreÉ?b gnaû¡g re.f¡Gd b æ sb q M lætr?[tG üF pt{ect otúrm b ü¡e local grdng ocürarrctf?UUtl ûmtg ad¡¡fiæs bc usÊd þ drt üte uref?Ât€ üe Bc¡¡ il¿ngþrßtt ffie ffiretl b thb permn appfcdore
SECTIOII¿ Bcd@enpntP¡acücosTlg qgd dsb¡æbrírd dscütsrgp ærtd rnãr.g€illerû Ènnhg uüilÊüttg aïl ffiig u* þ b r€üEepofiün b üE maÛnr¡ êtþlt Facücabþ ushg Belt n¡¡ageûtont.nacæs (BlfÐ. Cãn¡tr¡cñon laædræts' e€tneÊ ôembal reeiü¡ee slrù as dtffitg þan,-uææG, ûtd sfni rn¡st te ntahed uütûr ¡¡eFop€rlf bqrúÈs b_etnhe fanepoltûom üe sb b n€düi süëæ, ffir4te cqrcæ, æør¡¡g wabrs adaæcÉrü pÐgæ3, n i¡ üË t¡sponsUny of üe property orner-and üre csrhaÀrt æ¡inhe sfrtõh Brms rttÞ r¡srd h o¡derb ens¡æüd at contamûnnts a¡o æ¡*¡eO on,eÈ.
SßCII(D{a G¡rûiñcdont¡ae f€d and ¡ndqsaanrl üp ftbrtu$ lWæ cltgß #rgü.dW qngr¡rlütrq't.r Sdecþd t¡l8uil ÞeûpbmenËd sofidrffiSnff b notnqület fin*C byrrulørsürrlblrdffear I rnæetheseþêd BllFes mr¡stbe ffi, rffime{ r¡qürcd and reuf¡ed æ ræEsy soücy aaffiüue.r I rndeæl¡td H nm-cornplanæ ffii fte San D,qo Cotf,üy UlfaE¡tsl HoÞcüon O¡¡lrance nray rcslr[ h
erúlæ¡neüdsts byüre Cqmty. Tfpee rryhcü¡de fteq cHqr¡| tbPwtøas, adrerærs.r DEtl hspeær d peæonnd fionr dþr legubry æe¡¡Oes ae dü¡o¡tæd b etÊr my fp€r$ d ay tlnefrr purpg æd*d tfft ütb ræll pørnlt rrrü s¡ú ftre üe ue! ir ccrplæd b üe sffioñ ot DE{.t $lotid DEH dffite ú¡ñg üre feld reuiêu üd üþ wX lnsÞl¿¡on tiæü¡r6 corüraet ûris Dbdrargpnaqsnerü Flat all¡e treü pstnû apefcæoq üe u€t dr{trg perrü.¡rÌfo !e sspende¿ or reuolcd. Rrüt€rdunffl æqfe a new permËÊê arrd rim€ndrûentb üÞ €Ðdúñg Ê*f -
ecrtfea d^ Beet_Uz¡eg€ûg¡t ffi b contatr wü ffilr n¡nd tdde, hf ae nd &ned b,.Íætalû¡t ofa ¡edl¡e¡ü baßùt b dilatt run-off, ræ¡E g€eõe Êbña b cqtdn æfile¡¡t¡ and tûfrg mud, dffit¡ürg ütg tæ ddlllrng fram. W€bstÞ mrrún þ ar&þ d
Cotmor Mewyø"r* ' ,,rlt .I/- 7 <r Ddt -?1r' /-)
-Revìewedþ DEH Mc
æ
f Fuo Fiegs@mrlúgr.CnillEt r,. AI'ÉRA
. ffiltfotrElq¡a: (6rtr{1F.0¡10B¡rtAI'd¡ (d,Ð56{l.r5r¡t¡¡toæ frðXãû7lf
oeÞARTusfÎ oF EIWIRoHMENTåI HEâLr]l . ¡00grrrhsr,5rrroor,Êrc{€rca e¿.roe-O.Bü@t,S¡llDGGlO,GAø886281 5f0t¡s
COUNTY OF SAN DIEGODEPARTMENT OF ENVIRONMENTAL HEALTH
WELL PERMIT APPLICATION
t"*"1î0,::
Mailang Address
hN"*
Conductor Casing Filter/Filler MaterialOYes ONo OYes QNo
From: To:Depth:
Diameter in. Type:
Wall/Gauge: Wall/Gauge:(
ft. Sealing Material:
in. Conductordiameter:
DEH USE ONLY
PERMffLuELE qSWELL COMPUTER #
FEE:
WATER DISÎ
Perforatíons
From:
From:
From:
''P^o,'
Type of Work:
Type of Equipment:
Depth of Well:
Proposed:
,J
phone#: t.¿t/fr !,13 I c-s7#:L{gfll[/)þc".r.l Deposit tr Bond posted
Use: þrivate O Public tr lndustrial D Cathodic D Other4.
5.
6.
7.
8.
-
To:
To:Diameter
9. Annular Seal: Depth:
Borehole diameter: Annular
10. Date of Work: Start: Complete:
On sites served by public water, contact the local water agency for meter protection requirements.I hereby agree to comply with all regulations of the Department of Environmental Health, and with all ordinances and laws ofthe County of San Diego and fhe Sfafe of California perfaining to well construction, repair, modification and destruction.lmmediately upon completion of work, I will furnish the Department of Environmental Health with a complete and accurate logof the well. I accept respqpsibility for all work done as part of this permit and atl work witt be performed under my directsupervision. f
contracror'ssisnature: 'f J,+J, I t o"," LJílc .o*coj
"):Company Namfi
fl Reconstruction tr Destruction Time Extension:
DISPOSITION OF APPLICATION (Department of Environmental Health Use only)
ft epproveO O Denied Special Conditions: Grading and clearing associated with access to, or thecònstruction, maintenance or destruction of water wells, may require additional permits from the County of
DEH-LU-731a (Rev. 4/02) NCR
COUNTY OF SAN DIEGODEPARTMENT OF ENVIRONMENTAL HEALTH
Gontrot *: Ll,uú ,(<b4.1Assessor's parcet ttumoer: tzl & eQ,J.J i
LOCATION
lndicate below the vicinity and exact location of wetl with respect to the foltowing items: property lines,water bodies or water courses, drainage pattern, easements, roads, existing welll, sewers and privatesewage disposal systems and other potential contamination sources, including dimensions.
@ Ndl,vr*{,
¿50'.6Mil ,
b¡fl*,/W''fu""re
/5o 4,
lqc
DEH:LU 731b (Rev. 7/2002) NCR Page 2 oÍ 2
ORIGINALFllewlth DWRPageJ- of-J-Owno/sWel!Datework Began
Local PemitAgency --Ð-Permit No. LWEL 15698 Permit Date 12-3-03
GEOLOG¡C LOG
ORIENrAïON lvl L,rt"toa -HoRlzotÍ^L -A¡lG.r -FPÉoFn
ORILUNGMÉTHOD-FLUID-
DESCR¡PTIONOos¡ba ñaldiel, aû¡û 8lra, æloí elc.
ATTACHMENTS t¡¿¡
- GeoÍog¡c Log
- Well Construction Diagram
- Qeopþysical Log(s)
- SoilM/ater Chemical Analysis
TTACH ADDITIONAL INFORMATION, 'F
IT
STATE OF CALIFORNIA
WELL COMPLETION REPORTNn 771980
Joe Hector BrownWELLOWNER
À¡r¡r¿acc 8O5 Ticrra Del Sol Rd
"- = t WELLLOCAT¡ONAddress Same as abovec¡r
ACTIVITY-X- re',vwet'-
W@otxt^lañrsUt.htGFoLOGICLOG')
PLANNED USES (g)WÀIER SUPPLY
-I- æuæ¡r
-
Pu&E
_ nR6¡&
-
NÙSn^
x,
CERTIFICATION STATEMENTl, lhe undorsigned, ceniry lhât lh¡s report is complele and accurate lo tho bost of my knowledge and belief.
ÑAME(PERSON. FIRM. OR CORPORAIION}
P.O. Box 310153 Guatav Ca 91931
lwIS NEEDÊD. USE AODITIONAL FORMS AND CONSECUTIVELY NUMBER ALL
CATHODIC PROTEI
HEAT EXCH
OIRECT
WATER LEVEL & YIELO OF GOMPLETED WELLDÉPÍH TO FIRST WATÉR-139--(FI.} BÊLOW SURFACÉ
DEPTH OF STATICWATÊR LEVEL-__g!!-;;;;;ì;=-_ (cPM) a rEsr wPe-ê!¡!!!!-TEST LENGTH_-3-- (Hß.) TOTAL ORAWOOWNJ!!!!- (FI.)AL DEpTH OF BORTNG 800 (Feet)
TOTAL DEPTH OF CoMPLETED WELL -@Q-(Feet)
DEPTH FROMSURFACE
BORE-HOLEDIA.
(lnchæ)
CASING (S) DEPTH FROMSURFACE
ANNULAR IIATERIAL
MATERIAL /GRADÉ
GUAGEORWALL
THICKNESS
sLoT stzEIF ANY(lnchæ)
TYPE
3
zU0ûH
0
åI
UÀÀJJ
cE-MENT
BEN.foNtÏ FILL
FILTER PACK(TYPÊ/SIZE}Ft. to Ft.
DIAMETEF(lnchæ) Ft. to Ft.
0 20 12" x ,sTM s3 t 156 to 2O ft. X Y
0 6.5'
DWR 188 REV. I l-97 (REVISED 06-03 BY www.ThecontractorsGroup.com TO BE FILL-IN-ABLE)
COUNTY OF SAN DIEGODEPARTMENT OF ENVIRONMENTAL H EALTH
WELL PERM¡T APPLICATION
3. wett contractor - wett Dl"irr"r, Sh. nfUn D ¡¿rLof - "J:rno..u
Name:Po,B*3,,r'== è.,.o{^,
2. Well Location - Assessors Parcel Number
4. Use: $Private5. Type of Work:
6. Type of Equipment:
7. Depth of Well:
8. Proposed:
CasingType:
H,ó, 'Bô< '3,o rg> èc,*tq/phone#: Gt¿)
qqS.lå= I c-57#: e cash Deposit
Depth:- )-O fvr ,n DepthìJl-Yes D No
From: V0F To: From: i¡0KFrom: _From:
To:
To:
To:
L,.uel lsrlgDEH USE ONLY
PERMIT # W
WELL COMPUTER #
FEE:
WATER DIST
enone:Ç$^-Já¿¡ - t2 3i
¡p Bond Posted
tr Public O lndustrial E Cathodic D Other
Q New Reconstruction fl Destruction Time Extension: O 'lst tr 2nd
u 2oo - þaç Existing:
Conductor Casing Filter/Filler Material PerforationstrYes QNo
Diameter ì in. Dia Type:
Wall/Gauge: .19 6 wall/Gau Wall/Gauge:
9. Annular Seal: Depth: 2() fnnnntt. Sealing Materiat:
Borehole diameter: I L ¡n. Conductor diameter:
10. Date of Work: Start: I - ;'' 9- ö'l Complete: l:)* * ô9On sites served by public water, contact the water agency for meter protection requirements.I hereby agree to comply with all of of Environmental Health, and with all ordinances and laws of
to well construction, repair, modification and destruction.the County of San Diego and oftwill Department of Environmental Health with a complete and accurate logI mmediately upon completion i, t
all permit and all work will be performed under my directof the well. I acceptsupervision.
Contractor's Signature: Date:
,/ DISPOSITION OF APPLICATION (Department of Environmental Health Use only)
ôlpproved D Denied Special Conditions: Grading and clearing associated with access to, or theconstruction, maintenance or destruction of water wells, may require additional permits from the County ofSan Diego and/or other agencies.
Specialist: Date: /- Z't-o_l
€Annular Thickness
DEH-LU-731a (Rev. 4/02) NCR Page 1 of 2
COUNTY OF SAN DIEGODEPARTMENT OF ENVIRONMENTAL HEALTH
control #: Lv""Pi t9lI?Assessor's Parcel Number: é.,5b -Ò 7A* q:
LOCATION
lndicate below the vicinity and exact location of well with respect to the following items: Property lines,water bodies or water courses, drainage pattern, easements, roads, existing wells, sewers and privatesewage disposal systems and other potential contamination sources, including dimensions.
>o'
t
! hoeOÊk 3pr'dlcl iìu''YEa
Ittto
Is3Ja>9Aa'
/)l'%.¿uw'nwho
,<.u"%ç,
'e/d?
II
o\)\9
I
DEH:LU 731b (Rev 7/2002) NCR Page 2 ot 2
V r'12*sffi*friË,o*,OYvne/rWoll NoJ u^ 0905184
Permit NO. ¡wel'¡c'¡¿lv Pem¡tDale 'l-¿4-ur
GEOLOGICLOG TYELL OUUÍ{ERoRENfAnoN rvr a*,"*
-xoRaoNÍAL -¡NGIE -(sp.""ngEäS_4g x"tary_FLUD waterI'ETSCRlPÎloil
MailingBoulevard Ca 91905
artrtreqe 909 Tierra Del Luna
DñrûÉ mdtd- dù, s¿¡.- æbr- de
ORIGII{ALFlbwltlr DWRPaso-l- or1Daþt¡rloftBeSan o'ru'u¿r ,Ended -E14mol Þ"-lr-
crrY yyELL LocAnoN srArE æ
^,-- ttoulevaro
APt.lBook.%Page uou ParceTournsnip l8s n¿,6e 6E seaio
;- AGnUTYL r'¡ewrvru
LalifuCþ I I ¡on¡sBÜ.6
lorgiürcÞ I I wsÉ5-R
IF ADDITIONAL SPACE IS NEEDED, AND CONSECUTIVELY NUMBER ALL
t<xr5tc.ÂTloN,REP TR
OeaFl(XEISôÉü,!
â!t!d6dút¡ffi.ffi¡,GEC,LæbLæ)
PI¡NNED USES (yJWAIÊNSUPPLY
-L-næ -æ
n¡a'n_Mru
DEPTH FROMSURFACE
AIINULAR TATERIAL
cE-MENT
BEI{.roNtTr Fllt
FILTER PACK(fYPE/S|ZE)Ft. to Ft.
o 40 x x
u 50u 5r1õ Well Rock
CERTIFICANON STATETET{TI, the underuigned, oelif lhat this report is comdote snd accr¡rato to the bêst of my knonledge and belief.
"or- Franks Well Drllling
l*rsûaþoroesøiôo æã,tã oÍUtwfrun Rogds, &ùk&As,Éroes, F ffi, efc and ffit a t W. Uæ &hbnat øÊ1 il
DEprHToFrRsrwATcp 130 Gr)BELowsuRFAcE
DÉPTI{ OF STATICw¡rent.evel-$L- (Fr)&DATEMEAsuneo 64{ESNMATEDYIELD (GPM)&TEST
TEST r.ENGTHra- (Hrs.) TOTAL DRAVìíDOWÌ{._!I!!_ (Ft,AL DEPTH OF BORING uuu (Feet)
DEPTH OF COMPLETED ì/I¡ELL 500 (Feet)
DEPTH FROMSURFACE
BORE-I{OLEDIA.
(lnôæ)
CASING (S)TYP lal
MATERIAL /GRADE
INTERNA¡.DIAMETEf
(lncñss)
GUAGEORWALL
THICKNESS
sLoT stzEIF A'.IY(rl(tË)
Yz5@
zuuÉ(J
f
ï!
U&ÀJJ
Ft. to Ft.
o 4U 'lz x Þregt þ.c . t004t) cuu þ.5U 5UU PVG +' SDR ZI .040
- ATTAC}ITENTS f Y¡-
- Geologiclog
- trþll Çq¡sfucüon Diagram
- Geophyslcal tog(s)
- SoilMater Chem¡cal Analysis
ATTAC'í ADDINONAL INFORMANON,'F'T ÐíSTS.
(PÉRsON, mU. OR CORPORAÎþN!
P.O Box 310153 Guatay C_a 91931
DWR 188 REV. 11-97 (REVISED 0&03 BY wr¡vw.Thecontmcioßcror¡p.com TO BE F|LL-|Î$ABLE)
couNry oF sAN DrEGo u) t'l tlé, ( tCil nK t A'DEPARTMENT OF PUBLIC HEALTH
WELL PERMIT APPLICATIONI600 PACIFIC HIGHWAY SAN DIEGQ. GA. 92tOI
Page 1
Permit No.
d¡tl
Commercial n
Community ÜOther
lndividualDomestic
AgriculturalI ndustrial
EOUIPMENT (Check)
Rotary ECable Tool Y'Other fl
TYPE OF WORK (Check) -/New Well úRepair ór ModificationTime ExtensionDestruction
PROPOSED WELL DEPTH
Max.
-
Min. (Feet) Diameter- Wall or Gage,
PROPOSED PERFORATIONS OR SCREEN
SEALING MATERIAL (Check)
Neat Cement tl Puddled Clay E
Cement Grout Ú Concrete V
co pt"t¡on f1c7- 3 c /fQa
NAME OF WELL OWNER NAME OF WELL DRILLER
LOCATION OF WELL
rr-f¿Rrt \)ú( .So , /,/<uh4ëLsBUSINESS ADDRESS
Brrrl¿ uA{2bLICENSE NUMBER
D¡SPOSITION OF APPLICATION(FOR HEALTH OFFICERS USE ONLY)
tr APPRovED n DENTED/\E] APPROVED WITH CONDITIONS
Report Reason(s) for Denial or Necessary Conditions Here:
I hereby agree to comply with all regula-tions of the Department of the PublicHealth and with all ordinances and lawsof the County of San Diego and of theState of California pertaining to well con-struction, repair, modification and destruc-tion. lmmediately upon completion of workI will furnish the Department of PublicHealth with a complete and accurate logof the well
APPLICANT'S SIGNATURE
?/ ?-¿/8Ò_,/ ,/ DÀTF
EALTH OFFICER
Cash Deposit EBond Posted 'æ-'
$?g-Fee paid on9-aA- f q P. ÒO-7A7
sAN 53 (5-741
ûOUNTY OF S¡rrl DIEGODEPARTMENT OF PUBLIC HEALTH
T600 PACIFIC HIGHWAYSAN DIEGO'CALIF. 92tOt
WELL PERMIT APPLIGATIO¡
Permit N
Assessor's Parcel No.LOCATION
INDICATE BELOW THE EXACT LOCATION OF WELL WITH RESPECT TO THE FOLLOWING ITEMS: PROPERTYLINES, WATER BODIES OR WATER COURSES, DRA]NAGE PATTERN, ROADS, EXISTING WELLS, SEWERS ANDPRIVATE SEWAGE DISPOSAL SYSTEMS. INCLUDE DIMENSIONS.
Page2 of 2 pages
*wl\oño$N
fi\,l'Rl.rw lRAøF Ê I
N
'zwí$;
---=-
^qù
-d'ù..út
{\
a
---
øt!re?r*¿,
aek-
õþcF.) î\wLøftrôô )lD s
qWæ \
ftä,ry /t Ø o
<o/1t te , /? ,,4,
Ø(c¿c*
sAN B3 16-741
Do Not Fill InCOUNTY OF SAN DIEGODEPARTMENT OF PUBLIC HEALTH
r 600 PAcrFrc H|GHWAY, sAN DtEGO, CA 92t 0r
WATER WELL DRILLERS REPORT
(r.) owNER:
NameAddress
(2) LOCA N OF WELL: Owner'snumber, if anCount
Township, Range, and Secüion
Distance from cities, roads, railroads, etc.
If destruction, d.escribe mnterial and procedure ín ltem 1 1.
(3) TYPE OF WORK (chech):
Ñewwetll Deepening E Recondiüioning ! Destroying
State \{ell No.
Other Well No.
(L1) WELL LOG:
Total ft. of completed ,"tt '//Ò ft.ormation: Describe by color, character, size of material and structure
ft. to fr.
WELL DRILLER'S STATEMENT:Thís well was drílled under my jurisdiction and this report is true to
the best of my and
NAME
l¿
¡
(4) PROPOSED USE (chech):
DomesüÇIndustrial I Municipal fl\rngation W Test Well I Other I
6) CASING INSTALLED:srElt-t/ orHEF!l
snct-2Ø/,,ouer-e t
!'romft.
Tofr. Diam.
Size of shoe or well riDescribe ioint
Gageor
Wall
7) PERFORATTONS OR SCREEN:'ype of perforation or name of screen
!-romfr.
(B) CONSTRUCTION: To whatWas a surface sanitary seal YesZl No trWere any strata sealed n? Yes E
of strata From ft. to ft.From ft. to ft.
Method of sealing
(9) WATER LEVELS:at which water was first found if known 5l fr.
fr.Standing level before perforating, if known
Standing level after perforating and deve
(10) WELL TESTS:Was test made? Yes E Nol rc whom?
Yield: Zô gal/min. with ft. drawdown afterTem of water Was a chemical analvsis made
Was electric loe made of well? Yes I No License No. 3// Li21SKETCH LOCATION OF WELL ON REVERSE SIDE
OVER
(5) EQUTPMENT:RotaryCableOther
trtr!
If gravel packed
sAN 52 (9-74)
Dated,"r, ., ,î
,IØ
Contrr t, u)00. )G,
TYPE OF I{ORK (Check)
Ner rlerr là[Repalr or Modlf lcatlon l=lTlne Extenslon l-lDestructlon l-l
USE (Check)
lndlvldual Donrestlc ]!Agr I cu ltura I l-lI ndustr I al l-l
Connunlty l-lûthen
EQU!ruENT (Chcck)
Rotry ,,&Cable Tool l=lothcr El
PROFOSED TIELL DEPTH
Max. .2øO Mtn. /OO (Feet)
PROPOSED CASING
TvpeSTeel- oeptn 2o I Dtaneter /{ " yart r aas" ./52PROPOSED SEALI NO ZONE(S )
to
to
fo
PROPOSED PERFORATIONS OR SCREEN
From
From
Frcrn
From
From
From
From
to
to
to
to
Feet
Feet
Feet
Feot
Feef
Foet
Feet
Bentonlte Clay ElOoncrste El
SEALING M TERIAL (Check)
Neat Cgrpnt Grout E]Sand Ceflþnt Grout l:Other-Spec I fy:
DATE OF ïMK
NAI'IE 0F I{ELL O}INER
f/leoaa*e 4 îose¡v*<y fenrc/4sI,¡AME OF T{ELL DR ILLER
6/1L ÞtoF/z {rTLOCATION 0F }IELL 6pu1eL'/]/<2?/û V€Kr4 2e( So( Êo c/llty'<#? COI.IPANY
E 1, (ttØrts Qa,l U ry Øl/LL//véDI SPOSITION OF AFPL ICATION(Ffi IIEALT}I çFICERS 9SE OfY)
l{maoveo l: DENTED
l-l AFPRoVED }t|TH CONDTTTONS
Report Reason(s) for Denlal or Necessary Condltlons lþre:
ii;ä ffi\¿ ßo, ç tr f, ¡' - íîífrLICENSE NUMBER
J4eJ2? Cash Deposlt
Bond PostedKr=r
I hereby agree to comply rlth al I regulatlons of theDepartment of Health SErv lces and rlfh al I adt-nances and lars of the County of San Dlego and ofthe State of Callfornla pertalnlng to rell construc-tlon, repalr, modlflcatlon and destruqtlon. lmncdl-ately upon conpletlon of rork I rl I I furnlsh thcDepartment of Health Servlces wlth a conplctc andaccurate log of the rel l.
6,/-Æâ*2APPLICANTIS SIGNATURE
., /^* /'* n
/ /oxte v-
$ITY f Stt DIESDEPARTT.IENT OF HEALT}I SERVICES
- 0qo-36NnCJ tFrL PERttr(./\
^FL|C,AT|C
S..tnog
I
so
ìI
õ
DHS:EllP-751 $/85) Page I of 2
COUNTY OF SAN DIEGODEPARTMENT OF PUBLIC HEALTH
T600 PAC¡FIC HIGHWAYSAN DIEGO'CALIF. 92¡Ot
WELL PERMIT APPLICATIOI\ Page2of2pages
Permit N". U)OA77/
4-N+L
Assessor's P^r."1 No.L S?-oFa '^ o 7LOCATION
INDICATE BELOW THE EXACT LOCATION OF WELL WITH RESPECT TO THE FOLLOWING ITEMS: PROPERTYLINES, WATER BODIES OR WATER COURSES, DRAINAGE PATTERN, ROADS, EXISTING WELLS, SEWERS ANDPRIVATE SEWAGE DISPOSAL SYSTEMS. INCLUDE DIMENSIONS.
sAN r3 (6-7¡l
County Mail Statiòn -A'21I
FIRST CARBON COPY
Not¡co of lntcnt No.Local Permit No. or
Ðev tf t vtSt LU oû 7q(cou n-iY-oFsÃt ¡ o I eGõ_*'
DEPARTMENT OF HEALTH SERVICES17OO PACIFIC HIGHWAY, SAN DIEGO, CA 92101
WATER WELL DRILLERS REPORT(INSERT under ORIGINAL PAGE w/carbon of State Form)
ASSESSORS PARCEL NUMBER :
6Çg
Sut¿ Well No.Other Wetl No.
(12lWELL LOG: Torat ît. otp,t of complered wettLlLrt.f rom f t. to ft, Formation Describe .by color, character, size or materiall
Town¡hip- Rango
Orvræ¡'¡ Well Numbr
Section
(3I TYPE OF WORK:
New Wcll ! Deepening O
Fleconstn¡ction EFleconditioning tr
Well trDe¡truction E (Desc¡ibc'desm¡ction material¡ andprocedures in ltem (2)
(4I PROPOSED USE:
Domestic fllrr¡gstion trlndr¡lrid trTest Well trStock BMunicipal trOther E
(61 Gr¡v¡l P¡d<:
Ye¡ O tto fiSize
Packed from
-
to
-
ft.
C}EPAßTMS1.,!T USg ONLY
Completed Well Construgdon:
- 11-Daæ lnspecæd
Comments
Water Sarnple Taksn?
Ssnitarian's
{51 Equipmcnt:
Rotary ü Rwene
CaHe tr AirOther E Bucket
{71 Caring lnr¡llod!Steet tr Pla¡tic'E Concrete E
(9} WELL SEAL:
Wa¡ s¡¡dace sanitary seal provided?ver ff No tr lf yes, to depth 7 O n.
WerslrâEsealedageinstpollution?YesBNoE'lnærval-ft,Method of
workstarted r{-?-S ßg-(ê-compteted 4''/¡ 1&6
IIELL DRILLERS STATEIGXT: I hereby dec'l are under penal t¡rof perjury that the information provìded in this reporiis'truê.'This water well was installed in compìiancewith S¿n Diego County Code and State of Cal i fornia
'
trotr
Fromfr.
(101 WATER LEVELS: ã *Depth of f¡rst watar, if known I h Ð
=Sanding level afte¡ well complet¡on €D fa.
r{ì th 5¿n uìe90 Loun[y Looe ano, -)EðEe or Le
Department of -!tater Resources. Bul ì etin No. 71.
tàè- - Ãr--\
iilff:::lïi yov No tr rr vec, bv 'ñom,edn'ltÞ oill'if
Type of test Pump E ¡ þiler g Air iiftp lh
nÞôrh ?ô MrcÍ år çrâñ nl tßt (ÞtL ¡¡. At end of tert Jll- ft.Depth to wa¡ry at rtan or i*t -b$-,r. at en¿ át *. IDischaræ-l- gal/min after sZ- houn Water temperature
SIGNED
NAM
Addr
City
Ctremical analysis made? Yes E ¡¡oÃl tt Ye3, bY wtrom?License No Date of thrs reoort
wil sl€ctr¡c ioo made? Yes 0 lf ves, attach
DHS:EHp-732 (8€oNF|DENT|AL - NOT FOR pUBLIC USE - WATER CODE SEC. 13752
. 00üxrYfsIDlEeoDEPARI}IENT OF HEALTH SERVICES
Control fTYPE 0F l{GK (Check)
Ner t{ell lFRepalr or Modlf lcatlon l-lTlme Extenslon l-lDestructlon l-l
lndlvldual Domesttc FAgrlculfural l-l Connunlty
I ndustr I al l-l other
EQ|JlPilENT
RotryCable Tool
Other
(Chcck)
Fr=rl=t
PROPOSED }IELL DEPTH
Max. _Mln. _ (Feet) ,vr",5(É(L2
Dep+n .7O Dlanoter
From
From
Frm
PROPOSED PERFORATIONS OR SCREEN
to
SEALI NG I-IATERIAL (Check)
Neat Csnent Grout
Sand C¡nent Grout
Other-Spec I fy:
,r*r - q^ /î- %compretron // -âO - 4
}'IAME OF I{ELL DR ILLER
w vELr-, bbb
BUSINESS ADDRESS
/41/ PÍ% tTry\ { l3o.' [¿,un¿.| Q4,Y1-aaçD I SPOSITION OF AFPLICATION
(FM TEALTTI çFICERS TS€ OILY'
l-l APPRoVED v{|TH CoNDTTToNS
Report Reason(s) for Denlal or Necessary Condlllons llere:
Cash Deposlt
Bond PostedETr=r
Í ?f*Fee pard onLl^l4-%
I hereby agree to comply rlth al I regulatlors of füeDepartment of Health Serv lces and rlth al I ad l-nânces and lars of the County of San Dlego and ofthe State of Cal lfornla perfalnlng fo rel I oonstruc-tlon, repalr, modlflcatlon and destrustlon. lhncdl-ately upon completlon of rork I rl I I furnl¡h thcDepartment of Health Servlces wlth a ærplctc aldaccurafe log of the rel l.
\^oo
Ico
l
.bO{
T LPEN;IT ^ IO\^Fr-rc^ilo:+ xo" ^ftiçrV "41 nq
DHS:EHP-751 lJt851 Page I of 2
COUNTY OF SAN DIEGODEPARTMENT OF PUBLIC HEALTH
T600 PACIFIC HIGHWAYSAN DIEGO'CALIF.92IOT
WELL PERMIT APPLICATION Page2of2pages
Permit N". (r )Oô7UiPAssessor's earcer no.6.F9- OS l- nr.{
LOCATION
INDICATE BELOW THE EXACT LOCATION OF WELL WITH RESPECT TO THE FOLLOWING ITEMS: PROPERTYLINES, WATER BODIES OR WATER COURSES, DRAINAGE PATTERN, ROADS, EXISTING WELLS, SEWERS ANDPRIVATE SEWAGE DISPOSAL SYSTEMS. INCLUDE DIMENSIONS.
oo.davpt / íz
r1't I N
F\
v)-o
\.rorJ y207 ll}n/-
l-
,b"n2+ +-
.4
sAN t3 l!-?4¡
county Ma. station -)k f ., í i :,Fr'sr " Ç!"**té¿i,. ('. // ,:.3
L¿ _ tr,l
,74L'
'"y/ø/'ØÍîáza /,COUNTY OF SAN DIEGO
DEPARTMENT OF HEALTH SERVICES17(þ PACIFIC HIGHWAY,SAN DIEGO,CA 92101
WATER WELL DRILLERS REPORT
ASSESSORS PARCEL NUMBE R :
b6cA àt aQ
Local Permit No. or Date (INSERT under ORIGINAL PAGE w/carbon of State Form)Not¡cs of lntent No.
(1} OWNER:Adclesc
c¡w
EI LOCATION OF WELL (Sce in¡trucríon¡l:
County Owngr'sv
Wcll addres¡ ¡f d¡ffersnt fiom abovc
Date lnspectad
Comments
Water Sample laken?
Sanitarian's
(51 Equipmcnt¡
Rotary A, Rwer¡o
CaUe tr AirOther E Buckot
{71 Ca¡¡ng lní¡llod:Stær ! fla¡tic'E Concrete E
(9I WELL SEAL:Wa¡surfacesan¡tarysealprovided?YoÛNoElfye6,todepth-ft.Wero strata sealed ¡,¡oát
Msthod of
Completed Well Conctrucdon:-
o.r t4- 01- Y6-/q-g I
(10) WATER LEVELS: .. .
Depth of first water, if known I '{e n,
Sanding level after w€ll complet¡o n lO n.
No tr lf yes, by whom? gryltlP
Stats W€ll No.Otfier Well No.
{121WELI LOG: Toaldepth
-ft.Depü of completed w€ll
-ft.
fromft. ro ft. cllor, charsctor, sizs or matarial )
workstarted 1'Fl' ,"1b compreted l1-U -¡t%---IELL DRILLERS STATEIGIIT: I hereby decl are uncler penaì ty
of perjury that the information provided in this reportis true. This water welì was installed in complìancewith San 0ìego County Code and State of Cal'i fornia,Department of lJater Resogrces, Bulletin No. 74.
SIGNED
c¡t¡€t, road!,tc.vbA
OEPARÎMENÎ USE ON¡LY
Etrcl
Fromft.
{11I WELL TESTS:
Wa¡ uæll te¡t msde? Ye¡ts!
;:::,îi*.,*J:Ïåo. ryf"';:o i'Ï'f*. to n.
Oisctrarg-$-gl/min ¿¡s¡ J ¡6u6 Watertemperaturo
-
O¡emical analvsis made? Yes tr ruoÚ lt Yer, bV whom? Dare ol thrs report
War elecrric loa made? Ye¡ tr ¡¡o f lr ves, attach copv to tlti¡
{3I TYPE OF WORK:
. NewWdlfiDeepening ERocon¡trustion ERecond¡t¡on¡ng BHorizontal Well trDestruction tr (Dercribedeetruction materi¿l¡ and
(4I PROPOSED USE:
Domestic
lrrigotionlndustrio¡
Te¡t Well
Stock
Municipal
Other
Ftrtrtrtrtrtr
(61 Gr¡v¡l P¡d<:
Yer If No tr size
Packed from
-
to
-
ft.
DHS:EHp-73Z (8€oNFIDENT|AL - NOT FOR PUBLIC USE - WATER CODE SEC. 13752
Control fTYPE OF I{ORK (Check)
Ner }{el
Repalr or Uo¿ltlcatlon l-lTlme Extenslon |]lDestructlon l-l
USE (Check)
lndlvldual Domestlc g.Agr I cu ltura I l-l Corrnun lty t-tIndustr I al l-l Other
EQIJ lPllENT (Chcck)
Rotry [31Cable Tool Elothcr |-l
PROPOSED I{ELL DEPTH
uax. 4oo Mtn. --æ- (Feef)
PROPOSED CASINO
Type V?e L oeptn .)/ |
Dlamster it " Ìlal I r Gage
PROPOSED SEALINO ZONE(S)
From
From
Fron
to
to
to
Feet
Feet
Feet
PROPOSEO PERFORATIONS OR SCREEN
From
From
From
From
to
to
to
to
Feot
Feet
Feet
Feet
SEALI NG ttATERIAL (Check)
Neat Cement Grout l:Sand Cenent Grout lf
Bentonlte Clay ElConcrete El
Ofher-Spec I fy:
DATE OF I{ORK
Starf
Comp I et lon
NAr'18 0F WELL OI{NER t0_61 iírc*a**Ì ooq
/vlU¡t O u,tl t.f /\" {i,Ca.ton 4to:tt¡IAME OF WELL DR ILLER
ß-r(%*uLocArroN 0F I{ELL f,lK é S?-A^{C--Îj
7 2 ç fle4+lt Ðr,( urv4,onerr r, ^ / &.r)¡ c't) Wf o*ß i s c^/ D,<t¿t-/.y6
D I SPOSITI ON OF APPL ICATION(FM ffiALIH çFICERS ÚSE OILY'
./11( APPRoVED l-l DEN tED
l-l APPROVED }{tTll COI{DITtONS
Report Reason(s) for Denlal or Necessary Condlttons lþre:
BUSINESS ADORESS-ni;"äiì')/t tkQtre û qro. t
LICENSE NUMBER
Cash Deposlt
Bond PostedrfEL
Fee oald ôn
I hereby agree to comply wlth al I regulailons of theDepartment of Health Servlces and rlth all adl-nances and laws of fhe County of San Dlego and offhe State of Callfornla pertalnlng to rell construc-tlon; repalr, modlflcatlon and destructlon. lnncd¡-ately upon completlon of rork I rl I I furnlsh theDopartment of Health Servlces rlth a ænplete ardaccurate log of the rel l.
corrxTY f slll DlEeoDEPAR'ÍT,IENT OF HEALTH SERV ICES
'#IL Ft;ilIT
^FLIC Ttü ^il/.(? êtê 3':?
#l4tK
(t\g
I
o(){o
uJ
DHS:EllP-751 6/85')trJ vrv V)
Page I of 2
COUNTY OF SAN DIEGODEPARTMENT OF HEALTH SERVICES
I{ELL PERI,IIT APPLICATI0II Contro'l #
Assessor's Parcel No.LOCATIOl{
INDICATE BELOl,l THE VICINITY AND EXACT LOCATION OF I,IELL WITHITEMS: PR0PERTY LINES, þJATER BODIES 0R WATER COURSES,
EXISTING I,IELLS, SEWERS AND PRIVATE SEI,IAGE DISPOSAL SYSTEMS
TAMINATION SOURCES, INCLUDING DIMENSIONS.
RESPECT TO THE FOLLOI^IINGDRAINAGE PATTERN, ROADS,AND OTHER POTENTIAL CON-
(rtPtøeo Wrc
Iil
_0'-
I
Ptoc¿5nq Åv'^rtot/14¡ ¡¡ r-tìrf cTueep // tq e
lo,4c çrr'os'S
1,r l.< t\ttt
y'lt c
Ç/9zt
vvt-
A 'tÐL
DHS:EHP-731 (3/85) Page 2 of
ASSESSORS PARCEL NUMBER :Couáty Mail Station -A'21
FIRST CARBON COPY
Notice of lntcnt No.Local Pormit No. or
&- Òtc sJ
Datc
-
(INSERT under ORIGINAL PAGE w/carbon of State Form)
Distancr from c¡t¡€a, roads, ra¡lrosdt, fenca¡, etc.
DEPARTMENÎ USE ONLY
Completed Well Con¡truction:
Date
Dato
-4'
C¿mment¡<; 7-?
Water Sample Taken?
Senitarian'¡
(51 Equipm¡nt:
RoËry ECable Bother E(7l Ca¡ing lns¡¡llod:
Sred E Pla¡tic'O Concrete E
(9I WELL SE.AL:
Wa¡ surface san¡tary leal orovided?Ye¡þ No tr
{1} OWNER: l¡.m.Adc}e3s
C¡ty
Were rtrata s6ôl€d agg¡n3t
Method of seal
Was electric
(101 WATER LEVELS: /e--Deprh of f¡rst waûrr, if known /\J O - n'
S€nd¡ng level after woll complotio n 3f) A'
111I WELLTESTS:
Wa3 \,wll tort made? voìf- No E lf yes, bv vr¡trom?
Type of tsrt pump b Bailer E 'Air i¡ft */Depth to wster atlst¡¡rt of to3t- ft. At and of tftrt
-Oiæna¡ç-Úgal/min after
-hours
Watcrtampeature
Chemical analysis madc? Ye¡ E t'¡oll- tt ves, bv whom?
(See in¡truction¡l:Owner'¡ Well Numbor
Section
Revene
AirBucket
tf y€É, to ¿eptn 33 n7Yæ r
-
ft.
? Yer tr ¡to GL lf Yes, âttach to ttris
of perjr¡ry that t,he informatìon provid-eC in t^is reportis'truä. - This water well was installeo in :?ñoliancstti tn San D'iego County CoCe and State of
-C: ì : ícrnia '
EXtr
Fromft.
SIGNED
Aodress
Crty
L¡cense No
(21 LOCA'
U o//ôEState Well No.Oth€r Woll No.
(12) WELL LoG: Total ¿"ptÕítt. Depth or complottd *"tt 3 7'lít.from ft. ft. Formation (De¡cribe chsracter, s¡ze or material l
Work started ß F7 comptðted"--. .. _ _.f_
IIELL 0RILLERS STÂTElGllT: t hereby deciare uncsr cenajt]
(3I ÎYPE OF WOñK:
NewWdl-fl4eepening EReconstructìon trR€cond¡tioning trl'lorizontal Well tr.€)cftrustion tr ( Dccribede¡tn¡ction materials andproceduæs in ltem (21
I4I PROPOSED USE:
Dome¡tic .qlrrigstion 0lndustrial trTe¡t Well trStock trMunicipal O
other tr
fl -3'T"T ",- 6s'þ'Yç,4- No tr Size
Packed from -Q-to
L2Æ-ft.
DHS:EHp-732 (8€oNFIDENTIAL - NOT FOR PUBLIC USE - WATER CODE SEC. 13752
ooútTYosxDtEs E.L PER;ITr'r ranr*r d" l. *,kZ__ü_a^â_DEPART}IEN'I' OF HEALTH SERVICES l¡rLle Ttq
o þrt oll (( cont"o¡ ¡ l¡O53oTYPE 0F I{ORK (Check)
Ner l{el t ,tRepalr or Modlf lcatlon ElTlme Extenslon l-lDestructlon l-l
USE (Check)
lndlvldual Domestlc {Agrlculfural l-l Comnunlty l-llndustr I al l-l Other
EQtrlPl,tENT (Ghcck)
Rotry trCable Tool l=lother l=l
PROFOSED TIELL OEPTH
uax. /Øël) utn, -M-(Feet)
PROPOSED CASING
Dlanster > l( nall .:l. aog /f6PROPOSEO SEALING ZOI{E(S)
rr(l,[t € +o L2
PROPOSED PERFORATIONS OR
to
to
fo
to
Feet
Feet
Feet
From
Frcrn
From
Fron
From
From
Feot
Feet
Feet
Feet
Bentonlte Clay AConcrgÌe El
SEALI NG MATERIAL (Check)
Neat Csnent Grout l=Sand Cement Grout l]Other-Spec I fy:
DATE OF t{GK
starr 3-/t-?CCompletlon t/- tf ' 7L
NAIJIE OF WELL OWNER
Ll.p rlnu'r A , "'.l* lltJtlsfI.TAME OF I{ELL DR ILLER
/t*l Di. o ,þ nþLoc^Ttoil 0F I{ELL
q 7 L TrL, urn b¿ t .ñ L A ,l Eeu lcdc¿¿
COifANY
lr"ntyS u_z// nr//t;DISPOS ITION OF AFPL ICATION
(FM ffiALTTI çFICERS USE OñLY)
ìViì APPRovED l-l DENTED,7\,l-l AFPRovED t+t"rlr coNDtloNS
Report Reason(s) for Denlal or Necessary Condltlons lþre:
BUSINESS ADDRESS U
/g ß*lzto I*'Z 6r,'ho-* Co ?¿zLICENSE NUMBER
4?tt*,u
Cash Deposlt l=Bond Posted l=l-
Ztf Fee oard on 7 ) Å/q< Gn
I hereby agree to comply wlfh al I regulatlons of theDepartment of Health Servlces and rlth all adl-nances and lars of the County of San Dlego and ofthe State of Callfornla pertalnlng to rell construc-tlon, repalr, modlflcatlon and destruqtlon. lnncdl-ately upon conpletlon of rork I rlll furnlsh theDepartment of Health Servlces rlth a conplete ardaccurate log of the tel l.¡r/o ct*7¿ DitT<'¿7
HEALTH OFFICER
3-//,7( 7- lrl çeDATE
/
DHS:EHP-75I $/4,, Page I of 2
COUNTY OF SAN DIEGODEPARTMENT OF HEALTH SERVICES
I{ELL PERI.IIT APPLICATIOI{ contror # [,JC6]ÐiAssessorts Parcel No.
RESPECT TO THE FOLLOI.JINGDRAINAGE PATTERN, ROADS,AND OTHER POTENTIAL CON.
LOCATIO¡I
INDICATE BEL0tl THE VICINITY AND EXACT LOCATION 0F T,IELL t,lITHITEMS: PROPERTY LINES, IIATER BODIES 0R WATER COURSES,
EXISTING WELLS, SEI,IERS AND PRIVATE SEI^JAGE DISPOSAL SYSTEMS
TAMINATI0N SoURCES, INCLUDIN(tDIMENSIoNS.
^ a ?-/r
Iil
î
I(
,T,\
d\Ae-tÚoí-[- !rä^*ï7r o
fr&s ur/'il tln\*ftl olc-t"ttl
f 'r*,,
4.f'l ki; s"r''
ij;$o ¿4
+ '5þ/*
,fr'
DHS:EHP-731 (3/85) Page 2 of 2
GARY R STEPT{ATfI
otFECloR
I.A}ID USE DIVISION338 VrA VERA CRUZ, t20l - ^éñ uencos, cA 92069-2620(619) 47r-0730(619) 940-2925 rÆ(
OWNER:
Deer PropcrtY Owuec
6.rrarúg'tf F*o PteguOEPARTMENT OF ENVIRONMENTAL HEALTH
P.O. 8OX 8s26t. sâô¡ olE@. CA t2toes¿slGtg) 33t¡-2222 FA(t6t9l Cl8'23r7
OANIEL J. AVERA
åssrsT^ñf otREgfoR
j
wELL PERMIT NUMBERv@-APN--' V/ELL
This latcr is to íoform You that e:
-X- Dooestic wcll
CoomunitY wcll
Agriorltural wcll -
Otbcr
Indust¡ial well
bas bcca approved to bc instaltcd oû your propcrty. Tbc follcn¿iog !¡t¡tcd oooditions of approvd apply:
prior .o usc of this wcll ¡s a drioking warcr sourtê, bæcriological a¡d oitnt¿ aoatysis sbould-bo donc to ]s¡f compliancc
wirh Statc ste¡d¡¡ds. N" r.p,¡; *i gog¡it v/iu bc is$cd uJ"ss tbc saoplirg a.od aralysis is coopletcd and approvcd by
this Deparmeot and aa approvcd wcll log is rcccivcd from tbe well drillcr'
This well was aot proposcd to bc uscd as a drinkiog u¡ncr op¡þ. coi¡vcrsioo to a domestic wcll will require bacteriological
and nitnte analysis to cosürÊ cooopliaacc witb Stato g-nd¡fds.
prior.ro usc of rlis wcll in a public watcr opply, appro¡ral froo tbc eppropriatc rcgrrlatory â8èDcy oust bc obtaincd. coshcr
this D"p"rto*t's so¡llltaær s¡ttem slccidist ¡t 56951?3 for ¿ssisu¡cc.
This wcll is oot approvcd for poreblo usc a¡d sball not bc i¡rcrcoo¡cc¡cd witb tb¿ cxisti¡g poublc rvatcs sygcm' lo additioa'
an approvcd baculow prcncotioo dcvicc must bc instellcd a¡ tbc r¡æll bcad to protcct tbc wcll from potcntial cooteminatioo'
Tbis well site is locatcd in ea are¿ urùcrc grouodwatcr is kmr¡¡o to b¡vc high nitntc tcvcls. Tbc complacd wcll ca¡r bc used
for inigation purposcs only uotil it bas bccn tcsrcd a¡d approvcd l safe ui r¡¡s Dcpertmcot. unlcss it c¡n bc demonstra¡ed
thar poLblc *arci standatat ot bc oct. septic UnlS a¡d/or buildiog Pcrm¡ts c'nñot bc isslcd'
ln addition. included in rhc wcll pcrm¡r fcc is thc provision for onc watcr samplc ¡o bc collcc¡cd by rhis Depalment' Bactcriologiczl.analysis
and a nirntc scrccning ¡cst rviu bc pcrfornrca. The srmglc will bc åkcn for up to ooc ycar from thc <tatc of the approval
of tl¡c well permit.
tf you hfvc any qucstiors, plersc conurct one of tlrc fotto*ing lîdd ofr'¡ccs: El Cajon at 4414666, Ruffin Ro:¡d ¡¡t 565'5t73'
or Snn lr{:¡rcos at 471'0?30.
I,lo ¿,Jt> G< ' Dù2.¿,¿f _
If a public water supply is cuncntly scrvingprotcct¡on rcquircmcnts
this propcay, you must coûtact your tocal \va¡cr agcncy fof watcl mètêf
tlater Dlscrlct:
(2les)'Prcacncbn Qmc¡ Fírtt'
Local PermitAgency San Diege eeunÈy EnvirenmenÈal hea*bhPermit No. üf05303 Permit Date W
GEOLOCIC LOG
oRIENTATION ( / ) x- vÉRflcAL
-
HoRTzoNTAL _ ANGLE _ (SPECTFY)
, DEPTH To FIRST W^TER /46 (FI.) I}ELOW SURFÅCE
DESCNIPTIONDesril¡e mote¡ial, gain size , color, etc
WELL O}VNER
Address 972 Tierra ÐeI SeI RÐ;City Beu+evardCounty Sa n lt'i egoÅPNBook658 Page 09 Parcel 19foffi'sniplBS lìang$E Section 11LatituderrNoRrHLongituderrwEsr
DEG. MIN. SEC. - DEG. MIN. SEC.
LOCÅTION SXETCH ÅCTIVITY ( / )
--X"e* *e..
SOUTH
MODIFICATION/REPAIR
- Oê6pon
- Olh€r (Spoc¡ly)
PLANNED USIi(S)(!-l
- MONITORING
WATER SUPPLY
w+ Oomoslic
- Public
- lrrioat¡cn
- lnduslr¡al
- "TEST WELL"
- CATHOOIC PROTEC.froN
- omER (Sp€cily)
OEPTHFROM SURFACE
ANNULAR |vfATERIALTYPE
cE-MENT(L)
8EN.ONITI
(é)FItL(L\
FILTER PACK(TYPE / SIZE)Ft- to Ft.
// i.4,/^
(r/ i->u t'/ ,¿.¿¿/^(*/
/4#CERTI FI C¡\TIO N STÀTEiVI ENT
I, the undersigned, certify that th¡s report is complete and accurale to the best of my knowledge and bel¡ef
Franks Well DriIIin(PERSoN. frRM, 0R C0ßP0RAÍ0N) (
P.O. Box 310153 Guatay, Ca 91931
Name HerberË MeoreÌvtailingAddressA^??7 O] r1 Hwy 80
WELL LOCÅTION
q g?aN
tlo'
Tt erølllustnle ot Descr¡be Distance of Well from LandnnrkssucÄ ¿s Âo¿rls, Build.ings, Fencei, Rioe¡s, elc.PLE,^SE BE
^CCURATE Ü COMPLETE.
- OESÍROY (D€scriôePtocedures add MateialsUnder "GEOLOGIC LOG")
DRILLING À i TMETHOD Rotary ,,_r,o Water
WÅTER LEVEL & YIELD OF COùfPLETED WELLoEPrH OF Srlifrc lla,.WATER LEVEL
ESïMATED "rrro'--l-
(cPM) e ,rr, ,"r, Â-TESr LENGTH ,2 <^r") rorAL oRAwoowi- L/flç<n.la fulay not be rcpresmtatioe ol a,oell\ long-tmn yield.
TOT¡\L DEPTH OF BOfiING '1 ¿lLr' gee¡\
TOT¡\L DEPTH OF COMPLETED çELL --fOÚ ç""r1
DEPTHFROM SURFACE
BORE.HOLEDIA.
(lnches)
cAsINc(s)TYPE (
MATERIAL/GRADE
GAUGEOR WALL
THICKNESS
SLOT SIZEIF ANY(lnches)
zó
zDIAMETER
(lnches)Ft. lÕ Ft.
/ ) i '>/') // 7In>5H Lo V? , /1lt LI, It
0 iS(X) la/)t) 3(f) >udb¿/ 7 ,774'/ e UYU
ÂTTACHì!IENTS
- Geolog¡c Log
- Well Construcl¡on Oiagrâm
- Geophys¡cal Log(s)
- So¡l/waler Chemical Analyses
ATTACH ADOIIIONAL INFORMATION. IF 'T
€X'STS.
DWR tfß RE\',. 7.90 IF ADDITIONAL SPACE IS NEEDED, USE NEXT CONSEC Y NUMBERED FORM
1 -29-97
'ùiq$ COUNTY OF SAN DIEGODEPARTMENT OF PUBLIC HEALTH Pagelof2pages
Nns
IJU
ã
$vWELL PERMIT
t600 P/ICIFIC HIGHWAYAPPLICATION
SAN DIEGQ. CA.Permit N'. k ) f¡OJ ¿/7-
92t Ot
ÕO\qt
u\LJ-t
\0
TYPE OF WORK (Check)
New Well .ryRepair or Modification LJTme Extensíon -Destruction El
USE (Check) \et'nogå1#31 ," PH co""'¡'r ' @Agricultural fl Community Elndustrial n Other
EOUIPMENT (Check)
Rotary nCable Tool E
ttOther ,4 rl ,\
Max.
PROPOSED WELL DEPTH
Min./î'0 ffeetl
PROPOSED CASING
ACt ' oi"-"r", 7 " wat or c^n"rf.éType:
PROPOSED SEALING ZONE(S)
rro,n-{- to
From
From
Feet
Feet
Feet
PROPOSED PERFORATIONS OR SCREEN
From
From
From
From
Feet
Feet
Feet
Feetto
SEALING MATERIAL (Check)
Neat cement È( Puddled clay ECement Grout n Concrete Ú
DATE OF WORK
st"ft /j,/15/,t 3
co^pr"riont '/4 7/{3
.îï;:::y re#M .^w^Y'Hy. ahrtLocnroru ?f 'ELL "fü^^f Ð./-/",-64^4,J, n.//^Ì ß.*s0t3 úl¿rt 4
DISPOSITION OF APPLICATION(FOR HEALTH OFFICERS USE ONLY)
€ APPRoVED E DENIED
E APPROVED WITH CONDITIONS
Report Reason(s) for Denial or Necessary Conditions Here:
BUSIÈ/ESS ADDRESS tV?# L ar-* 7t á:-o,Jl-,9st¡LICENSE NUMBER
:< Ì +? ,rsCash Déposit
Bond Posted4E
a oo"4 6$25_ Fee paid on
I hereby agree to comply with all regula- Rtions of the Department of the Public ylìHealth and with all ordinances and laws q I,
of the County of San Diego and of the -State of California pertaining to well con- tEstruction, repair, modification and destruc- !*.-tion. lmmediately upon completion of work f0I will furnish the Department of Public 7ifii1! ;tJTi
. comprete and accurate ros Z9"Ar/ZZ- q3-'fu
<<2 /rsAPPLTCANT'STS'GNATURE J
,t, / s â/f3DATE E!ATË
sAN õ3 lõ-7/rl
COUNTY OF SAN DIEGODEPARTMENT OF PUBLIC HEALTH
I600 PACIFIC H¡GHWAYSAN ÞIEGO'CALIF. 92tOT
WELL PERMIT APPLICATION Page2of2pages
Assessor's Parcel No.LOCATION
INDICATE BELOW THE EXACT LOCATION OF WELL WITH RESPECT TO THE FOLLOWING ITEMS: PROPERTYLINES, WATER BODIES OR WATER COURSES, DRAINAGE PATTERN, ROADS, EXISTING WELLS, SEWERS ANDPRIVATE SEWAGE DISPOSAL SYSTEMS. INCLUDE DIMENSIONS.
Permit n'. (.u nrla4{
ü
b
d
&e, /) c,
-f-, D' S,
t&¿.t¿la
S. ts I tK-:;
:ä;;/**.La/
il¡r,s e\ ÎaçTg"¿,t ø.4,*i,l
w'eçT- S
t?o(,
Rl -¡ - r3t,l
Bar\"a {awel[sìte !
,ú00 !";*^Þ.g
sAN A3 (8-7i¡l
County Maìl Station -A-21
FI RST CARBON COPYsend to County Health Dept. Room 104
Noticc of lnrent No,Local Permit No. or Date
(1)€NN
Adcf essltg
City
Ø(t o 3,Jg,u->'J¿t4'L.
couNrY or dru orEcoDEPARTMENT OF HEALTH SERVICES
17OO PACIFIC H¡GHWAY, SAN DIEGO. CA 92101
ASSESSORS PARCEL NUMBER:,/'t(_r,h,, ((.¿.- f ¿-_--1---
3 WATER WELL DRILLERS REPORT(INSERT under ORIGINAL PAGE w/carbon of State
fromft. to f(. Format¡on (Describe
zip
*u^*,t !
(12) WELL LOG: Total o"orn Jú or compreted *"u /5 4r.
State Well No.Form) orher wett No.
ch ara cter sizeor materiall
(51 Equipmont:Rotary OCaHe tlOther tl
FOR HEALTH OEPARTMENT USE ONLYCompleted Well Construct¡on:
Date lnspected
Comments
Water Sample Taken?
San ita r ian's
(71 Casins
Stael
Revgrso
AirBucket
I nstalled:
Plastic Or(Concrete
oKn
Was surface sanitary seal provided?Yes QQo D lf yes, to depth
-2/-rr.Were slrata sealed TYesD NoDMethod of
(9) WELL SEAL:
(10) WATER LEVELS:Depth of f irst water, if known
Standing level af ter well complet
(11) WELL TESTS:
Was well test made? Yes O No O lf yes, by whom?Type of t"tt /0 Pump D å4l!e. O Air lift D
l!)SIGNED
¡on) (Typed or prrnted)
Depth to water at start of test
--j¿. At end of test _
Discharç- gal/min u1,"r --rÈurs Water temperature
-Chemical analysis made? Yes D No O fÞyes, by whom?
Add¡
City
License No Date of this reportWas eloctric log made? Yes O No D lf yes, attach c to lh¡s report
Well address ü dnÍera¡tt from dbov
to*nrt'¡p*/ i -ì- Rong,,lläi;i*;æ27"')
(3I TYPE OF WORK:
NewWell dlqgepening OReconstruction tlReconditioning 0Hor¡zontal Well ODestruction 0 (Describedestruction materials andprocedures in ltem (2)
(4I PROPOSED USE:
Domest¡c .Clrrigation f)Industrial DTest Woll nStock OMunicipal OOther O
(61 Gravel Pack: Z -1 I IYeslQ No o JizeDiameter of abo@r--_PackectÍromA to -76Ñ
(81 Perlorations¡
Type of perforation or size of screen
SAN52(2-8I} CONFIDENTIAL _ NOT FOR PUBLIC USE _ WATER CODE SEC. 13752
cournfsxolE€oDEPART},IENT OF HEALTH SERVICES
EL PE¡IIT
^FLICÂT|Ç ì
îtà^ è0N
trerv 6'lo t¡¡
vc ,.r APil /rr oîo
-
6lr oî0 -df."._ ûre-7r'Control f
TYPE 0F I{ORK (Check, /New ïlel , llRepalr or Modlf lcatlon l-lTlme Extenslon l-lDestructlon l-l
t
lndlvldual DmstlcAgrlcultural l-l Comnunlty l-llndustr I al l-l Other
EqrlffENT (Chcck)
Rotry trCable Tool l=lother [l
Max. Ml n. (Feet)
PROFOSED TIELL
qþ Mr- Type Depth vtalt q,ffi /OPROPOSED SEALING ZONE(S)
Frm-h-þ Feet
Feet
Feet
Feqt
Feet
Feet
Feet
Frcrn
From
From
From
From
PROPOSED PERFORATIONS OR SCREEN
to
to
to
to
SEALING MATERIAL (Check)
Bentonlte Clay äConcrete El
Neat Cernent Grout E]Sand Cement Grout L:Othor-Speclfy:
DATE OF l{MK
Starf t ' 7tt -? I
Completlon 2 ^ Le-?c
NArt{E oF WELL o|{NER 4ef-7o7bmATt t'l ' ß e''YDon'F 3221 s hn"¡q' aî
iIAME OF WELL DR ILLER
/,*l P/eêlarLocATloN 0F WELL , tr"-ï rq,'7 Itf t
i-:rl ¿,r(a- bil C¿L P¡,,ul"-,1*rÎ
*W*nr.t u^¿( ar,'rt,,ol/r-î7s
t
DI SPOSITION OF AFPL I CATION
- (Ffi HE^LTT| çFtCf,RS US€ oüLY)\1lxl APPRoVED l-l DEN tEDl-\r/'l-l
APPROVED t{|TH CONDTTTONS
Report Reason(s) for Denlal or Necessary Condltlons llere:
BUSINESS ADDRESS
Pe 6r¡310 tçe (-r^f* à. Çraa tLICENSE NUMBER
lez7oe(,
Cash Deposlt ElBond Posfed Y
4, --2.1 J5 Fee oald on
I hereby agree to comply wlth all regulatlons of theDepartment of Health Servlces and wlth all rdl-nances and lars of the County of San Dlego and ofthe State of Callfornla pertalnlng to rell construc-tlon, repalr, modlflcatlon and destructlon. lhncd¡-ately upon conpletlon of rork'l rlll furnlsh theDepartment of Health Servlces rlth a conplete andaccurate log of the rell.
ZZb,/ ue¡ttn oFFtcER
/-)/- f6 /- 3/- 1¿DATE DATE
DHS:EHP-751 6l85) Page I of 2
COUNTY OF SAN DIEGODEPARTMENT OF HEALTH SERVICES
I{ELL PERIIIT APPLICATIOI{ control #lrASå:ìS_Assessor's Parcel No. ÒíV'ry?-t/
RESPECT TO THE FOLLOI.JINGDRAINAGE PATTERN, ROADS,AND OTHER POTENTIAL CON-
LOCATIOII
INDICATE BELOW THE VICINITY AND EXACT LOCATION OF þIELL I,IITHITEMS: PR0PERTY LINES, IIATER BODIES 0R WATER COURSES,EXISÏING Ì,IELLS, SEWERS AND PRIVATE SEI,IAGE DISPOSAL SYSTEMSTAMINATION SOURCES, INCLUDING DIMENSIONS.
ffgy*"t þI.. .,rT
'ìu5't'
Ifìlçtu
ó
lfo
l,
"#,/
,"y'fd
o ,o' l/øu'
trt /'¿of
,fcø"0 a$slL
Ç7s ,
/nkYr rl . K eì s Do ¿t'4oç- 10lb
I ¡*nr<ç q-r.f¿ pt,' tt t, n7 ( é/ f _ f 7t tDHS:EHP-731 (3/85) Page 2 of 2
,, lT) 557969 t-,-l--'--l-JfOwncr's \Vcll No.
--.,4-
I):rtr' \\/rrrk ltagan (Å / .- f-i,'.. ,. .|,ìp<krll,oc¿rl ll'rrrrit Aqf"cyi
l)t'rntil No.
oRIENTAT|oN (/- ) -/- ve¡¡lrc¡L
- l.torìtzoNTat.
- ^N(ìr.t.
__ (sp€ctr:y) Nlrr'¡<.'7t. .';/ ',/
tl.i ì lll.:1.{ }\\' SIllli\( :l i\l;¡i{irrg ArLlrcss {,:t)t.:t"ilt 'Io liltst w^1 r.:IDuf'tlt ftìoM
strtìFAcE Dl.;s(; nttt'toNnutoiil, çrnin tirÌ. .\,lot. at.
t )t,J(tÇr': ,/-2..¿
I,OCATION4Z::":Jî-: Arlclress( )it r'( i¡u¡ltr
bfrt.lrurur:n)usr(s)tu I
- MoNlloFlNG
WATER SUPPLY -.'/-4oñoEtic
- Publ¡c
-. lrrlgrllon
-
lndustrlel
_ "lEsl w€LL',
- souTll -
cArlloDlc PRoTEC'
lllt¡tntr or l)trtilx, ,)isf.ln.r' ol ll'tll lron l,anrlÌl¿il.s I -
oIHER (Spoc¡ty)sr¡r'i ¡¡s ll¡¡¿lrls. lluililitus. l.i.r¡rtsl. lìirvrí. t,l¡.. Irr¡r'i ¡¡s ll¡¡¿rrls. llu¡l¿inßs. li r¡rts. lìirvri. t,l¡.. I,T,,i.1.\¡;,,li,t(ì(]{r,|Ár¡.Ü(:ot|ll,I'þ:|L.l-
?#'ä,i3 /itx /,'b h'r¿'rt ,,,,, 'í'/111't'¡'t,;R Ll:\'tit, t r¡ul,D oÌ o0MPLHTED WELI,
-
' tll¿y ¡tot ltc rcprcsc,rrrrtti..'t' of a uclt\ long-tcrn yicld
(: ti nTt l; I(: Âl' I o N s't'Â1't: M It NT
'lirrvrxlri¡rlÞ) Iìllrgc\¿2F Se<:tio¡r I 5l,:rtilrltk'-.-r - r NORTH l,¡¡gitrule r I wESr
L rrrf MtN sEc " DEG. M¡ñ. --sEc-r LOOÁ't'loN SKltï'OtI - ^ÞTlVITY
1¿ ¡--/ZNew wett¡ t'rì
l/ I.'./
t 1 n- luootrtcrnoHrntentn
i/, ì -l r | -o"*unl:'[ \ i'"\ ¡,r,.1 -
o,h€'(speci,v)
t t y,.t,r., l_-/ i t;Í'", I-g:^s^T9.1-1o-11"f19,-,
! .-ñ IMODIFICAnON/REPAIn
| '/ t I Prccedurcaandvato¡¡âtâ
I \ | undet"c1oLoÀtcLoo".
I \ bfPLANNHD)usr(s)
i '---.r' I -^;.:::':"'i:'
EST.M^TE' "*'# io"rr, * r;s;;y;; --Ã'K
lEsr t.ENcrr.f / M,".) rorAl DRAwDo *^ fu'ft- <rr.l
DEPTHFROM SURFACE
BORE.HOLEDIA
(hchos)
( st\(;(sT
zó
rPE (a)_
lÉþ$:MAtEfìtAt-
GNADÈ
INIERNALot^Mfiì ER
(krchos)
GAUGEolì wALl-
T}IICKNESS
SI.OT SIZEIF ANY(lnches)Ft. to Ft
/) I | ,'l 5t,, .:, i /firç1/ ,!¡'{) ¿i-.1 tt /v. ¿
iINNUI,AR MATIIRIAI
A'l"l',\ (: II I\f li N'l'S
-- Goolo0rc LoO
- Woll Cr)[struclioo f)rn0r¡tnt
- coophysrcal Lo0(s)
- Soil/Wator Chem¡cal
^nalys€s
A|TACH ADDITIONAL INFORMAI'ION 'F 'r
ÊX'SI.S
SP¡\Ofi lS NEEOED, t,SF NÍ:XT CONSECUTTVELY NUMBERÊD FORMl)\l'll tx¡t lu.\ ? !() ADDITIONAI
DUPLICATEDriller'e Copy -Pusu f ot /
S-I'ATE oF CAùT¡TONNIJT
WELL COMPLETION REPORTReler to Iustrvctiott pamphlet
Owner's lVell No.Date Work Began
Lor:al Pe¡rnitPerrnit No. Permit D¿te
EOLOOIC LOG
oRIENTATTON ( r' ) VERÌICAL
-
HOFIZONÍAL __ ANGLE
-
(SPÊCIFY)
DEPrH T0 FTRST WÂTER-.(Fr.) Bllt.Ow SUnFÀCE
DESCRIPTIONcolor. etc
t
557s69 n
'l'owushio'Ú- '
LOCATION SKETCH - 4fftvt't't 1" ¡
-ll Hrw wnr
Illustratc or Describc Distance oÍ Well front .{andnt¿r|ffisrlch ot Roods, Bulldíngs, Fenccã, Rlærí, etc.PLE,ASE BE ACCLIRATE 4i COMPLETE-
PLÁ.NNED USE(S)(!|
"t'ffi..- Pqõllc
- lr.¡g¿tion
- lndutlr¡ðl
- "TÊSIWELL"
.- cA?HOÐtC ÞÂOÍEC.TTON
- OÎ}EÊ (Spoc¡fy)
t |llay not be rryresentative of a v;ell't
TOTAI. DEPTH OF BORTNG ëw Feet)rorAl DËpr*r oF coMpLrrED ryELL S&.irn¡l
DEPTHFROM SUBFACE BORE.
HOLEDIA.
(lncho8)
cA sIN C( S)
(PÊ, I LIMATERIAL/
GRADE
GAUGEOR WALL
THICKNESS
SLOT SIZCIF ANY(lûchos)
z5€
2åE3!Ft. to Ft.
DIAMETER(lnchsâ)
t) 4J¿,/ fl )fiH"å'/ 6 4/A /8fr -Øp cÅa á4 Í)&{- ç" HR ó}J
DEPTIIFROM SURFACE
Ft- tô Fr
ANNULÀR MÂTERIALTYPÊ
cE.MENT(!l
8EN.'ONITI
(/-lFILL(!)
FILTEF PACK(TYPE/SIZE)
f,.¡ qt tlü w')
CERTIFICATION STÀTE }IENT
;iyfi;åT' "t mv knowredge and bêr¡êr'
7/3Ít
¡s
{*+
c.5? UCFltSr t{r,rBrn
contror I lJC6Èê.TYPE 0F WORK (Checkt ./
New rúel , ld'Repalr or Modlf lcatlon l-lTlme Extenslon l-lDestructlon l-l
lndlvldual Dornestlc
Agr I cu I tura I
I ndustr I all:rt-l
Comunlty l-lOther
EQU lPl,lENT (Chcck)
Rotry dCable Tool Elother [l
PROFOSED I{ELL DEPTH
uur. 1)ØO ¡¡¡tn.2OO (Feet) ,rr. ,ffo/ororn t{all t:r. aags /s-éPROPOSED SEALING ZOI{E(S )
From
From
Frcrn
á3¿ to
to
to
å2 Ð' Feet
Feet
Feet
PROPOSED PERFORATIONS OR SCREEN
From
From
From
From
to
fo
to
to
Feot
Feet
Feef
Feet
SEALINC l,l TERIAL (Check)
Neat Cenrent Grout |]]Sand Cenent Grout |]]
Bentonlte Clay trConcrete l=l
Other-Spec I fy:
DATE OF I{frK
start t2--q - qt'compretlon l2 - Ltr- X {
NAt',tE 0F wELL O!{NER ^ ,10Ç-qo6t,
tnmT d. R¿ì çbn¿ÉITAME OF I{ELL DRILLER
f*rj' Dl ¿Ltz-PLoCATlol.l 0F l{ËtL
fìnsç,kß vJ ac gb,,lu.,nAtä.**
,,^/// D/t/.^,n/('- ï'zgt
D I SPOSITION OF APPLICATION(Ffi IIEALT}I çFICERS USE OII-Y'
Eí APPRovED l-l DEN rED./r{-/l-l APFROVEO l{tTH CONDTTTONS
Report Reason(s) for Denlal or Necessary Condltlons llero:
BUSINESS ADDRESS
Pgøn j¡arf3 â,J-a-'- {t,. ?t?,LICENSE NUMBER
Cash Deposlt |]]Bond Posted El/
Fee pard . \21 4(OL l
I hereby agree to comply vlth al I regulatlons of theDepartmont of Health Servlces and wlth all rdl-nancos and laws of the County of San Dlego and ofthe State of Callfornla perfalnlng to rell construc-tlon, repalr, modlflcatlon and destructlon. lhñrcdl-ately upon completlon of rork I rl I I furnlsh theDepartment of Health Servlces wlth a cornplete ondaccurate log of the rell.
7 - L/-?fAPPL I CANT IS
DATE
¡Ja ua!.-r D.;'\-.:f
oorilrTY f sÆr DtEcoDEPARTIIENÍ OF HEALTH SERVICES
E.L PERIITAFLICATIC + , bïg o?o fZ
7t.ÁJ
?a1P,7!Srq\^
I
o\oI
S
DHS:EHP-751 $/85, Page 1 of 2
COUNTY OFDEPARTMENT OF
SAN DIEGOHEALTH SERVICES
I{ELL PERI.IIT APPLICATIOÎI
løL. LocArlorr
BELOW THE VICINITY AND EXACT LOCATION OFPROPERTY LINTS, I.IATER BODIES OR WATER
ISTI NG WELLS, SE!,IERS AND PRIVATEs' qo'
ICATEMS:
contror # LJOS>YAssessor's ParceJ ito. 65f '07a_sv
l,lELL IIITH RESPECTCOURSES, DRAINAGE
J-entn/
TO THE FOLLOI.IINGPATTERN, ROADS,
TIAL CON.
).il
uÞ(',.,
_0*
,L{!e ti
V+c.
/uffr d' ß e,cÙoû'f hittot'4ør- %gu (/rcc ,
F*4r' wolt Þr!il'iw¡
tlq ç- s73 t
DHS:EHP-731 (3/85) Page 2 of
ORIGINALFile with DWR
rng -,.Lu¡ ,/
f ,or':rI I'r.nrit n*;,:".1..,
ORTENTATTON ( / ) Ø_ venr¡c¡L __ HoRtzoNr^L ..--_ ANGLE _ (spEctFy)
r¡er,rrr rn<¡u---f l)l:l'1 ll fT) lìlìsl'\ì'11'l':ll ¿:¿: rlrr r llt,:t.o\\'st'Rtij\(:1,:
- Ol;.(ll,O(;I(: t,O(;
Na nu' lt */7DüS(:RIPI'I0\
Nl¡jlirr¡¡ r\<\.' /r11 .r'ln,ss
=
r\<kllt'ss(lit r
( Ì¡rrr¡tr, .
tìt,r. 0ìt Nr.:B
-721,,'y'¿¡1>
I,0CÂTIOI,I
'-/*,W- fi::ïia'1fu1;,,\l'N lltxrk _
'li¡r,¡tshir¡ _l.;rlilr¡tlt. .. .__._t. ._ -r Noftrilot:(ì. ÀíN .st c--*---. l,o r r g i t r rtlt' iæ_\¡ñ. r_s€_õ:$
l'a rcel
Lo(:Â1'¡ o ¡i s ti tit'(;ItxI',:,1:".,MODIFICAIToN /REPAIR
- Dsepen
- Olhor (Spoc¡ty)
-- - souTHIll¡ßlr.tt¿' o¡ Iltst¡tlr It:.l.antt. o! \l'dl fttnn l.tnt.lt,utrl¡\::,., ll 1,.). I',flt4' lt u ill u p. l. r.a,r.ri ¡¡¡".r"í. ..;;:.' - """'"' ""r,¡.ri..rsri rr; ¡ <;rr'¡i,i rri o <iiiiiili:Ti:.
- DESIROY (0eccri¡ePtocedwoa and MatortUîd* -GEOLOGIC LO<
PLÁNNED USE(S(!t_ MONITORING
w^tEn supPLY
å Dome¡r¡c
_ Pubtic
_ lf.rgal¡on
_ lndusir¡al
- .'TEST
WELL''
_. c^tHootc PnoTuTION
- OTHER (Spocity)
i (-.\it{<:* (,. ,!.,
-
NORTH
l*t lo'/7 t: '
( \51\(;(s)
MAT[-_.RtAr, ItNTERNAI. sLoT StzEc¡iÁöÈ- ¡ornurrenl on wnù I -ìÈ;;i;
-JrÂNNUI,AR ilt/TTI:NIAI,
FILTER PACK(TYPE/SIZE)
l, the under¡r¡¡ned. cert¡fv
,AMF lP ,l þ|.
^T'l'Å(.II lrt r.;X'f s 1 < ¡
--. G(ìok)grc l-oo
* Woll C()nslruction Otr0rarn
-- Gcophysrcât Log(s)
__ Sorl,,Wâtor Chernical ,\¡ralys€s
-- Othl¡
ATTACH ADOIÍION,\I INFORMATIOAI ¡F ,r SX'SI.S q3,7,t)u'ß t.\5 til..\ ; u, ADDITIONAI SPACF IS NË.FDED, tJIìtJ NFXT CONSECUTIVELY NUMBERED FORM
C
COUXTY f SAX DIEÊODEPARÏ},IENT OF HEALT}I SERVICES
.:LL PË'ilIT *'/!5t (a8 / Ò5^tLrcArril fuc#-'\r33)l ) Control , W()cl,_ld
TYPE 0F'I{ORK (Check)
New |lelt ç1Repalr or Modlf lcatlon l-lTtme Extenslon l-lDestructlon l-l
USE (Check)
lndlvldual Dor¡rsstlc WAgr I cu ltura I l-l Comnun I ty l-llndustr I al |ll other
EQIJ lPrenf (Chcck)
Rotry ÊGable Tool l-lother l=l
PROPOSED I{ELL DEPÍH
Max. (Feet)
PROFOSED CASING
Depth 4P\f Dranotor l{all a.rz
aor, //SEAL I NG zoilE (s )
to
to
to
Feet
Foet
Feef
PROPOSEO+ PERFORATIONS OR SCREEN
From
From
From
From
to
to
to
fo
Fest
Feet
Feet
Feet
SEALI N0 IIATERIAL (Check)
Neat Csnent Grout ÉSand Cement Grouf l]
Bentonlte Clay Elconcrqte l=l
Othor-Spec I fy:
Start
Conp I et lon
DATE OF YoRK
NAlrlE OF WELL OtlNER
lll,q*rÌ ^) 0 øolÉ,t-Nh'q 0F I{ELL DR|LLEFa r
¿)7¿tit /(¿¿/a,*^"ä;Y**'ù1 Jot á COi,PANY \ / -
þa (lrrçn è"/ //,-,
ì'ln
\J)
={
D I SPOSI TION OF' AFPTICATION(Fm ffi LTlt çFtCfRS USE ofrLY)
l-l APPRoVED l-l DEN tED
lpl APPRovED vtrrli cor{DrnoNs
Report Reason(s) for Denlal or Necessary Condltlons lþre:
BUSINESS ADDRàSS
Jëa:&r,*' 4 (b,ø t4LICENSE NUMBER
3taK3/
Cash Deposlt $.Bond Posted El
Fee pald on
I hereby agree to comply wlth al I regulailons of füeDepartmenl of Health Serv lces and rlth al I ad l-nances and laws of the County of San Dlego and ofthe State of Callfornla pertalnlng fo rell construc-tlon, repalr, modlflcatlon and destructlon. lhncdl-ately upon conpletlon of tork I rl I I furnlsh theDepartment of Hea I th Serv lces r I th a ærnp lete endaccurate log of the rell.
DHS:EHP-7Jl ltß5',ûr(\,
Page I of 2
COUNTY OF SAN DIEGODEPARTMENT OF HEALTH SERVICES
I{ELL PERIIIIT APPLICATION conrror # LÐ 0) ,tk-?Assessor's Parcel no. ("58-0fl-àf
LOCATIOII
INDICATE BELOI,I THE VICINITY AND EXACT LOCATION OF I^IELL t,lITH RESPECT TO THE FOLLOWINGITEMS: PROPERTY LINES, WATER BODIES OR WATER COURSES, DRAINAGE PATÏERN.,. ROADS,EXISTING WELLS, SEI^IERS AND PRIVATE SEI.JAGE DISPOSAL SYSTEMS AND OTHER POTENTIAL CON-TAMINATION SOURCES, INCLUDING DIMENSIONS.
Inl
q ú,{
\
É-
-¡øe*ùøt Sol-
lD, "//"us€l)o J777a-
M**rru At¡*,-Ì lssÊ 66grrh Ë
^
DHS:EHP-731 (3/85) Page 2 of
run¡y Mll St¡rir.n -A'21
RsT cAiì8Õn"c-óív
¡r¡c¡ ot t¡r¡¡¡¡t No. 2 4 :l [] 6 3 -
¡ot P¡n¡¡ No. {t o.¡. U02 ^ B 1-
ASSËSSOHS PA RÜEL I'IUM tsE II :
(¡ 5 tl __ . 0tl.l__ lft _..___.
WATER WELL DfI¡I.I.ERS RÊPOfìT(INSEHT untl¿r Ofìl(ìll'l¿\L PAtiÉ'¡r/c¿rbo¡r of S¡¡tu Fc¡r¡¡¡l
û_"____5
br¡c¡¡¡¡rl $údl Cooruucdon:
¡rt
)¡¡ l¡¡¡+rcod
r¡ ovúNE R:t, .0. Box 1 265
¡¡rr. Mart iu S. (llìllt)(, I
û..aßorrl ev¿ìr(l zio 921)tl1_
l¡ LOCATION OF WELL (Sr¡ ir¡¡ruc¡x¡¡¡¡l:
o.r.,.y s a ¡1, l) i e t" o- ow¡r'¡ w¡ll Nur.t¡¡þl ¡ú¡¡¡¡ rl olf¡¡¡nr from ¡t¡¡vr 'f i rt r r;¡ l)r' l S
oxrrrug- -l
[ì S Rr¡gr Ji l'ì scc¡¡r¡r .
lir¡¡rca trorn c¡atr¡a, foadt õllfo.dr, ,arlst, ¡(c.S<¡ut.lt of I[rvy 94 c¡r¡ 'l'isr'¡.¿¡ l)t: ]_ Sl¿f ...!l¡[.-.ust D¿lst I of 'f icL-r'ir_ l)t. l_-liol.
;li sOSPAåTM€MT USÉ ONLY
(l?l wELL LOG: lor¡t u.r.r, -2.Qll. orprlr ul con¡r,r.u¡J-.u 2(i0--1,It,,iltlt-Ü) ,.1) ll(fr. ijw,¡u¡to¡¡ (Do¡urt¡r ÞY col(¡. cl¡¡.((Er. ¡¡¡rol n¡aþrr¿l¡
--*--L-:_:--_--_---
.-..-.0 --- -in*-._----]-up- St¡ i I -S¿ru1|y--.----..I B - /r0 Ì,tprl Hir rrl C ran i t c
-:t0-_J-0q-- --tii[ ï'r¡,1-Ererúr . - -- "----0.0 __--___l?A _Ujr i t.t: (l r'¿r1ti te rv/-|f¿ì(:!]l-t(j.¡i
-1.30_--:___líQ__-!últi Le liraui le -*l riO - 2.402 10---- zõ0 -nTI¿i[finlËå"å|l;tlå'tttllf '""
-. l]0--_- iì0 - -----4-Jì¡rI -*P---Lr'l90 160 ()-l 6 rr----I B û-**' -li-cãr--P7
¡ñt ¡-t* t",t-l î :-2 dl- r eif9ã;;,;,,,t. r",ti,¡¡¡¡o[ste¡ I 1 - ?Z:tg-..-!91
'17
(3¡ TYPÉ, OË WoflX¡No¡r W¡ll [X Ðrrporrtrtg
fìro¡ ¡¡t¡c ¡¡o¡ ¡
flrconr{ trorrirrg
ùlor¡¡on¡¡l W¡¡l
clt.l{-J
LI
O¡suc¡¡on ü {O¡¡c¡¡l¡¡d.¡¡f\¡cl¡On rnaat¡ b¡¡ ¿¡¡.1grocdrrrr ro ltrrrr ( t2 )(¡tl PHOSOSgO tJSË:
Oor¡r¡¡ a¡c
lrf r ga rror¡
laì(^¡¡(rr.¡'fr¡( l¡l¡ll5¡r¡ck
Munsrpd
Otl¡¡¡
¡iautluütlL')
lól Equrenrr¡cñoory l¡ xC¡u. C¡
Orlr¡r O
l?l C.¿¡ra{¡ l¡uulld:s¡ra EIX Pl¿¡r¡c 0
ooe
lom
I9I WELL SEAT.:
W¡ ¡¡¡rr.c. ¡ånrøry ¡¡¡l prouri¡dl Y¡¡ EXNo tJ lt yu. .o uq)¡¡¡ --2 ().---- ,,.
Sr¡l ¡rr¡¡¡ ¡r¡.d ag.tn¡t pollu¡tor¡? Yo 8lX No O k¡t¿¡ vo¡ .. -.- -.---.- l(.
t¡lr¡Ìroo ol ¡o¡ljnq
-C.Ê'IIIllLIl..---*--- -.--- .-.- . ,. .. .-. . . -.--.. -:---:-::.-----
IIOI WATER LEVELS:
D.9 ¡h ot ttr¡¡ w¡r¡r. ¡r known -_- - ilil:
.-- , .-- - -.-. - r(.?q I
Srrndinglrvrl ¿t¡¡r w.ll compl.¡lon---- L ' -.--..--....-...... l¡.
ffiIt|r rËrl ¡.r. r¡r.ú., Yo¡ CX No L-l ll yor, b¡ xrurtr? ,S C I l'Tyg¡ ol t¡¡t Pu¡¡¡p O 8¿rl¡r O Au irlr !(1f, .) (l
Orp¡n ¡o w.¡a( al ¡ttß o, ¡o¡¡ '25 ,r. A¡ or¡tl ul to¡¡ - 4. )......- tt
Oart¡¡rç-- I D grl/mrn rltrr -JL-h.r.,,
Wð(er ¡.r¡porúauro -.-.---..--Ch¡r¡ic¡l ¿n.lYr¡l mr¡¡¡? Yc¡ O NoX;X It yor, by wlrorttl
w- alac¡nc loe ¡n¡cl¡l Yt¡ O HJtI ¡l Y!¡, ¿¡tacn c()rrv ¡o úrt¡ r€t)o. I
U[Il. 0Rll ltRS SlAIt]ltllf: I hcrcby dccl¿¡e u¡¡tlcrpcl.rlty of ¡rcrjury tl¡¿t tl¡c ll¡fr¡¡r¡¿tiun pruvi,lctti¡¡ tl¡ir le port i5 [¡uc. Ihis x¿tcr *ll v¿s ll¡st¿l lc,litt ctur¡rl i¿¡rcc ¡i th 5¿n 0icao County Corlc ¿¡rd 5t¿le
lm''""'i rii;;T "li;;ä; "''"'l
r{AXr NcGttl't'is: l{r: I I l)r j.l.lilre /( t',: ¡'sdirl i ínir,' or'cõ r:¡¡õ r¿t tõ¡i)- (i lr¡ï ii tr i n t )
AI)IJRI. S 5
cr rr J:l_tttP9I rcr-n5L nu.'J I
¿rP 9.?99q
rs nu,oß¡ IIl'¿llIttg
brrnrn¡¡ ,i*-f St?-(
¡.tú S{n9¡. Tex.nt
Rw¡roAi¡tfuckr¡
Conc¡¡tr O
{01 Gr¡vrl P¡cr:Y.¡ $ N¡¡ Q s¡.. =----./t." -.------.Ordrr.ld ul ¡I¡¡r --!å. ..
PErii¡ fÍq¡r -A- -,u.?ÞQ ..t,.Jul t-,"r*.,*
*l'yp¡ of prr lorlttort or ¡i¡r t¿l r¡ r¡r¡
¡.å¡¡¡rt¡¡'¡ Ap9rova¡¡
flrs:flrp-n2 (scotvFlDENTlAL -- t\¡oT FOf I lrtJllt-lc usE -.wATEtì COtIE SEC. l37ti2
Contn t t hl}nTYPE 0F I{ORK (Check)
Ner l{el I þ-Repalr or Modlflcatlon l-lTlme Extenslon l:Destructlon |]l
USE (Cteck)
I ndustr I al l-l Other
lndlvtdual Dorngstlc qAgr lcu ltural l:l Comun lty l-l
EQtr|P!¡IENT (Chcck)
Rotry 8Cable Tool l=lothcr l=l
Max.
PROPOSED þ'ELL DEPTH
fuf ,,n. (Feet) o"ptn ú-D I anoter Ial I r Gage
PROPOSED CAS I}IG
tvp"fuPROPOSED SEALING ZOI{E(S)
to
to
fo
PROPOSED PERFORATIONS OR SCREEN
From
From
Frcrn
From
J' Feet
Feet
Feet
Feet
Feet
Feet
Feet
From
From
to
Bentonlte Clay ElConcrste ¡:l
SEALI ¡¡G MATERIAL (Check)
l,leat Cenpnt Grout ELSand Ce.nent crout lfOthor-Spec I fy:
DATE OF' IIORK
,r*r // - trp .Q{- 8qCompl etlon
NAI'IE OF I{ELL O¡INFR.- f1
/Y)ø*nn S. (hopø+}IAME OF }IELL DR]IôER
ÜJ*,,n ruz/atLæ'^rt*:ry1
òd W flr' 6¿4ú'êa) ffiôþ*,*, àit//¡ruDI SPOSITION OF AFPL ICATION
(FA TEALTH CfICERS USG MY)
l-l APPRoVED El DENTED
lll APPRovEo ttlrn coNDlrlows
Report Reason(s) for Denlal or Nacessary Condltlons fþre:
BUSINES$.ADDRESS '1
/gÇo t_*, //_ (/¿*oo * g*¿¿éLICENSE NUMBER '
3/åls 3f
Cash Deposlt l=lBond Posted |]l
Fec oald on
I hereby agree to comply wlth al I regulatlors of theDepartment of Health Serv lces and rlth al I ad l-nances and lars of the County of San Dlego and ofthe State of Callfornla pertalnlng to rell construc-tlon; repalr, modlflcatlon and destruqtlon. lhncd¡-ately upon conpletlon of rork I rl I I furnlsh theDepartment of Health Servlces rlth a conplete ardaccurate log of the rell.
ßØo,ry,tuII
HEALTH trFICER
I t ']¿- {?DATE
c0úxrYfsIDlEsDEPARTMENT OF HEALTH SERVICES
(r&3t31^P,t
à€tr ô8/ 06U,T. PER¡IIT
^¡F*lt Tlq
å
Nì
m
[\ttL Pase I or 2DHS:EHP-75! $/85,
COUNTY OF SAN DIEGODEPARTMENT OF HTALTH SERVICES
I{ELL N:R|,IIT APPLICATIOI{ contror * LL)Õntg>Assessor,s parce.t no. ú,5î-Oîl -O6
RESPECT TO THE FOLLOI,IINGDRAINAGE PATTERN, ROADS,AND OTHER POTENTIAL CON-
LOCATIOl{
INDICATE BELOI,I THE VICINITY AND EXACT LOCATION OF I,IELL bIITHITEMS: PROPERTY-L.IIIES, WATER BODIES OR WÀrrN COUNSTJ,TII.:I$ I,IELLS, SEh'ERS AND PRIVATE SEI,IAGE OISPõSru SVSiÈÍ,ISTAMINATION SOURCES, INCLUDING DIMENSIONS.
Iñl
1a &,,,*t
qx'o h
I
lur*de'tt' Do l"us€/Uo Sqrru
ïl*rr^t UFTttsA Ò69cr ¡{
DHS: EHP-731 (3/85) Page 2of2
taotlcr o, lntrrt No. 2A33-95 =
.
l"oot Prmir No. a Ort¡ t¡¡O ? ? R ?
Grtrrcr lrr¡rt citic, roldt. rrilro'ö' lrrr' tte' **---- --
-;o ú Ui- of -ruv-94 --0 ! ì --.!lj (ì -r t'a .-l) ç' l.*'! q M d
- Jil a-rasr*ilJo'r\llr--o'['"1j er r a "-D e 'l' --S o l'
(t ?l wEl-l- l-OG: rot¡t ¿.çr¡U-9tr. orpü ol comÞl't'd -n' 2ZO' ¡t'tro¡rrlr. Vl ,"')..')ç\. Focm¡rion (Oarorbr bvcolø,cñr.€trr. ti¡.or 7Ì.rtrlrll
l, 6 {) - - -- 2. 2 0--.N.erL -l I ar.d-tollri-L-e--G-r¿¡rij.e----w/ snrall lr@
ÂSSESSONS PANCEL ¡¡tJMEERI
658 081 06
Sr.ra Wrll No.Oth.r W.ll No.
- - T'f 'f '*-I çTççT-TT T '".
* ç
rlountv M¡i1 Slrriorr -A'21
FIRSf CABBON COPY
l5l Eqrliom¡rt:Rorrry ß X
crur Ct
Othrr O
O€PARTMENl USE ONLY
e.omolarrd Wdl Corrit.rlctlolrl .
W¡t¡¡ Sarr¡lr rau",i N 0-
o, *tllt¿J-03orrr r¡rnrc¡rcr .!J ç /3k-- - --'--:---" :
co."rnorr tr e-gg-ry- t{:t L:: l-rr' u'tUj-:ti,r::t-LYr-I---
I3l TYPE OF W()fIX:
llaw W¡lt \T Olr¡orrirrg fi
FìForrrtrtrttorì I
flrcoilrJition¡trq {
llôri lont¡l W¡ll (
O¡lr!,ctiÕrl l.J lO¡cr ilt¡C¡ tructiolr rnllttrill alrrlÞ¡ocrl¡ror in ltrrn ( l2 )
IlI PROPOSED I.ISE:
Odn.r t ic
lrrigrtlrxtlrrclrrt¡iif¡r Wrll
Stnck
LtrrrricioC
Otlt rr
\È ìp'K -,\ -).ki --foJS,1(Ì-ì I -a Lr
cotjl¡ f Y oF s^l^¡ f)lÉ(ì()
DEP/\RTMEN-f OF t lt:Al-l'l I SEflVICËStToo PAclFlc lllcrlw^Y, s^t'l olEGo. c 92lot..2417
WATER WELI,. DNII I.FNS NEPONT
(lNSEn f uncj¡r ORIGINAL. PA(ìE '¡¿lcarbon of State Forml
ø -_:-)5-:tlll :(r0
.- 5 ! - :. -d----------------*
*-' -- -:- -J.00. --.-.-*7*-G¿-l-P-lù1- ¡
--!!A ----l--Çtr--L-tG_...-?:¿,!).__.- rJ __(rc_.L*Llll
-,1
-tI
lll Cerrnq lrxl¡llxl:Stml rt{ XÞlætic L) Conoctl
Stenrtlng lw.l ¡rlllr wrll completion--.'---
II tI WEI.L ÌESTS:
tl'i¡ r¿tl tárt m6(riJ V¡r dJ llo (:J ll ver. t¡r
I'vor ol tr¡t Pr¡mo fl 8¿rl¡r l l
Orgth tó w.t.r at rtttt ol ttrt ---3-0 -- lt'
lßl Gr¡v
Ym ft No QQX Si¡r --..-....**-D¡&nrt.r ol rtrxr
!:l,t'.-l1*:t -:-::::: 19 .',=-=-=.rl: -'.lf,l Pslotrri'¡"r:fypr ol pot lotetion 6¡ ¡i¡¡ c''l cr rrtr
wfir:rtrl srt ll
^ir iirt ( lX X
^r ân(l of r.tt 3 0
Nilu(ltltìfl
iì
R ¡r ¡rraÂlr
Buckrt
únu
þli r b-ar,lll j,__)À-, fivl I l. 0Rll l.tRS 5l.\tt.X[t{I: t heretry decl¡re under
Wrt srrllcl rlrìittrv r¡¡l rlrovidxll Y6f,li tto l-'l ll ver' to rt{tlh 51.
9a.ra rtt¡tl lr.ltrl tgaitrtt pollulirrr? YaYX No fil lntrrvrl
l!1!19:!. 9f..:9:! il-! .--99S9¡!l: -' -=.=:::- -'= - : -'i : .r : : -:'
llol w/\f En LEVET-S:
f.)rprh ol flrtt wtttr. il known --5 t -'-'lll
p..rrrlty o( perJrrry that the lnforrr¡tlon providedln thi.s .ep,rri li tr.,n. lhls ¡ater vell xas lnst¡lle<lln crx,,¡rl lanr:e vl th San 0leqo County Corle ¡nd St¡teof C¡litorni¡, l)epartnpnt of ìl¡ter Rcsources. 8ul'letln
i';,,,,1; I ¡ rr , i( f-',, ,i,C, .:\ _ ___ __' {i¡óiliir:iiirlil 1
'n"',,,0 l!3Íì'i [,* i l¡ 8"?**¡ ¡ làri' ù]¡t'H' F;.r ñi r-/\tlrìnf ss 1390 l)p¡vqy...PJ_
Carrr¡l<.r, CA ¿¡P 9_2,00.()-
_Lr(:rH,;r no.'Ì I 2tÞ 3 .D^¡t lllls Rl-PoRl 1j,481.09 ¡
Orrc¡rrrp.--...1..$..-9rl/min llt"'--4'-'--- hotttt wrtir titrìo'r{ltrrn -.'
Ch¡ric¡l ¡rr.lvll t¡66¡f Yn Cl ¡¡o (X Xr yat' try -rlrorrrT
ìrr rtrcrnc toq m¡or? Yc¡ cJ -No -B:l.lli:.i-11":l ""nv-i!. ":i: 'ln'l:i
æ.#æ
Dils:nrp-¡rz (BCONFlllEt'J I t^.1.- tl()'l' I:r-i[]' Írl ltì l l(l l lSl: W/1,TER CODE SEC" 13752
3rÕ"t'-'ó;ffifr^DEPARTMENT OF PUBLIC HEALTH ,t _, - r> t
r600 pAcrFrc HrcHwAy, sAN DrEGo, cA ezror wæ -
¿lb (State Iüell No.
Other \{ell No.WATER WELL DRILLERS REPORT
(L) O\{NER:
tla*e'.'i2!
CouOwner'snumber, if
Townsh
from
(3) TYPE OF WORK (chech):NewWell& Deepening n Reconditioning n DestroyingIf destruction, describe mnterialand procedure in ltem 11.
(4) PROPOSED USE (chech):
Domestic [l Industrial ! Municipal nInigation n Test Well n Other E
CASING INSTALLED:STEEL: OTHER:
srrvcue (' ooueue E
Tofr. Diam.
Gageor
Wall
Size of shoe or wellDescribe ioint
7) PERFORATTONS OR SCREÐN:of perforation or name of screen
Fromft.
(8) CONSTRUCTTON:
If ves. bv whoft. drawdown after
attach License No.
SKETCH LOCATION OF WELL ON REVERSE SIDE
OVER
(11) WELL LOG:
Torardeprh SAt ' tt.
\ryELL
NAME þ <'1^ - ^¡ l^, t',
firm, or
Thís well was drilled under my jurisdíctíon and this report is true tothe best of Wuhnowledgeandbeilief. -/ -
ë, ¡ â
: Describe by color, character, size of material and structureft. to ft.
19>,S STATEMENT:
hof completedwell fÅ O ' tt.
¡
(5) EQUTPMENT:Rotarv f-lCable' -other A tV e
If gravel packed
Diameter I
of I FromBorelft. ltt.
Size of sravel:
te? f,com
as a chemical analvsis made? Yes tr No
!'romfr.
$R
ù
- Was a surface sanitary seal\W ided? Yes Ø No tr?YesD No
ft. to ft.From ft. to ft.
To whatdepth AO
tn of strata
Method of seal
,. (9) WATERI Depth at which water was fìrst
)@found. if known
if knownSta level after and deve
(10) WELL TESTS:Was test made? Yes
tn. wrTemperature of water\{as electric log made of well? Yes n No
fr.ft.ft.
sAN 52 (9-74) n0/'L'
t,;
ß 7y
**'#ffi'oFrÊffrfl ,Fffn, r.,
, *il'ffi;1.*:i*g.JgÌ,N- ÂPPRovED
. ß \r¡oÉ\ng>controlrllgY
,trãtrJJ
5s
I
lJ ArpRoyED
Reporf Roason(s) for
lt,TH cot¡DtiloNSL-l DENTED
Condltlons Here;
¡Þ
Dental or Necessary
/Eìlu'ùìôa
ho-tI 4
Indlvldual Domest¡c
Agr tcu I tura I
I ndustr I all]l Conrnunltv r-,El orher ' r-r
____
EaurHïEËffiRotryCable ToolOl'her^pR-oposeD
pE¡¡-li!frMax. /OOA
(Feet)n.^
pRoposuo ,^.-FL__Hof l or
rnorosu, , ãEõ{ +o
-AÒ e".+.---to
---ro.Ht**
PRoposED ***^r,lñiir t "___^Frorn Ê Feet
- -____to
From ÊFeet_ _roFrom
-
Fm+:-ro-
sealrHorra-¡s]1ft;;iNeat cenenf Grout ,:l Þ^_¡
Compleflon
Sand cenenf sout ¡-r Bentonlte ctay
ofher-spoclfy¡ ll concrete
DATE OF I{ORK
¡tnuE orGiñilG
445-?"Bl
eusrrlEsT;õãõ
r-rceruseffiEn'-
2-\t-{" Fee patd * ¿k8e-6
%
ffilj
tP-7Jl ß/g9 )
Page I of 2 Á)o a)âf¿-,.¿-Arcya
OUADRUPLICATE t AFo- Lpcal Requirements ^r kl d
\uu"I,,.rL- ¿- \ \-STA'I'I' OI.'CALII.ORNIA çWELL COMPLETION REPORT \
Rcfet tc Instructiott pau¡hlet
Owner's Well No.Date Work llegan 45s 942
: ìllr \ )'''i)+I Ir
Local Permit Agency ' { . '., r '\\ ,l ,. _.. ( Tj i' J
permit No. i,.,_ l_ì i, ü_'t 'j I ' - permit Date
GEOLOCIC LOC
ORIENTATION (/ ) )f. ur"r'ao.
- HoRtzoNrAL
- ANGLE
-
(spEcrFy) NameDEPTH TO FIRST WATER-(FI,) BELow SURFACE Mailing
DESCR I PTI ONnaterial, grain siæ, color. etc.
Address
City
,ELL
WELL LOCATION
MODIFICATION/REPAIÊ
- Do€pon
- Other (Specily)
- OESTROY (DoscriôoProcodurcs dnd MaaeilâlsUndeî
1"
Pr.ÄNNID US[(S)(Lt
- MONITORING
WATER SUPPLY
X oomesricÀ".¡.atI'(
'' i
li.t, ,rl, ìv'rD^
- Publ¡c
- lrrigalion
- lnduslr¡al
..TEST WELL''
CATHODIC PROTÊC.TIONOTHER (Spocily)lllustratc or Describe D¡staùce of Well [ron l-and¡nrk¡
¡1cf1 as_!ìo4ls, Buìklhgs, Fencei, Ríærí, etc.Pu|ASE BE ACCURATE t¡ COUpt,bii..
SOUTH
CERTIFICATION STATEMENTI, the
NAME
\l {:
, certify that this report iS complete and,
,r\K'^ ,. ,. ''l lt t 'i,) 1", 'r I ''--
*-l
to the best of my knowledge and belief.
ri-ì
l:
iSigned
Y
Countv ; =aPN Book(.='4 page (,¡</!',' parcel,-. _
:
I,OCATION SKETCH
DEPTHFROM SURFACE BORE-
HOLEDIA.
(lnches)
cAsrNc(s)TYPE I
MATERIAL/GRADE
INTERNALDIAMETER
(lnches)
GAUGEOR WALL
THICKNESS
sLoT S|ZEIF ANY(lnches)Ft. to Ft.
t¿
z5
zùçf¿J:
c
.. ' ' t' ¡ , ii i \'. \ , r'r' i7 i tl.l-.2t-r \íl t !
DEPTHFROM SURFACE
ANNUL,l,R MATERIALTYPE
Ft. to Ft.
cE.MENT(L)
8tN.ONITI(r' |
FILL(Ll
FILTER PACK(TYPE/SIZE)
\\ ittlt
ì r/. lr rl=l,/ t,? V
ATTACH MENTS
- Geologic Log
- Woll Conslrucl¡on D¡agram
- Gsophys¡cat Log(s)
- Soil/Water Chsmical Analysos
ATTACH ADDITIONAL INFORMATION. IF IT EXISÍS..
DWR lllS lìEV. 7-90 IF ADDITIONAL SPACE IS NEEDED, USE NEXT CONSECUTIVELY
')
rl
