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'The free Adobe Reader may be used to view and complete this form However,software must be purchased to complete,save,and reuse a saved form. File Original with DWR State of California DWR Use Only-Do Not Fill In Well Completion Report 1 , 1 -71- 1 I Page 1 of 2 Refer to Instruction Pamphlet State Well Number/Site Number Owner's Well Number mw-8 No. e0338899 I I I IN w Date Work Began 04/13/2017 Date Work Ended 4/17/2017 Latitude Longitude Lon itude Local Permit Agency San_toaouin County Environmental Health Department I 1 I 1 1 I I I I Permit Number 2901 Permit Date 4/12/17 APNrrRStOther Geologic Log Well Owner Orientation O Vertical O Horizontal OAngle Specify Name Poul Franzia Drilling Method Hollow Stem Auger Drilling Fluid Mailing Address 21801 E.highwav 120 Depth from Surface Description Feet to Feet Describe material,grain size,color,etc City EScolon State CA Zi 95320 0 8 POORLY GRADED SAND SP WELL SORTED, Well Location FINE-GRAINED, DRY Address 21801 E.hiahway 120 8 13 8- 13 FT:TRACE GRAVELS(5-10%), PEBBLE City Escolon County San Joaquin SIZED GRAVEL,MEDIUM-GRAINED SANDS, Latitude N Longitude �N TRACE COARSE-GRAINED SANDS(5%) Deo Min sec Deo Min sec 13 14 12.5-14 FT:TRACE GRAVELS(<5%), COARSE- Datum Decimal Lat. Decimal Long. GRAINED APN Book 205 Page 25 Parcel 016 14 23 SILT(ML)LOW PLASTICITY, HEAVY Townshi Range Section OXIDATION, FEW ORGANICS, SOFT, DRY Location Sketch Activit 23 24 23 24 FT: MEDIUM-GRAINED, SLIGHTLY Sketch must bedrawn b hand after form is ed • New Well North O Modification/Repair CEMENTED,SLIGHT OXIDATION Q Deepen 24 25 24-25 FT: 5-10%COARSE-GRAINED SANDS O Other 25 27 SILTY SAND(SM)FINE-GRAINED SANDS, O Destroy Oe.cnDe wocaares.na mn.nm (10-15%SILT), SLIGHT OXIDATION, DAMP wnOer GEOLOGIC LOO' 27 32 POORLY GRADED SAND(SP)FINE-GRAINED, Planned Uses TRACE SILT(<5%), SLIGHTLY DAMP O Water Supply []Domestic [3 Public 32 33 32-33 FT: SLIGHT OXIDATION, DRY ❑Irrigation ❑Industrial 33 34 SILTY SAND(SM)FINE-GRAINED SANDS, 3 Lu O Cathodic Protection (10-15%SILT),WHITE STREAKS, DRY O Dewatering 34 39 POORLY GRADED SAND(SP)FINE-GRAINED, O Heat Exchange SLIGHT OXIDATION, DRY O Injection 39 43 SILTY SAND(SM)MODERATELY CEMENTED, O Monitoring HEAVY OXIDATION, FEW ORGANICS, DRY O Remediation 43 44 43-44 FT: MEDIUM-GRAINED O Sparging 44 45 44-45 FT: FINE-GRAINED, NO GRAVEL, NO South O Test Well COARSE-GRAINED SANDS, DRY rHeInsanewdo dbemunuaiwNli mrwa.oulartgc lences O Vapor Extraction n.nc-d nisch.map.Use ddUmN papa if neces...1 O Other 45 48 SILTY SAND(SM)MODERATELY CEMENTED, `NaibeCa" aodc HEAVY OXIDATION,WHITE STREAKS Water Level and Yield of Completed Well 48 49 POORLY GRADED SAND(SP)FINE-GRAINED, Depth to first water 68 (Feet below surface) Depth to Siatic TRACE COARSE-GRAINED SANDS(5-10%) Water Level 70 (Feet) Date Measured 04/21/2017 Total Depth of Boring 100 Feet Estimated Yield' 1 (GPM) Test Type Total Depth of Completed Well 98 Feet Test Length (Hours) Total Drawdown (Feel) 'May not be representative of a well's long term yield. Casings Annular Material Depth from Borehole Wall Outside Screen Slot Size Depth from Surface Diameter Type Material Thickness Diameter Type If Any Surface Fill Description Feet to Feet Inches Inches Inches Inches Feet to Feet 0 68 110 Blank PVC Sch.40 4 61 Cement neat 68 98 110 Screen PVC Sch 40 Milled Slots 0.010 61 65 Bentonite Cetco Medium 65 98 Filter Pack #2/12 Attachments Certification Statement El Geologic Log I,the undersigned,certify that this report is complete and accurate to the best of my knowledge and belief 0 Well Construction Diagram Name Cascade Drilling, LP 2086 Lias` 'FI�"aIn`�Treet Woodland 95776 ❑Geophysical Logs) CA ❑Soilfwater Chemical Analyses Address z� city 10/30/17 s e8110 zip ©Other Signed ✓" Attach addibonal information 0 it exists C-57 Licensed Water Well Contractor Date Signed C-57 License Number DWR 168 REV 12006 IF ADDITIONAL SPACE IS NEEDED.USE NEXT CONSECUTIVELY NUMBERED FORM