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Qtrr1DRUF'LICATE STATE OF CALIFORNIA DWR USE ONLY — DO NOT FILL IN <br />For Local Requirements WELL COMPLETION REPORT <br />Page 1 of 2 Refer to Instruction Pamphlet STATE WELL NO.I STATION NO. <br />Owner's Well No. 95236 No. e0354327 ❑ <br />Date Work Began 10/5/2017 , Ended10/16/2017 LATITUDE LONGITUDE <br />Local Permit Agency Environmental Health _ <br />Permit No. Wp0036991 Permit Date 8/3/2017 APN/TRS/OTHER <br />GEOLOGIC LOG WELL OWNER <br />ORIENTATION (✓) <br />DEPTH FROM <br />SURFACEDESCRIPTION <br />Ft. to Ft. <br />+L VERTICAL — HORIZONTAL — ANGLE —(SPECIFY) <br />DRILLING ROTARY <br />METHOD FLUID Mud <br />Describe material, grain, size, color, etc. <br />Name Calosso Dondero Investments <br />CASING (S) <br />Mailing Address 20480 E. CoRDeroDolis Rd <br />Linden <br />CA 95236 <br />CITY <br />Address 23757 E Chris Ln ELL LOCATION <br />STATE ZIP <br />-- <br />0 3 Top Soil <br />3 <br />5 <br />Hard Pan <br />Cit, Linden CA 95236 <br />5 <br />13 <br />Clay <br />County San Joaquin <br />400 580 <br />13 <br />21 <br />Gravel <br />APN Book Page Parcel <br />Township Range Section <br />Latitude I <br />DEG. MIN. SEC. <br />LOCATION SKETCH <br />NORTH <br />to N <br />Q <br />LLJ <br />SOUTH <br />11 ustrate or /Describe Distance of Well from Roads, Buildings, <br />Fences, Rivers, etc. and attach a map. Use additional paper if <br />necessary. PLEASE BE ACCURATE & COMPLETE. <br />1 <br />DEG. MIN. SEC. <br />ACTIVITY (✓) — <br />I/NEW WELL <br />MODIFICATION/REPAIR <br />— Deepen <br />—Other (Specify) <br />— DESTROY <br />a0nd Materials <br />Under "GEOLOGIC LOG' <br />PLANNED USES() <br />WATER SUPPLY <br />Domestic — PuNic <br />Irrigation — Industrial <br />MONITORING - <br />WELL <br />ATHODIC PROTECTION - <br />HEAT EXCHANGE - <br />DIRECT PUSH_ <br />INJECTION — <br />VAPOR EXTRACTION — <br />SPARGING _ <br />REMEDIATION <br />OTHER (SPECIFY) - <br />21 25 Clay <br />25 28 Gravel <br />28 33 Clay <br />33 58 Gravel and Rocks <br />58 68 Clay <br />68 88 Gravel <br />88 148 Clay umrdCOEIVED <br />148 168 Sand <br />168 192 Clay <br />192 198 Sand OCT 3 0 2017 <br />198 210 CIa --- <br />210 216 Sand <br />216 223 Clay <br />223 226 Black Sand <br />226 243 ClayTEST <br />243 248 Black Sand <br />248 252 Shale <br />252 268 Black Sand <br />268 283 Clay <br />283 2881 Black Sand <br />288 297 Shale <br />297 298 Black Sand <br />298 <br />370 <br />Clay <br />WATER LEVEL & YIELD OF COMPLETED WELL <br />DEPTH TO FIRST WATER (Ft.) BELOW SURFACE <br />DEPTH OF STATIC <br />WATER LEVEL 152.6 (Ft.) & DATE MEASURED 10/16/2017 <br />ESTIMATED YIELD ' (GPM) & TEST TYPE <br />TEST LENGTH—(Hrs.) TOTAL DRAWDOWN (Ft.) <br />_,___ ._ . 11 <br />370 372 Black Sand <br />372 386 Shale <br />386 408 Black Sand <br />TOTAL DEPTH OF BORING 580 (Feet) <br />TOTAL DEPTH OF COMPLETED WELL 580 (Fee) <br />DEPTHBORE <br />FROM SURFACE <br />A l l Al.tliq Gl\ L J <br />- <br />HOLE <br />DIA. <br />CASING (S) <br />DEPTH <br />FROM SURFACE <br />Ft to Ft. <br />ANNULAR <br />CE - <br />MENT TONI <br />MATERIAL <br />TYPE <br />FILTER PACK <br />��FI��LL (TYPE/SIZE) <br />_ <br />TYPE <br />Y w o. MATERIAL / INTERNAL GAUGE SLOT SIZE <br />Z w O o GRADE DIAMETER OR WALL IF ANY <br />0 <br />m a (Inches) THICKNESS (Inches) <br />Ft. to Ft. <br />0 400 <br />24 <br />V <br />400 580 <br />.080 <br />50 580 <br />GRAVEL <br />(IL) CERTIFICATION STATEMENT <br />— Geologic Log I, the undersigned, certify that this report is complete and accurate to the best of my knowledge and belief. <br />— Well Construction Diagram NAME MASELLIS DRILLING INC <br />— Geophysical Log(s) (PERSON, FIRRIM CORPORAT (T)TED Of PRINTED) <br />— Soil/Water Chemical Analysis 119 Alber IF A 0 Mindesto <br />— Other ADDRESS CITY <br />ATTACH ADDITIONAL INFORMATION, IF IT EXISTS. Signed 10/25/17 <br />WELL DRILLERIAUTHORIZEt:.MPRESEfMTIVE DATE SIGNED <br />DWR 198 REV. 11-97 IF ADDITIONAL SPACE IS NEEDED, USE NEXT CONSECUTIVELY NUMBERED FORM <br />STATE ZIP <br />668622 <br />C-57 LICENSE NUMBE <br />