Laserfiche WebLink
QUADRUPLICATE STATE OF CALIFORNIA DWR USE ONLY — DO NOT FILL IN <br /> For Local Requirements WELL COMPLETION REPORT17 <br /> Page I of I Refer to Instruction Pamphlet STATE WELL NO./STATION NO. <br /> Owner's Well No. 95337 NO.e0365033 III , IDE1111TI El <br /> Date Work Began 4/18/2018 Ended4/19/2018 LATITUDE LONGITUDE <br /> Local Permit Agency -ii i I I i I I I I I I J <br /> Permit No. Permit Date APN/TRS/OTHER <br /> GEOLOGIC LOG WELL OWNER <br /> ORIENTATION(✓) v!�-VERTICAL —HORIZONTAL — ANGLE —(SPECIFY) Name Marti Anderson <br /> DRILLING <br /> DEPTH FROM METHOD ROTARY FLUID MUD Mailing Address 6890 Avenue D <br /> SURFACEDESCRIPTION Manteca CA 95337 <br /> Ft. to Ft. Describe material, grain, size, color, etc. CITY STATE ZIP <br /> 0 3 Top Soil Address 6890 Avenus D WELL LOCATIO <br /> 3 25 Sand City Manteca CA 95337 <br /> 25 32 Clay <br /> 32 70 Sand CountySan Joaquin <br /> APN BookPage Parcel <br /> 70 133 Clay Township Range Section <br /> 133 142 Sand Latitude I I <br /> 142 147 Clay DEG. MIN. SEC. DEG. MIN. SEC. <br /> 147 152 Blue Sand LOCATION SKETCH ACTIVITY (v) <br /> NORTH __V_' NEW WELL <br /> 152 155 Blue Clay <br /> FICATIONIREPAIR <br /> MODI <br /> 155 160 Sand —Deepen <br /> 160 164 Clay —other(Specify) <br /> 164 167 Sand <br /> — DESTROY(Describe <br /> 167 170 Clay Procedures and Materials <br /> Under"GEOLOGIC LOG' <br /> 170 192 Sand PLANNED USES() <br /> 192 210 Clay WATER SUPPLY <br /> cn Domestic public <br /> uu <br /> Q Irrigation _ Industrial <br /> LLl MONITORING— <br /> TEST WELL-- <br /> ATHODIC PROTECTION— <br /> HEAT EXCHANGE— <br /> DIRECT PUSH_ <br /> INJECTION— <br /> VAPOR EXTRACTION <br /> SPARGING— <br /> SOUTH REMEDIATION— <br /> Illustrate or Describe Distance of Well from Roads, Buildings, <br /> Fences,Rivers,etc. and attach a map. Use additional paper if OTHER(SPECIFY)— <br /> necessary. PLEASE BE ACCURATE & COMPLETE. <br /> WATER LEVEL&YIELD OF COMPLETED WELL <br /> DEPTH TO FIRST WATER (Ft.)BELOW SURFACE 1 <br /> DEPTH OF STATIC <br /> WATER LEVEL 17 (Ft.)&DATE MEASURED 4/19/2018 <br /> TOTAL DEPTH OF BORING 210 ESTIMATED YIELD ' (GPM)& TEST TYPE <br /> (Feet) TEST LENGTH (Hrs.) TOTAL DRAWDOWN (Ft) <br /> TOTAL DEPTH OF COMPLETED WELL 200 (Feet) May not be representative o a well's long-term yield. <br /> DEPTH BORE- CASING(S) DEPTH ANNULAR MATERIAL <br /> FROM SURFACE HOLETYPE ✓ FROM SURFACE TYPE <br /> DIA. Y P a MATERIAL I INTERNAL GAUGE SLOT SIZE CE- I BEN- <br /> Ft. to Ft. (Inches) g U O GRADE DIAMETER OR WALL IF ANY MENT TONT FILL FILTER PACK <br /> co LL (Inches) THICKNESS (inches) Ft. to Ft. (Typ-/SIZE) <br /> `0 (`0 (0 <br /> 0 180 11 <br /> 180 200 <br /> ATTACHMENTS 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,FIRM, q)2 OR�TfO l-vD�OR PRINTED) <br /> — Soil/Water Chemical Analysis 119 Albers Rd l _ R Modesto CA 95357 <br /> — Other ADDRESS , CITY STATE ZIP <br /> ATTACH ADDITIONAL INFORMATION,IF IT DOSIS. Signed 04/30/18 668622 <br /> 11 WELL DRILLER/AUTHORIZED REPRESENTATIVE DATE SIGNED C-57 LICENSE NUMBER <br /> DWR 188 REV.11-97 IF ADDITIONAL SPACE IS NEEDED,USE NEXT CONSECUTIVELY NUMBERED FORM <br />