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QUADRUPLICATE STATE OF CALIFORNIA DWR USE ONLY — D NOT FILL IN <br /> For Local Requirements WELL COMPLETION REPORT I I I I <br /> Page 1 of 2 Refer to Instruction Pamphlet STATE WELL NO.I STATION NO. <br /> Owner's Weil No. 95358 No.e0364002 <br /> F1Date Work Began 2/12/2018 Ended2/202018 LATITUDE LONGITUDE <br /> Local Permit Agency En%dronmental Health _ <br /> Permit No. wp0037444 Permit Date 10/172017 APN/TRS/OTHER <br /> GEOLOGIC LOG <br /> WELL OWNER <br /> ORIENTATION VERTICAL —HORIZONTAL —ANGLE —(SPECIFY) Name Paul McManis <br /> DRILLING ROTARY <br /> DEPTH FROM METHOD FLUID MUD Mailing Address 6303 Beckwith Rd <br /> DESCRIPTION Modesto CA 95358 <br /> Ft. to Ft. Describe material, grain, size, color, etc. CITY STATE ZIP <br /> _ 0 31 Top Soil Address 28755 Dry Creek g&L LOCATION <br /> 3 26 Shale City Galt CA Ra <br /> 26 38 Gravel County San Joaguin <br /> 38 116 Clay APN Book Page Parcel _ <br /> 116 118 Sand Township Range Section <br /> 118 133 Clay Latitude l l l <br /> 133 150 Black Sand DEG. MIN. SEC. DEG. MIN. SEC. <br /> 150 158 Shale LOCATION SKETCH ACTIVITY (✓) <br /> NORTH __V_' NEW WELL <br /> 158 164 Black Sand <br /> 164 218 Shale MODIFICATION/REPAIR <br /> --Deepen <br /> 218 288 Black Sand —Other(spear) <br /> 288 292 Shale <br /> ESOY 292 298 Black Sand —Pescribe <br /> oe dumas aDnd Materials <br /> Under"GEOLOGIC LOG' <br /> 298 305 Shale PLANNED USES() <br /> 305 311 Black Sand WATER SUPPLY <br /> 311 330 Shale '' Domestic— Public <br /> 330 358 BLack Sand �C Irrigation — Industrial <br /> 358 364 Gravel MONITORING— <br /> TEST WELL— <br /> 364 367 Shale ATHODIC PROTECTION- <br /> 367 376 Black Sand HEAT EXCHANGE- <br /> 376 386 Shale DIRECT PUSH- <br /> 386 394 Black Sand INJECTION— <br /> 394 405 Black Sand VAPOR EXTRACTION—_ <br /> SPARGING_ <br /> 405 414 Gravel SOUTH REMEDIATION_ <br /> I/trnrrare or Describe Distance of Well from Roads, Buildings, <br /> 414 418 Shale 11-ces,Rivers,etc. and attach a map. Use additional paper if OTHER(SPECIFY)_ <br /> 418428 Gravel necessary.PLEASE BE ACCURATE & COMPLETE. <br /> 428 433 Shale WATER LEVEL&YIELD OF COMPLETED WELL <br /> 433 446 Black Sand DEPTH TO FIRST WATER (Ft.)BELOW SURFACE <br /> 446 4601 Shale DEPTH OF STATIC <br /> 460 5021 Black Sand WATER LEVEL 158.1 (Ft.)&DATE MEASURED 2/20/2018 <br /> ESTIMATED YIELD (GPM)& TEST TYPE <br /> TOTAL DEPTH OF BOFJNG 660 (Feet) TEST LENGTH—(Hrs.) TOTAL DRAWDOWN (FL) <br /> TOTAL DEPTH OF COMPLETED WELL660 (Feet) Mav not be representative of a well's long-term yield. <br /> DEPTH BORE- CASING(S) DEPTH ANNULAR MATERIAL <br /> FROM SURFACE HOLE 4TYPE -1 FROM SURFACE TYPE <br /> DI MATERIAL/ INTERNAL GAUGE SLOT SIZE CE- BEN- <br /> (Inches) GRApE DIAMETER OR WALL IF ANY MEN* TONIT FILL FILTER PACK <br /> Ft. to Ft (Inches) THICKNESS (Inches) Ft. to Ft. ✓ (✓) U (TYPE/SIZE) <br /> 0 460 24 ,/ <br /> 460 6601 1 .080 50 660 GRAVEL <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) (PERSO M OR CORP TIOt�1 PRINTED) <br /> — Soil[Water Chemical Analysisff <br /> AlA 95357 _ <br /> — Other ADDRESSCITY STATE ZIP <br /> ATTACH ADDITIONAL INFORMATION,IF IT EXISTS. Signed SA r _ I '''' 03/23/18 668622 <br /> WELL DRILLER/AUTH D REPFVSENTATAtE DATE SIGNED C-57 LICENSE NUMBER <br /> DWR 188 REV.11-97 IF ADDITIONAL SPACE IS NEEDED,USE NEXT CONSECUTIVELY NUMBERED FORM <br />