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WP0037572
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ESCALON BELLOTA
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4200/4300 - Liquid Waste/Water Well Permits
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WP0037572
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Entry Properties
Last modified
9/29/2018 10:55:48 PM
Creation date
7/24/2018 10:45:55 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0037572
PE
4369
STREET_NUMBER
2700
Direction
S
STREET_NAME
ESCALON BELLOTA
STREET_TYPE
RD
City
FARMINGTON
Zip
95230-
APN
18718010
ENTERED_DATE
11/8/2017 12:00:00 AM
SITE_LOCATION
2700 S ESCALON BELLOTA RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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QUADRUPLICATE STATE OF CALIFORNIA DWR USE ONLY — DO NOT FILL IN <br /> For Local Requirements WELL COMPLETION REPORT El I <br /> Page 1 of 2 Refer to Instruction Pamphlet STATE WELL NO./STATION NO. <br /> Owner's Well No. 95320 No.e0358711 ❑ <br /> Date Work Began 11/14/2017 Ended5/17/2018 LATITUDE LONGITUDE <br /> Local Permit Agency Environmental Health I I 1 1 I I I I I I I I <br /> Permit No. wp0037572 Permit Date 11/8/2018 APNrrRS/OTHER <br /> GEOLOGIC LOG WELL OWNER <br /> ORIENTATION(✓) VERTICAL —HORIZONTAL —ANGLE —(SPECIFY) Name C&T Murphy Partners <br /> DRILLING ROTARY <br /> DEPTH FROM METHOD FLUID Mud Mailing Address 1506 Countrywood Dr. <br /> SURFACEDESCRIPTION Escalon CA 95320 <br /> Ft. to Ft. Describe material, grain, size, color, etc. CITY STATE ZIP <br /> 0 3 Top Soil Address 2700 S. ESCalon"Ve4lotaC�TIO <br /> 3 12 Gravel Cit,Escalon CA 95320 <br /> 12 14 Clay County San Joaquin <br /> 14 19 Gravel APN Book Page Parcel <br /> 19 23 Shale Township Range Section <br /> 23 26 Sand Latitude r I 1 1 <br /> 26 51 Shale DEG. MIN. SEC. DEG. MIN. SEC. <br /> 51 68 Black Sand LOCATION SKETCH ACTIVITY (✓) <br /> NORTH __V1' NEW WELL <br /> 68 78 Shale <br /> 78 87 Black Sand MODIFICATION/REPAIR <br /> —Deepen <br /> 87 111 Shale —Other(Specify) <br /> 111 117 Black Sand <br /> — DESTROY(Describe <br /> 117 124 Shale Procedures and Materials <br /> Under"GEOLOGIC LOG' <br /> 124 127 Black Sand PLANNED USES(.--) <br /> 127 1331 Shale WATER SUPPLY <br /> 133 154 Black Sand t~n Domestic— Public <br /> 154 173 Shale C Irrigation Industrial <br /> 173 184 Black Sand MONITORING— <br /> TEST WELL_ <br /> 184 240 Shale ATHODIC PROTECTION_ <br /> 240 248 Black Sand HEAT EXCHANGE- <br /> 248 251 Shale DIRECT PUSH_ <br /> 251 281 Black Sand INJECTION <br /> 281 288 Shale — <br /> VAPOR EXTRACTION <br /> SPARGING_ <br /> 288 306 Black Sand and Gravel SOUTH REMEDIATION_ <br /> 306 309 Shale Illustrate or Describe Distance of Well from Roads, Buildings, <br /> Fences,Rivers,etc. and attach a map. Use additional paper if OTHER(SPECIFY)— <br /> 309 345 Black Sand and Gravel necessary. PLEASE BE ACCURATE & coMPLETE. <br /> 345 352 Shale WATER LEVEL&YIELD OF COMPLETED WELL <br /> 352 358 Black Sand DEPTH TO FIRST WATER (Ft.)BELOW SURFACE <br /> 358 361 Shale DEPTH OF STATIC <br /> 361 397 Black Sand WATER LEVEL 184 (Ft.)&DATE MEASURED 5/17/2018 <br /> TOTAL DEPTH OF BORING 525 ESTIMATED YIELD • (GPM)& TEST TYPE <br /> (Feet) TEST LENGTH <br /> 25 (Hrs.) TOTAL DRAWDOWN (Ft.) <br /> TOTAL DEPTH OF COMPLETED WELL5 <br /> (Feet) May not be representative o a well's/on -term yield. <br /> DEPTH BORE- CASING(S) DEPTH ANNULAR MATERIAL <br /> FROM SURFACE HOLE jTYPjE _,2L) FROM SURFACE TYPE <br /> DIA• MATERIAL I INTERNAL GAUGE SLOT SIZE CE- BEN- <br /> to <br /> Ft. to Ft. (Inches) GRADE DIAMETER OR WALL IF ANY MENT TONIT FILL FILTERPACK <br /> (inches) THICKNESS (Inches) Ft. to Ft. ✓ (✓) �) (TYPE/SIZE) <br /> 0 365 24 ,� <br /> 365 525 0 50 525 <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,FIR CORPORATI (TYPED OR PRINTED) <br /> — Soil/Water Chemical Analysis 119 Albe a t` Modesto CA 95357 <br /> — Other ADDRESS F CITY STATE ZIP <br /> ATTACH ADDITIONAL INFORMATION,IF IT EXISTS. Signed05/22/18 668622 <br /> RI <br /> WELL DRILLER/AUTHOZEI PRESENTATIVE DATE SIGNED C-57 LICENSE NUMBER <br /> DWR 188 REV.11-97 IF ADDITIONAL SPACE IS NEEDED,USE NEXT CONSECUTIVELY NUMBERED FORM <br />
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