Laserfiche WebLink
QUADRUPLICATE STATE OF CALIFORNIA DWR USE ONLY — DO NOT FILL IN <br /> For Local Requirements WELL COMPLETION REPORT Filliililliill <br /> Page I of I Refer to Instruction Pamphlet STATE WELL NO./STATION NO. <br /> Owner's Well No. 95366 No.e0361488 <br /> Date Work Began 1/12/2018 Ended1/18/2018 LATITUDE LONGITUDE <br /> Local Permit Agency Environmental Resources 11 1 1 1 1 1 1 1 <br /> Permit No. wp0037765 Permit Date 1/3/2018 APNITRS/OTHER <br /> GEOLOGIC LOG WELL OWNER <br /> ORIENTATION(✓) -,/—VERTICAL —HORIZONTAL —ANGLE —(SPECIFY) Name VMV Hulling <br /> DRILLING ROTARY <br /> DEPTH FROM METHOD FLUID Mud Mailing Address 506 S.Wilma AVe <br /> SURFACEDESCRIPTION Ripon CA 95366 <br /> Ft. to Ft. Describe material grain, size, color, etc. CITY STATE ZIP <br /> 0 3 Top Soil Address_1299 E Hwy 120 ELL LOCATION <br /> 3 45 SandManteca CA 95336 <br /> 45 137 Clay City <br /> 137 140 Sand County San Joaquin <br /> APN Book Page Parcel <br /> 140 1481 Clay Township Range Section <br /> 148 153 Sand Latitude � r I <br /> 153 187 White Clayi DEG. MIN. SEC. DEG. MIN. SEC. <br /> 187 1931 Shale LOCATION SKETCH ACTIVITY (✓) <br /> NORTH --v/— NEW WELL <br /> 193 196 Clay <br /> 196 206 Shale MODIFICATION/REPAIR <br /> —Deepen <br /> 206 209 Sand —other(Specify) <br /> 209 211 Clay <br /> — <br /> DESTROY(Describe <br /> 211 217 Sand Procedures and Materials <br /> Under"GEOLOGIC LOG' <br /> 217 224 Clay PLANNED USES() <br /> 224 232 Sand WATER SUPPLY <br /> 232 260 Clay f~nN --ZDomestic— Public <br /> 260 269 Sand Irrigation — Industrial <br /> 269 272 Clay MONITORING— <br /> TEST WELL—_ <br /> 272 279 Sand ATHODIC PROTECTION_ <br /> 279 282 Clay HEAT EXCHANGE- <br /> 282 285 Sand DIRECT PUSH— <br /> INJECTION— <br /> VAPOR EXTRACTION— <br /> SPARGING <br /> SOUTH REMEDIATION_ <br /> Illustrate or Describe Distance of Bell 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 S <br /> WATER LEVELLrj (Ft.)&DATE MEASURED 1/18/2018 <br /> ESTIMATED YIELD ' (GPM)& TEST TYPE <br /> TOTAL DEPTH OF BORING 285 (Feet) TEST LENGTH—(Hrs.) TOTAL DRAWDOWN (Ft.) <br /> TOTAL DEPTH OF COMPLETED WELL 275 (Feet) May not be representative o a well's long-term yield. <br /> DEPTH BORE- CASING(S) DEPTH ANNULAR MATERIAL <br /> FROM SURFACE HOLE nTYPE ) FROM SURFACE TYPE <br /> DIA. a MATERIAL/ INTERNAL GAUGE SLOT SIZE CE- BEN- <br /> (Inches) aJ GRADE DIAMETER OR WALL IF ANY MENT TONT FILLFILTER PACK <br /> Ft to Ft. a (Inches) THICKNESS (Inches) Ft. to FL ✓ (�) (� (TYPE/SIZE) <br /> 0 255 11 <br /> 255 275 .045 100 275 GRA EL <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,FI RPO ) (Tye D P I D) <br /> AAt— Soil/Water Chemical Analysis Iber <br /> — Other ADDRESS CITY STATE ZIP <br /> ATTACH ADDITIONAL INFORMATION,IFITIXISTS. Signed01/19/18 668622 <br /> WELL DRILLER/AUTHORIZ .,,gEPRES ATIVE DATE SIGNED C-57 LICENSE NUMBER <br /> DWR 189 REV.11-97 IF ADDITIONAL SPACE IS NEEDED,USE NEXT CONSECUTIVELY NUMBERED FORM <br />