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QUADRUPLICATE STATE OF CALIFORNIA DWR USE ONLY — DO NOT FILL IN <br /> For Local Requirements WELL COMPLETION REPORT <br /> Page 1 of 1 Refer to Instruction Pamphlet STATE WELL NO./STATION NO. <br /> Owner's Well No. 95320 NO.e0365034 <br /> Date Work Began 4/20/2018 Ended4/25/2018 LATITUDE LONGITUDE <br /> Local Permit Agency Envirnnmpnatl Hpalth I I I I I I I I I I <br /> Permit No. wp0038097 Permit Date 3/27/2018 APNITRS/OTHER <br /> GEOLOGIC LOG WELL OWNER <br /> ORIENTATION(�) �L VERTICAL _HORIZONTAL —ANGLE —(SPECIFY) Name Steve Sawyer <br /> DRILLING ROTARY <br /> DEPTH FROM METHOD FLUID MUD Mailing Address 15400 Steinegul Rd <br /> SURFACEDESCRIPTION Escalon CA 95320 <br /> Ft. to Ft Describe material, grain, size, color, etc. CITY STATE ZIP <br /> 0 2 Top Soil Address 15400 Steinegul ff&L LOCATIO <br /> 2 4 Hard Pan City Escalon CA 95320 <br /> 4 8 Sand County San Joaquin <br /> 8 121 Clay APN Book Page Parcel <br /> 12 20 Sand Township Range Section <br /> 20 53 Clay Latitude I I <br /> 53 57 Sand DEG. MIN. SEC. DEG. MIN. SEC. <br /> 57 78 Clay LOCATION SKETCH ACTIVITY (✓) <br /> 78 94 Sand NORTH -Al' NEW WELL <br /> 94 125 Clay MODIFICATION/REPAIR <br /> y —Deepen <br /> 125 127 Gravel —Other(specify) <br /> 127 137 Clay <br /> — DESTROY (Describe <br /> 137 139 Gravel Procedures and Materials <br /> Under"GEOLOGIC LOG" <br /> 139 247 Clay PLANNED USES() <br /> 247 248 Sand WATER SUPPLY <br /> 248 277 Clay Domestic_ Public <br /> 277 278 Sand Streaks <br /> Irrigation — Industrial <br /> u] <br /> 278 285 Clay MONITORING— <br /> TEST WELL_ <br /> 285 286 Sand ATHODIC PROTECTION- <br /> 286 294 Clay HEAT EXCHANGE- <br /> 294 307 Sand DIRECT PUSH__ <br /> 307 325 Clay INJECTION—_ <br /> VAPOR EXTRACTION—. <br /> SPARGING_. <br /> SOUTHREMEDIATION— <br /> Illustrate or Describe Distance of Well from Roads, Buildings, <br /> —] <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 STAT1C <br /> WATER LEVEL-y4 (Ft.)&DATE MEASURED 4/25/2018 <br /> TOTAL DEPTH OF BORING 325 ESTIMATED YIELD ' (GPM)& TEST TYPE <br /> (Feet) TEST LENGTH—(Hrs.) TOTAL DRAWDOWN (Ft.) <br /> TOTAL DEPTH OF COMPLETED WELL 310 (Feet) May not be representative of a well's long-term yield. <br /> DEPTH BORE- CASING(S) DEPTH ANNULAR MATERIAL <br /> FROM SURFACE HOLE TYPE ✓ FROM SURFACE TYPE <br /> DIA. Y W a MATERIAL/ INTERNAL GAUGE SLOT SIZE CE- BEN <br /> - <br /> Ft. to Ft. (Inches) g U J GRADE DIAMETER OR WALL IF ANY MENT TONIT FILL FILTER PACK <br /> m LL (Inches) THICKNESS (Inches) Ft. to Ft. (TYPE/SIZE) <br /> 0 290 12 <br /> 290 310 -045 107 310 GRAVE <br /> ATTACHMENTS (s ) 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 IQI QR PRINTED) <br /> — Soil/Water Chemical Analysis 11 I R F t I. Modesto CA 95357 <br /> ADDRESS - '� CITY <br /> Other ,.' STATE ZIP <br /> ATTACH ADDITIONAL INFORMATION,IF IT DCISTS. Signed 04/30/18 668622 <br /> ., <br /> WELL DRILLER/AUTHORIZED RESEN IVE DATE SIGNED C-57 LICENSE NUMBER <br /> DWR 188 REV.11-97 IF ADDITIONAL SPACE IS NEEDED,USE NEXT CONSECUTIVELY NUMBERED FORM <br />