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<br /> File Original with DWR State of California 11111111111111111k DWR Use On —Do Not Fill In
<br /> Pa1 of 1 Well Completion Report
<br /> 9e Referto mstructon Pamphlet State Well Number/Site Number
<br /> Owner's Well Number KI-18 No. e0215231 NI II w
<br /> Date Work Began 04/21/2014 Date Work Ended 4/21/2014 _ LatitudeLon itude
<br /> Local Permit Agency San Joaauin Environmental Health D partm nt F i I I I I I I I I I I I ,
<br /> Permit Number SR#69242 Permit Date 3/17/14 APWTRS/Other
<br /> Geologic Log Well Owner
<br /> Orientation OVerticai O Horizontal OAngle Specify Name Kearney National, Inc.
<br /> Drilling Method mud rotary Drilling Fluid drilling mud
<br /> Depth from Surface Description Mailing Address 565 Fifth Avenue,4th Floor
<br /> Feet to Feet Describe material rain size,color,etc City New York StateNei 10017
<br /> 5 5 Silt with clay, very fine sand,dark brown, moist Well Location
<br /> 10 10 Silty fine sand,slight compaction,brown Address 1624 East Alpine Ave
<br /> 20 20 Clayey, silty fine sand,yellowish brown City Stockton County San Joaquin
<br /> 30 30 Silty fine to med.sand,trace clay, dark yellow-broa Latitude 37 59 4 N Longitude 121 16 49
<br /> 40 40 Silty fine sand,trace clay,yellowish brown Dao Mie. Sec. Deo. Mia. sec.
<br /> 50 50 Fine sand,trace silt,dark brown Datum NAD83 Dec.Lat. 37.984346 Dec.Long.-121.280376
<br /> 60 60 Fine to med.sand with silt and clay,trace gravels, APN Book Page_ Parcel 11708006
<br /> yellowish brown Township 02N Range 06E Section 35
<br /> 70 70 Silty,well graded sand,trace coarse/gravels,trace Location Sketch Activity
<br /> clay, brown, loose. Clay increases at—73 ft Sketch must be drown by hand after for,isprinted) 0a New Well
<br /> 80 80 Clayey,silty fine sand,cemented silts, North O Modification/Repair
<br /> O Deepen
<br /> compressible clays,yellowish-brown O Other
<br /> 85 85 Predominantly fine sand with silt,trace clay, O Destroy
<br /> Desalts,noax.res aM mat¢,ak
<br /> brown, loose uMer'GEOLOGIC LOG'
<br /> 95 95 Silty fine sand,trace day, cemented silts, Planned Uses
<br /> yellowish-brown. Gravels, angular @-93ft RECEIVED ., []Domestic El Public
<br /> OWater Supply
<br /> 105 105 Fine sand with silt and clay,dark yellowish brown, b ❑Inigation ❑Industrial
<br /> loose 3 w
<br /> 110 110 Silty fine sand with gravels,trace clay,angular, JUN 19 2014 O Cathodic Protection
<br /> O Dewatering
<br /> dark gray gravel,dark yellowish-brown. O Heat Exchange
<br /> 115 115 Clayey sand,trace gravels,cohesive,plastic clay, ENVIRONMENTAL HEALTH O Injection
<br /> yellowish-brown PERMIT/SERVICES O Monitoring
<br /> 120 120 Predominantly clay and silt,some fine sand, O Remediation
<br /> compressible, plastic,soft,yellowish-brown O Sparging
<br /> South O Test Well
<br /> Inlm,ateadesaite amanita Mxell rmn mals.milainps.rea«e. . O Vapor Extraction
<br /> R,ax.eM anam a meo. use aeenunel Paoa'e naass.a. O Other
<br /> Ms.la, ccuram ane can late.
<br /> Water Level and Yield of Completed Well
<br /> Depth to first water (Feet below surface)
<br /> Depth to Static
<br /> Water Level 44 (Feet) Date Measured 05/12/2014
<br /> Total Depth of Boring 120 Feet Estimated Yield (GPM) Test Type
<br /> Total Depth of.Completed Well 115 Feet Test Length (Hours) Total Drawdown (Feet)
<br /> 'Ma not be representative of a well's long term yield.
<br /> Casings Annular Material
<br /> Depth from Borehole Wall Outside Screen Slot Size Depth from
<br /> Surface Diameter Type Material Thickness Diameter Type if Any Surface Fill Description
<br /> Feet to Feet Inches inches Inches Inches Feet to Feet
<br /> 0 1105 110 Blank PVC Sch.aD 14 1 0 3 concrete surface seal
<br /> 105 115 10 Screen PVC Sch.80 4 Milled Slo s 0.020 3 95 Cement sanitary seal
<br /> 95 100 Bentonite bentonite pellets
<br /> 100 102 sand No.30 mortar sand
<br /> 102 120 Fitter Pack No. 3 monterey
<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 /> I]Well Construction Diagram Name Dudek/Greao Drilling
<br /> ❑ GPerson,Finn or Carpomtian
<br /> Geophysical Log(s)
<br /> 605 Third Street Encinitas CA 92024
<br /> ❑ SoiVWater Chemical Analyses rens city s
<br /> ❑r Other well location figure Signed
<br /> Aitach additional infoanetion ITk exists. "71-iater WeA CarNactor Date i ned C-57 License Number
<br /> - DWR 186 REV.720X6 --- IF ADDITIONAL SPACE IS NEEDED,USE NEXT CONSECUTIVELY NUMBERED FORM
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