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<br /> File Original with DWR State of CaliforniaOYlVEftise:Ortr .,'9it iVotFil!1n.
<br /> Well Completion Report ,
<br /> Page 1 of 3 Refer to Instruction Pamphlet State Well NumberlSlte Number
<br /> Owner's Well Number MW-12 _�- No. e0219699
<br /> F77
<br /> = I T—T] I w
<br /> Date Work Began 04/26/2014 Date Work Ended 4/28/2014 Latitude I Lon rude
<br /> Local Permit Agency San Joaauin County Environmental Health Department — APN/IRS/otner
<br /> Permit Number SR#0069442 Permit Date 4/16/14 �m
<br /> Orientatiun G V3rlical 1-10zol Ital OAngle Opacify I Name City of Stoc ktun
<br /> Drilling Method Sonic Dnlhng Fluid Mailing Address 425 EI Dorado Street
<br /> Cit Stockton State Chi 95202
<br /> 0 5 Air Knife-no recovm T
<br /> 5 .10 Lean clay%A,/card, dark olive brown, moist gravel, Address 1634 S Stockton Street
<br /> _ fine sand,clay, high plasticity, soft _ City Stoickto
<br /> n County San Joaquin
<br /> 10 l,fine sand, Latitude N I onpitude
<br /> 12 Lean, light olive brown, moist,grave
<br /> Clay,medium plasticity,firm Dec Min.— Seo. Dea. Min 7;c-
<br /> 12
<br /> Decimal Lat. Decimal Long. .
<br /> 12 19 Lean clay w/sand, light olive brown, moist, gravel, APN Book Page Parcel _
<br /> fine to med. sand,clay, high plasticity,hard
<br /> 19 23 Lean clay, light olive brown, dry,fine sand. med. Townshi P.an a Section
<br /> al
<br /> plasticity,firm, red modling Q New Well
<br /> 23 24 Clayey sand, light olive brown, moist,fine to med. North O Modification/Repair
<br /> sand,clay, high plasticity,firm O Deepen
<br /> 24 25 Lean clay w/sand, light olive brown, moist,fine O Other
<br /> —
<br /> 24 Destroy
<br /> sand, clay, med. plasticity, hard, black mottling u der eproceduresand materials
<br /> under'GEOLOtfIC LOG"
<br /> 25 26 Poorly graded sand, fight olive brown,wet; med.
<br /> sand Q Water Supply
<br /> �g 28 Sandy leen clay, light olive brown, dry,fine to med. C1Domes:ic OPub!ic
<br /> sand, clay,rned. plasticity,firm J t ❑Irrigation []industrial
<br /> 28 33 Poofly graded sand, light olive brown,wet,-med_ O Cathodic Protection
<br /> sand _ _ O Dewatering
<br /> 33 i 35— Poorly graded sand w/silt,dark greenish gray, O Heat Exchange
<br /> moist,fine to med sand,silt O Injection
<br /> OO Monitoring
<br /> 35 41 Silty sand, greenish gray, moist,fine sand,silt O Remediation
<br /> 41 44 Silty sand,dark greenish gray,wet,fine to med. O Sparging
<br /> sand, silt O Test Well
<br /> Sour
<br /> 44 47 Lean clay,der`:greenish gray,dry,fnu sand, clay O valor Extraction
<br /> illusbale or desa,.,e dis2nca..r xel,from roads,nuldina�,lances, O
<br /> medium plasticity rivers,etc.and attach a map.Use adcitiona!paper if necessary. Other
<br /> [Please be accurate and complete.
<br /> 47 _ ,49__ Poorly graded sant!, dark greenish gray, moist, - a €
<br /> fine tc medium b&rtd Depth to first water 41 (Feel below surface)
<br /> 49 151 �tLa
<br /> lay,dark greenish gray: do/,trace sand, Deptn to Static
<br /> I ne sand;clay, med plasticity, hard _- Water Level 75 (Feet) Date^treasured7ctalDepthofBrri�g c5 - _ Feet Es'.imatr;GY•eld' (GPM) Tes' ;�-Ire
<br /> Test Le tgth (Hours) T-)tsl Oraw':own (Feet)
<br /> Total Depth of Completed Well 86 ___ Feet "Ma nct be re resentatNe of a will';!coq tarm yield.
<br /> — �-�=-
<br /> Depth from BorehoieJ-= Material wall Outside Scrcen Slot Size Depth from
<br /> Fill Description
<br /> Surface Diameter
<br /> Type Thickness Diameter Type if Any Surface
<br /> T
<br /> Feet tc Feet ilrches _ inches !Inc e= — Inches` Feet to Feet
<br /> 0 76 BlankY EPLO Sch.8P i�= - -
<br /> 76 $6 t Screen C Sch.d0 i 2.5 I siotted 0.010 71 74Bentonite
<br /> --�-_ 74 87 Fiber Pack - #2112 — _
<br /> -- --- -- ---- --- -----I---- -- --- -- . $--
<br /> 95-- +
<br /> v -�3entenit�
<br /> f (
<br /> ❑Geologic Log I the undersigned,certify that this report is complete and accurate to the best o.my knowledge and belief
<br /> ❑Well Construction Diagram Name National EWP Inc-Chris Tatum
<br /> Person,Firm or Corporation ! ,� 9804
<br /> C7 Gacphyaicai Legs) t 1961 Itfeaker Avenue Kichmonc
<br /> /�$Edros� Cit? btacF Zsp
<br /> I- :3oii�Waler Chemical Analyses � Signed �( �° eL - r--�364E --
<br /> _ _
<br /> G tither Site.MaD -� '' -
<br /> Licersedk a`, r':V. .00�r r USlie Signed C-57 License Number
<br /> Adach acditi� orate into matio� if it exists.
<br /> T CONSECUTIVELY NUMBERED FORM
<br /> 138 REV.1i2OC6 IF ADDITIONAL SPACE IS NEEDED,USF NEX
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