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ORIGINAL STATE OF CALIFORNIA <br />' <br /> File with DWR WELL COMPLETION REPORT <br /> Pagel of l Refer to instruction Pampblet STATE WELL NO/STATION NO <br /> Owner's Well No MW-1 No 500548 E] <br /> $/19/9 6 9/19196 LATITUDE LONGITUDE <br /> Date Work Began Ended <br /> Local Permit Agencv Sari Joa uin County Public Health Servi S l <br /> Permit \o 009823 Permit Date 07/12/96 ' T" <br /> GEOLOGIC LOG WELL OWNER <br /> ORIENTATION (!) X VERTICAL `HORIZONTAL ANGLE __(SPECIFY) Name Citv of Stockton ; <br /> DEPTH TO FIRST WATER 19 .2 425 N. E1 Dorado <br /> DEPTH FROM (FL) BELOW SURFACE Matting Address I <br /> SURFACE DESCRIPTION Stockton CA 95202 <br />' Ft to Ft Describe material,gram size color etc CITY STATE ZIP <br /> 0: 14 ; Gravel dk gray. 1/4 to 1/2 Victor Park ,L1201 Pershin Ave. <br /> Address <br /> inch diameter , subangular to city Stockton CA <br /> subroundedPoorly graded; County ,,,,San Joaquin _ <br /> 15 : 17 : SAND w e 1 ay; yellow brown APN Book13 5 Page 150 Parcel 01 <br /> fine to very fine rain well Township Range Section <br /> ' <br /> graded. Latitude Latitude I NORTH Longitude WEST� DEC, MIN SEC DEO MIN SEC <br /> 17 23 : SAND; olive brown medium <br /> LOCATION SKETCH ACTIVITY {�) <br /> rain poorly graded . NORTH —NEW WELL <br /> 23 : 40 iSAND w cls • olive brown <br /> MODIFICATION/REPAIR <br /> ; medium to very coarse rain See Attached ^peepon <br /> we 11 _graded. _Other(Specify) <br /> ! Monitoring well was destroyed x DESTROY@escribe <br /> : bover-drillin cash —ProceduresendM <br /> Under GEGICLOG'L0G' <br /> OLO7 <br /> : removing casing, and back- I.- i,- PLANNED USE(S)- <br /> ! filling entire borehole with <br /> W X_ MONITORING <br /> neat cement slurrV. WATER SUPPLY <br /> Domestic <br /> Public <br /> 1 <br /> Irngatlen <br /> industrial <br /> TEST WELL <br /> ' CATHODIC PROTEG <br /> SOUTH TION <br /> Illustrate or Describe Distance of Well from Landmarks OTTER(Specify) <br /> such as Roads Buildings Fences Ricers etc <br /> PLEASE BE ACCURATE t COMPLETE <br /> MElTHOD Hollow—stem Auger FLUID NIA <br /> WATER LEVEL h YIELD OF COMPLETED WELL <br /> ' DEPTH O <br /> WATERLE EL nG19 .2 (Ft) a DATE MEASURED 8/19/96 <br /> ESTIMATED YIELD' N A (GPM) S TEST TYPE <br /> TOTAL DEPTH OF BORING 40 (Feet) TEST LENGTH O*s) TOTAL DRAWDOWN (Ft) <br /> TOTAL DEPTH OF COMPLETED WELL . 39 . 5 (Feet) May not be representwtve of a well's long-terra yield <br /> DEPTH CASINC(S) DEPTH <br /> MATERIAL <br /> FROM SURFACE BORE- TYpIE ✓ FROM SURFACE TYPE <br /> HOLE INTERNAL GAUGE SLOT SIZE <br /> DIA z MATERIAL! CE BEN <br /> (Inches} z i GRADE DIAMETER OR WALL IF ANY MENT T'E FILL FILTER PACK <br /> Ft to Ft u OncMa) THICKNESS (Inches) Ft to Ft (TYPE/SIZE) <br /> 0. 5: 19 . 5 9" PVC 2 Sc ; oncre e- <br /> 19 . 5 39 . 5 9" PVC 2 SCh. 47 7 x <br /> 12. 5 ; 15 . 5 x <br /> 15 . 5 ; 40.0 x #2 Sand <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 /> Wall CanatntetionDugram NAME The Twining Laboratories , Inc . <br /> Geophysical Log(a) (PERSON FIRK OR CORPORATION) (TYPED OR PRINTED) <br /> 1 _ <br /> Sod/Water Chemical Anayses P.O. B 1472 Fresno--- CA <br /> other Location ADDRESS CITY STATE ziP <br /> x <br /> nr���jj�nT�¢ Stgned z�/ 6 <br /> ATTACH ADDITIONAL'Ai�'ORTArATrONGF tT EXSSTS DRILLER RIZED RE AirVE DATE SIGNED C 57 LICENSE NUUMV <br />' DWR 188 REV;90 IF ADDITIONAL SPACE IS NEEDED USE NE CONSECUTIVELY NUMBERED FORM <br />