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QUADRUPLICATE STATE OF CALIFORNIA DWR USE ONLY — DO NOT FILL IN <br /> For Local Requirements WELL COMPLETION REPORT <br /> Page I of 1 Refer to Instruction Pamphlet STATE WELL NO./STATION NO. <br /> Owner's Well No. 95320 No.e0369842 1111 E101 11111 <br /> Date Work Began 9/18/2018 Ended9/19/2018 LATITUDE LONGITUDE <br /> Local Permit Agency Environmental Health I I I I I I I III 1 1 I <br /> Permit No. wp0038545 Permit Date 7/13/2018 APNIrRS/OTHER <br /> GEOLOGIC LOG WELL OWNER <br /> ORIENTATION(Z.) VERTICAL _HORIZONTAL —ANGLE —(SPECIFY) Name Alan 8t Joan Sneed <br /> DRILLING ROTARY <br /> DEPTH FROM METHOD FLUID Mud Mailing Address_18792 S. Steinegul Rd <br /> SURFACEDESCRIPTION Escalon CA 95320 <br /> Ft. to Ft. Describe material, grain, size, color, etc. CITY STATE ZIP <br /> 0 3 Top Soil Address 18792 S Steinegu h LOCATIO <br /> 3 26 Sand City Escalon CA 95320 <br /> 26 45 Clay CountySan Joaquin <br /> 45 531 Sand APN Book Page Parcel <br /> 53 69 Gravel Township Range Section <br /> 69 132 Clay Latitude I I <br /> 132 148 Shale DEG. MIN. SEC. DEG. MIN. SEC. <br /> 148 160 Clay LOCATION SKETCH ACTIVITY L) <br /> NORTH —V—" NEW WELL <br /> 160 169 Sand <br /> 169 195 Clay MODIFICATION/REPAIR <br /> —Deepen <br /> 195 196 Sand —other(Specify) <br /> 196 223 Shale <br /> _ <br /> DESTROY(Describe <br /> 223 228 Sand Procedures and Materials <br /> 228 235 Shale <br /> Under"GEOLOGIC LOG' <br /> 235 248 Sand <br /> PLANNED USES() <br /> WATER SUPPLY <br /> 248 255 Shale Domestic— Pubk <br /> Q Irrigation — Industrial <br /> tL MONITORING— <br /> TEST WELL <br /> ATHODIC PROTECTION— <br /> HEAT EXCHANGE— <br /> DIRECT PUSH_ <br /> INJECTION— <br /> VAPOR EXTRACTION— <br /> SPARGING— <br /> SOUTH REMEDIATION— <br /> Illustrate or Describe Distance of Well from Roads, Buildings, <br /> Fences,Rivers,etc. and attach a map. Use additional paper if OTHER(SPECIFY)— <br /> necesury. PLEASE BE ACCURATE & COMPLETE. <br /> WATER LEVEL&YIELD OF COMPLETED WELL <br /> DEPTH TO FIRST WATER (Ft.)BELOW SURFACE 1 <br /> DEPTH OF STATg <br /> WATER LEVEL- 6 (FL)&DATE MEASURED 9/19/2018 <br /> TOTAL DEPTH OF BORING 255 ESTIMATED YIELD ' (GPM)& TEST TYPE <br /> (Feet) TEST LENGTH—(Hrs.) TOTAL DRAWDOWN (Ft.) <br /> TOTAL DEPTH OF COMPLETED WELL 250 (Feet) M not be representative of a well's lon -term Yield. <br /> DEPTH BORE- CASING(S) DEPTH ANNULAR MATERIAL <br /> FROM SURFACE HOLE FROM SURFACE TYPE <br /> DIA. fl�YIPE —!-L <br /> MATERIAL/ INTERNAL GAUGE SLOT SIZE CE- BEN- <br /> (Inches) Ir GRADE DIAMETER OR WALL IF ANY FILTER PACK <br /> Ft. to Ft. (inches) THICKNESS (Inches) Ft. to Ft. MENT TONT FILL (TYPEISIZE) <br /> (`O L) <br /> 0 230 11 PLASTIC 6 20n 1 0 100 V, <br /> 230 250 ✓ 100 250 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.FIRM.OR CORPORATION) (TYPED OR PRINTED) <br /> — Soil/Water Chemical Analysis 119 Albers Rd Modesto CA 95357 <br /> — Other ADDRESS CITY <br /> STATE ZIP <br /> ATTACH ADDITIONAL INFORMATION,IF IT EXISTS. Signed 09/24/18 668622 <br /> WELL DRILLER/AUTHORIZED REPRESENTATIVE DATE SIGNED C-57 LICENSE NUMBER <br /> DWR 188 REV.11-97 IF ADDITIONAL SPACE IS NEEDED,USE NEXT CONSECUTIVELY NUMBERED FORM <br />