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QUADRUPLICATE STATE OF CALIFORNIA DWR USE ONLY 00 NOT FILL IN <br /> For Local Requirements WELL COMPLETION REPORT <br /> Page I of I Refer to Instruction Pamphlet STATE WELL NO./STATION NO. <br /> Owner's Well No. 95236 No.e0368074 <br /> Date Work Began 7/17/2018 Ended7/19/2018 LATITUDE LONGITUDE <br /> Local Permit Agency Fnvircinmental Health <br /> Permit No. wp0038556 Permit Date 7/16/2018 APNtrRS/OTHER <br /> GEOLOGIC LOG WELL OWNER <br /> ORIENTATION(!) VERTICAL —HORIZONTAL —ANGLE —(SPECIFY) Name Steve Raney <br /> DRILLING <br /> DEPTH FROM ROTARY METHOD FLUID Mud Mailing Address P.O. BOX 1492 <br /> DESCRIPTION Linden CA 95236 <br /> Ft. to Ft. Describe material, grain, size, color, etc. CITY STATE ZIP <br /> 0 3 Top SoilAddress 27112 E. Shelton hhL LOCATIO <br /> 3 10 Clay Cit,Linden CA 95236 <br /> 10 21 Sand <br /> 21 48 Shale County San Joaquin <br /> APN Book Page Parcel <br /> 48 56 Sand Township Range Section <br /> 56 64 Gravel Latitude I 1 1 <br /> 64 110 Shale/Clay DEG. MIN. SEC. DEG. MIN. SEC. <br /> 110 133 Sand LOCATION SKETCH ACTIVITY (✓) <br /> NORTH IL NEW WELL <br /> 133 196 Shale MODIFICATION/REPAIR <br /> 196 202 Black Sand —Deepen <br /> 202 221 Shale —other(Specify) <br /> 221 226 Black Sand <br /> 226 237 Shale — DESTROY <br /> cores(Describe <br /> nd Materials <br /> 237 251 Black Sand Under"GEOLOGIC LOG' <br /> PLANNED USESO <br /> 251 261 Shale WATER SUPPLY <br /> 261 2621 Black Sand Domestic Public <br /> 262 272 Shale — Irrigation — Industrial <br /> 272 276 Black Sand MONITORING— <br /> TEST WELL <br /> 276 310 Shale ATHODIC PROTECTION— <br /> HEAT EXCHANGE— <br /> DIRECT PUSH_ <br /> INJECTION— <br /> VAPOR EXTRACTION— <br /> SPARGING_ <br /> SOUTH REMEDIATION <br /> /llustrale or Describe Dismnce of Well from Roads, Buildings, <br /> Fences,Rivers,etc. and attach a map. Use additional paper if OTHER(SPECIFY)— <br /> neeessary.PLEASE BE ACCURATE & COMPLETE. <br /> WATER LEVEL&YIELD OF COMPLETED WELL <br /> DEPTH TO FIRST WATER (Ft.)BELOW SURFACE 1 <br /> DEPTH OF STATIC <br /> WATER LEVEL 118 (Ft.)&DATE MEASURED 7/19/2018 <br /> TOTAL DEPTH OF BORING 31 O ESTIMATED YIELD ' (GPM)& TEST TYPE <br /> (Feet) TEST LENGTH—(Hrs.) TOTAL DRAWDOWN (Ft.) <br /> TOTAL DEPTH OF COMPLETED WELL 280 (Feet) May not be representative of a well's lon -term yield. <br /> DEPTH BORE- CASING(S) DEPTH ANNULAR MATERIAL <br /> FROM SURFACE HOLE TYPE ✓) FROM SURFACE TYPE <br /> DIA. Y w t o MATERIAL/ INTERNAL GAUGE SLOT SIZE CE- <br /> riches Z w p n GRADE DIAMETER OR WALL IF ANY MENT TONI FILL FILTER PACK <br /> Ft. to Ft. m v LL (Inches) THICKNESS (Inches) Ft. to Ft. ✓ (✓) L) (TYPE/SIZE) <br /> 0 240 11 <br /> 240 280 .045 100 280 GRAVEL <br /> -4 <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 RdModesto CA 95357 <br /> — Other ADDRESS CITY STATE ZIP <br /> ATTACH ADDITIONAL INFORMATION,IF IT EXISTS Signed 07/26/18 668622 <br /> WELL DRILLER/AUTHORIZED REPRESENTATIVE DATE SIGNED C57 LICENSE NUMBER <br /> DWR 189 REV.11-97 IF ADDITIONAL SPACE IS NEEDED,USE NEXT CONSECUTIVELY NUMBERED FORM <br />