Laserfiche WebLink
QUADRUPLICATE STATE OF CALIFORNIA DWR USE ONLY — DO 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. 95366 No.e0369872 ED ❑ <br /> Date Work Began 10/24/2018 Endedl0/26/2018 LATITUDE LONGITUDE <br /> Local Permit Agency Environmental Health <br /> Permit No. wp0038671 Permit Date 8/16/2018 APN1rRS/OTHER <br /> GEOLOGIC LOG WELL OWNER <br /> ORIENTATION(✓) VERTICAL —HORIZONTAL —ANGLE —(SPECIFY) Name Dale VanGroningen <br /> DRILLING ROTARY <br /> DEPTH FROM METHOD FLUID Mud Mailing Address 21171 Jacktone Rd <br /> SURFACE <br /> DESCRIPTION Ripon CA 95366 <br /> Ft. to Ft. Describe material, grain, size, color, etc. CITY STATE ZIP <br /> 0 3 Top Soil21025 S. Jacktone Kq LOCATION <br /> 3 75 Sand Address <br /> City Ripon CA 95366 <br /> 75 80 Clay CountySan Joaquin <br /> 80 105 Sand APN Book Page Parcel <br /> 105 135 Clay Township Range Section <br /> 135 190 Sand Latitude I 1 I <br /> 190 230 Clay DEG. MIN. SEC. DEG. MIN. SEC. <br /> 230 233 Sand LOCATION SKETCH ACTMTY ) <br /> NORTH _3L NEW WELL <br /> 2331 245 Clay MODIFICATION/REPAIR <br /> 245 247 Sand —Deepen <br /> 247 250 Clay —other(Specify) <br /> 250 253 Sand <br /> 253 260 Clay PEroced res escribe a0nd Materials <br /> 260 268 Sand Under"GEOLOGIC LOG' <br /> 268 275 Clay IPA EER S <br /> PANNE <br /> 275 277 Sandw in <br /> _-ZDomestic— Public <br /> 277 300 Clay — Irrigation Industrial <br /> MONITORING— <br /> TEST WELL— <br /> ATHODIC PROTECTION— <br /> HEAT EXCHANGE— <br /> DIRECT PUSH— <br /> INJECTION_ <br /> VAPOR EXTRACTION— <br /> SPARGING— <br /> SOUTH REMEDIATION— <br /> 111-trate or Describe Distance of Well from Roads, Buildings, <br /> Fences,Rivers,etc, and attach a map. Use additional paper if OTHER(SPECIFY)— <br /> necessary.PLEASE BE ACCURATE & COMPLETE. <br /> WATER LEVEL&YIELD OF COMPLETED WELL <br /> DEPTH TO FIRST WATER (Ft.)BELOW SURFACE 1 <br /> DEPTH OF STATIC 10/26/2018 <br /> WATER LEVEL 40 (Ft.)&DATE MEASURED <br /> ESTIMATED YIELD (GPM)& TEST TYPE <br /> TOTAL DEPTH OF BORING 300 (Feet) TEST LENGTH <br /> (Hrs.) TOTAL DRAWDOWN (Ft) <br /> TOTAL DEPTH OF COMPLETED WELL 280 (Feet) May not be representative of a well's loo -term yield. <br /> DEPTHCASING(S) DEPTH ANNULAR MATERIAL <br /> FROM SURFACE BOE TYpE FROM SURFACE TYPE <br /> DIA. y w a MATERIAL/ INTERNAL GAUGE SLOT SIZE CE- BEN- <br /> 2 <br /> Z w z0 a GRADE DIAMETER OR WALL IF ANY MENT TONIT FILL FILTER PACK <br /> Ft. to Ft. m 0 v LL (Inches) THICKNESS (Inches) Ft. to Ft. ✓ (✓) �) (TYPE/SIZE) <br /> 0 260 11 PLASTIC 6 200 0 200 _ <br /> 260 280 ✓ GRAVEL <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 /> — SoiltWater Chemical Analysis 119 Albers Rd Modesto CA 95357 <br /> — Other ADDRESS CITY STATE ZIP <br /> ATTACH ADDITIONAL INFORMATION,IF IT EXISTS. 11 Signed 11/20/18 668622 <br /> WELL DRILLER/AUTHORIZED REPRESENTATIVE DATE SIGNED C-57 LICENSE NUMBER <br /> DWR 189 REV.11-97 IF ADDITIONAL SPACE IS NEEDED,USE NEXT CONSECUTIVELY NUMBERED FORM <br />