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QUADRUPLICATE STATE OF CALIFORNIA DWR USE ONLY — DO NOT FILL IN <br /> For Local Requirements WELL COMPLETION REPORT L__1____1-1__.i_ 1 I I I I <br /> Page 1 of 2 Refer to Instruction Pamphlet STATE WELL NO.I STATION NO. <br /> Owner's Well No. 95320 No'e0369852 ❑ ❑ <br /> Date Work Began 10/`x/2018 , Ended LATITUDE LONGITUDE <br /> Local Permit Agency Fnvimnrn antal Hgsnkh <br /> Permit No, wpv 0038758 pmt jjate 9/10/2018 APWTRSIOTHER <br /> GEOLOGIC LOG WELL OWNER <br /> I �L VERTICAL -__.__HORIZONTAL ANGLE —(SPECIFY) Name Joe DaSilva <br /> ORIENTATION(—} DRILLING <br /> DEPTH FROM METHOD ROTARY FLUID Mud Mailing Address 2466 Mariposa Rd SURFACE I <br /> DESCRIPTION Escalon CA 95320 <br /> FL to Ft Describe material, grain, size, color, etc. CITY STATE ZIP <br /> 0 ___ 3 Top Soil Address 23335 Dodds RITELL LOCATTO <br /> 3 7 Hard Pan City Escalon CA 95320 <br /> 7 9 Sand County San Joaauin <br /> 9 13 Shale APN Book Page Parcel <br /> 13 16 Sand Township Range Section <br /> 16 43 Shale Latitude I 1 r <br /> 43 61 Clay DEG. MIN, SEC. DEG. MIN. SEC. <br /> 61 68 Sand LOCATION SKETCH A(.'TIVITY L) <br /> NORTH _3L NEW WELL <br /> 68 140 Clay <br /> MOOIFICATIONlREPAIR <br /> 140 146 Gravel —Do"- <br /> 146 1491 Clay Dth-(Sp-gy) <br /> 149 151 Gravel <br /> end M <br /> 151 163 Clay — ceDESTROY ba <br /> Prodrxes ane aearYla <br /> Under"GEOLOGIC L <br /> 163 166 Sand and Grave! <br /> PLANNED 166 192 Shale WATER SUPPLY <br /> PuW <br /> Danatk <br /> 192 195 Sand and Gravel ~ ~ <br /> — <br /> 195 201 Shale Irrl�rbn — Ira,st <br /> MONITORING- <br /> 201 208 Sand <br /> TEST WELL <br /> 208 214 Shale THODIC PROTECTION_ <br /> 214 215 Sand HEAT EXCHANGE- <br /> 215 230 Clay DIRECT PUSH_ <br /> 2,.30 242 Sand INJECTION <br /> 242 253 Shale VAPOR EXTRACTION— <br /> SPARGING, <br /> 253 260 Sand and Gravel SOUTH REMEDIATION— <br /> Rhrna�r or D-4,Dim—of Mdi frow Ruud+. Bddding, <br /> 260 311 Shale Para,RiwA aft. and WWh a srp. Um additivad POW it OTHER(SPECIFY)- <br /> 311 317 Black Sand emery"PLLAM BZ ACCURATIE A cohn,[ZTs <br /> 317 334 Shale WATER LEVEL&YIELD OF COMPLETED WELL <br /> 3UI 337 Black Sand DEPTH TO FIRST WATER (Ft)BELOW SURFACE <br /> 337 356 1 Shale DEPTH OF STATIC <br /> 3NI 36 <br /> 1 Mack Sand WATER LEVEL (FL)&DATE MEASURED <br /> ESTIMATED YIELD (GPM)& TEST TYPE <br /> TOTAL DEPTH OF BOPJNG 600 (Fed) TEST LENGTH (Hrs.) TOTAL DRAWDOWN <br /> (FL) <br /> TOTAL DEPTH OF COMPLETED WELL (Foot) May not be reymmmative o a well's lon -term vidd. <br /> DEPTH CASING(S) DEPTH ANNULAR MATERIAL <br /> FROM SURFACE HOLE TYPE FROM SURFACE p <br /> DIA. Nice MATERIAL I INTERNAL GAUGE SLOT SIZE CE- BEN- <br /> (�) SGRADE DIAMETER OR WALL IF ANY FILTER PACK <br /> FL to FL m (Inches) THiC10JESS (Irx;tw) Ft. to Ft MENT 70NIT FILL (TYPFJSIZE) <br /> f (�) ci) <br /> ATTACHMENTS (y CERTIFICATION STATEMENT <br /> -- Oeobdc LW I,to w%WWpwd,oortfy that this report Is complete old secura*to the haat of my Wiaaftdge end beld <br /> OW Cawtnarion olevwn NAME MASELUS DRILLING INC -- <br /> Geophysical top(a) (PERSON,FIRM,OR CORPORATION) (PIPED OR PRINTED) <br /> — SoiNWaar Ch.rncr Andytla 119 Albers Rd Modesto CA 95357 <br /> Phar ADDRESS CITY STATE ZIP <br /> ATTAC H ADARICAIAL M FORAdATION,iF ITEM MSV-d 10/05/18 668622 <br /> WELL DRU-MAUTHORIZED REPRESENTATIVE DATE SIGNED C-57-LICENSE NUMBER <br /> DWR IU REV I1A7 IF ADDITIONAL SPACE IS NEEDED,USE NEXT CONSECUTIVELY NUMBERED FORM <br />