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ORh�,INAI. 1� STATF OF CALIhOR`IA Dwrl USE ONLY - Do N T rJLL IN <br /> File with DWRWELL COMPLETION REPORT <br /> Page--I—of I Refer1r; lnoructlanPamphlet STAI�E WELL NO(STATION NO <br /> Owner's Wel) No UK 2 No 703816 l--� -(- � D D <br /> • DatetiVOrkBegan - -4455�cl& Ended 9,/2" l-- VC18 LATITUDE LONGITUDE <br /> Loctl Pelma Agency San_ Joagiu I-r_oYltY-_Enyiro� ea th__.__� I <br /> APNOTFISIOTHER <br /> Permit ho _015568 Porn-0 Date 8/598 <br /> GEOLOGIC LOG kVELL OWNER <br /> ORIENTATION (t!,) X VERTICAL —HORIZONTAL _ANGLE —(SPECIFY) N,-I1Ie Che ron PrOdu _tCompiany <br /> ILLING <br /> METHOD FLUID Mw[wg Llddres§ P.Q. Box 6004 <br /> DEPTH <br /> om <br /> s RFACL DESCRIPTIO` San Ramon <br /> Ft to M Describe material gran size, calor etc CITY srnTC ZIP <br /> L LOCATION <br /> 0 t 58 ; Pressure grouted FIT utb �F3 Dnra4lo <br /> r�ddress 131.7 ��-rmegt <br /> + <br /> cement. To f casing— city grkton <br /> t <br /> drilled out. County S a Al <br /> 0TownAVIV Book tj_- P_a`ge___fA0 Parcel 030- <br /> Township <br /> ship Range Sechon <br /> L.It>tudeN2919Longttflde, I I WEST <br /> r DEQ MIN. SEC- DCG MIN SEC <br /> LOCATION SKETCH ACTIVITY (�} <br /> + NORTIi _NEW WELL <br /> I <br /> MOBlFECATIONIR@PAIR <br /> I I oeepen <br /> 1 r <br /> See map. Otrer{Specify) <br /> t r <br /> DESTROY 112escrl9a <br /> f r Prccadaros and MRteaats <br /> Under WCOLOG(G LOG) <br /> + + PLA�NNED USES (:) <br /> r WATER SUPPLY <br /> Domestic ___ Public <br /> I r <br /> � irngafioq lrutfrstnai <br /> l t L W MONITORENG <br /> l r TEST WELL_ <br /> r CATHODIC PROTECTION�. <br /> FfkDI Fa(CrN <br /> ow <br /> f l=_cPUSH� r usrl_ <br /> f 1 vWFCTION <br /> r I VAPOR CCTnACTION <br /> ! I SPARGING <br /> t r SOUTH REMEDfAT1ON <br /> Ilfartrate or Describe DWanee of iVell imm!lards Baddf os <br /> r recce%Rf&ers etc and attarh a rnapp IUssee addition{�rep il OTHER(SPECIFY) <br /> neres+an� PLEASE 1*AGGVRAffi dr CONFIT:TLj <br /> r f WATER LEVEL & YIELD OF COIIPLETED WFLL <br /> ! f <br /> t I DEPTH TO FIRST WATER (FL)9ELOW SURFACE <br /> DEPTH OF STATIC; <br /> f WATER LEVEL (Ft)a,DATE MEASURED <br /> f ESTIMATED YIELD (GPM)&TEST TYPE <br /> TOTAL DEPTH OP SORriG (Feat) TEST LENGTH (Hes-)TOTAL oRAWDOWN (FL) <br /> TOTAL DrFrff OF COMIPLETFD WELL (Feet) May not be representative of a well's long-terns yield <br /> DEPTH BORE_ CASING (S) DEPTH ANNU1,111 1IATERIAL <br /> FROM SURFACE HOLE TYPE{✓y FROM SURFACE TYPE <br /> DIA MATERIAL INTERNAL GAUGE SLOT SIZE CE <br /> (Irfchea) a GRADE DIAMETER OR WALL IF ANY HENTI',ll!r <br /> TEFRt FIL7ER PACK <br /> FI_ to Ft, (Inches) 'THICKNESS (Inches) Ft to FL (TYPSSIZE) <br /> � <br /> ! r <br /> t + <br /> E 1 <br /> + ATTACI[IIP.RTS (�} C17RTII:ICATION STATEMENT <br /> Geologic Log I,the Undersigned,cortify that this report Is complete and accurate to the best of my knowledge and belief <br /> .` <br /> PaCific Environmental Grou , Inc. --_ __-- <br /> Well Cgnsiructlan Diagram N E'tPERSON FIRM OR CORPORATION) (TYPLO OR PRINTED) P <br /> — Goophysicaf Log(s) 11315 Sunrise Cold Cr. , Ste. M, Ranco Cordova, CA <br /> SoN1N11 <br /> r Chemical Analyses <br /> Other 0.00RE55 ' f CIN STATE TP <br /> (k"4kz,_ ® ra <br /> ATTACH ADDITIONAL INFOA TION 1F R DUST& S>gaoB— <br /> L ERf RIZED REPRE I c DDA E 5 Ei/ 53 UCEIZE MrdBER <br /> Dwit Iso Rry It 91 IF ADDITIONAL SP IS NEEDA USE NEXT CONSECUTIVELY N <br />