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u Lj <br /> ORJGiNAL r STATE OF CALIFORNIA ["W" <br /> R ua ONLY — oo <br /> "or <br /> t N <br /> File with WR WELL COMPLETION REPORT 0 <br /> jpS��T �D�,•.�_ -_ Refer to Inrtractfan FrupnphIpt STATE WELL MOISTATION NO <br /> Owner's Well NO MW-4 No 7 8 ❑ <br /> g/25 98 9/25/98 LATITUDE LON4itTUoE <br /> DRte Werk Began _ Ended:. <br /> LocalPe -ut Nz o 01 5 ^T APNIYR510THER <br /> Pcrrnrt�Io Q1��S�LR _..._.Permit Date_..81r5.1A.$ <br /> GLOLOGIC LOG WELL 0WINEI1 <br /> ORIENTATION (.L) VERTICAL _K()R$Z0NTAL —ANGLE _(SPECiFn N81ne <br /> RW ETHOD FLUID art u1tng Addmss,9n_ Team 4 _- <br /> LJNQ <br /> o s8URrACC DESCRIPTION fl a n )R atenn h �YQ ` p <br /> R to Fr Datoribe material,grnin size, color, etc c�T�� ttATE <br /> SvrLL LOCATION <br /> 6Q.91, Adrlress <br /> City e-.tar�Ct on <br /> ' ('oTtntyPan aaacuin <br /> ' AFN Book 44Waj, Parcel <br /> TowFlchiB Rzinge Section <br /> ' Latitude � , rtDRTH Longltttdo^ 1 �1 WEST <br /> r r DEG ratty. BEG OEG WN SEC <br /> LOCATION SKETCH ACTIVITY (�} <br /> r NCQ) NEW WIZU <br /> tdODiFtCA110N1 REPAIR <br /> I 1 SS e e map. Deepen <br /> _ Other(SPOCIIA <br /> 1 h \ <br /> DESTROY Ivsscdbe <br /> f t Aroeedwas and MatenRls <br /> Under VEOLnQtc LOG 7 <br /> PLANNED USES (�) <br /> WATER SUPPLY <br /> t r Domesltc�.., Prt4ito <br /> � ,�_ hnga4o¢ .,,�Sndlisirlal <br /> ` 3 a MORGOWNG <br /> I r TEST WELf,..`_ <br /> CATFi0 HPROTECTION <br /> HEAT <br /> h � AT EXCHANGE <br /> 1 DWELT PUSH <br /> , 1 <br /> W.rEOTrO'd,�_ <br /> 1 VAPOR EXrRAGTION^� <br /> I 1 SPARO XG <br /> I 1 RCMEDIATION <br /> Ilf atrete or Desrnbe Dlstame of Well from Itnads Buth tngs <br /> I r Fences Rfizry eta aarl attach a Innyy..L'ur adail[U 1 paprr If OTHER(SPf:G4Fy►,� <br /> neeeafert� PLEASE Bt ACCURITL tr COfPIE3E <br /> 1 WATER LEVEL & YIELD OF COMPL1:TFI) WE LL <br /> 1 <br /> 1 DEFTR TO FIRST WATER (R)BELOW SURFACE <br /> r DER714 OF STATIC <br /> WATER IAVEL (FL)&DATE t+dMURED <br /> ESTMATED YIELD' (GPM)A TEST TYPE <br /> TOTAL DEPTH OF B013INIG (Iect) TEST LENGTH lira)TOTAL URAINDOWN _(Ft) <br /> TMAL DEPTH Or COMPLT:TED WrLL (Feet) 'May not be representeuve o fr Tuell's lan -re»n ytdd <br /> DEPTHCASING (S) DEIzTH ANNULAR NIAMRIAL <br /> FROM SURFACE 8ORE <br /> HOLE TYPE fROM"SURFACE; TYPE <br /> f } <br /> DIA }wz R MATERIAL INTERNAL GAUGE St OT SITE CE REN- <br /> FL io FL (Irpchea' g y GRADE CKAMETE(Inchag)R THICKNESS (Inches)ANY <br /> FL to Fl OR WALL tr- MENT TONkT£ Fill <br /> I t <br /> I r <br /> r I <br /> 1 h <br /> , 1 <br /> \TTACII�iEVIS (!) CERTIFICATION STATRIM IVT <br /> — Geoiogc Log f,the undersigned,certify that this report IS compiete and accurate to the best of my knowledge and belief <br /> Well.ConinxtionDiagram NAME P_pr$g1G�p' Friyi-ronmental Group _ _ <br /> — GeophYsic.alLog(s) 13 °N �ui13C79�i10 d�i� GSte. M, Rancho Cordova, CA <br /> Soillwater Che real Analyses <br /> AD°RfSSCH <br /> T Y STALE L,P <br /> Other <br /> ATTACH ADDITfONAL tNt�RMATt N 1F IT EX1$TS 8lgnad M& _ A��_ - ' <br /> °fllUFltJPll tiIZE EC IY ` °7r rC I�iy C 37 , SE NllM�ER <br /> DUA 1%AEN, it-W IF ADDITIONAL SPA IS NEED D, USE NEXT CONSECUTIVE N MER <br />