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J <br /> ORIGINAL STATE OF CALIFORNIA DWR USE ONLY — DO NOT FILL.. iN <br /> File with DWR WELL COMPLETION REPORT <br /> ]page-_ofd_ Refer to Instruction Pamphlet STATE WELL NO/STATION NO <br /> Owner's Well No .MW-4R ., No 807234 <br /> ❑ <br /> Date Work Began,March 24.2003 —, Ended March 24 2003 LATITUDE LONGITUDE <br />' Local Permit Agency San Joa um County Public Health Services <br /> Permit No 31047 Permit DateAuAusl 30,2002 APNITRSIOTHER <br /> i <br /> GEOLOGIC LOG WELL OWNER <br /> ORIENTATION VERTICAL —HORIZONTAL ANGLE —(SPECIFY) Name Rase RodgeGs Estate n. <br /> MET= Mailing Address 11900 S Union goad <br /> DEP*SURFACE DESCRIPTION Manteca ,_,�_ CA 95336 <br /> FL to FL Describe material grain size color etc CITY STATE Zip <br /> WELL LOCATION <br />' 0 I 5 r Fill,sand with ravels and fines Address_51510L Charter Way <br /> 5 , 32 I Clayey Silt,brown City <br /> 32 34 Silty Sand dark gray County San Jnaqiljp <br /> 34 r 44 1 Gravelly Sand,dark gray APN Book .147 page 74 Parcel 8 _ <br /> 44 57 r Sand,dark gray Township—Range Section <br /> 57 I 60 I Silty Clay,dark gray Latitude I I NORTH <br /> 60 I 62 Silt Sad dark ra I ongitude I wesT <br /> DEG MIN --SEG DEG MIN SEG <br /> 62 , 72 ,' Silt,olive gray LOCATION SKETCH ACTIVITY (�) <br /> 72 75 , Silty Clay gray NORTH ✓ NEW WELL <br /> MODIFICATIONlFIEPAIR <br /> 75 I 79 1 Gravelly Sand,9Y — Deepen <br /> 79 , 80 , Sandy Silt,olive gray — Omer(Spectly) <br /> I r DESTROY(Describe <br /> Procedn <br /> Under <br /> res GEOOLOGICILOG) <br /> PLANNED USES (i) <br /> 1 WATER SUPPLY <br /> 1 r <br /> — Dowel* ^, Pubilc <br /> — tn)geilm �_ Indusirlel <br /> I 1 W MONITORING✓ <br /> TEST WELL <br /> 1 r CATHODIC PROTECTION— <br /> { , HEAT EXCHANGE— <br /> DIRECT PUSH— <br /> 1 r INJECTION_ <br /> r n VAPOR EXTRACTION <br /> I r SPARGING— <br /> SOUTH REMEDIATION <br /> 1111,51rale ur Describe Ur.rtanee of LVell front Roads Bndd„1gs <br /> 1 r Fences Rr.n de and attach a rtnpp Use additional paper ifOTHER(SPECIFY) <br /> necessanl PLEASE BE ACCURATE b COMPLETE <br /> , 1 <br /> 1 WATER LEVEL h YIELD OF COMPLETED WELL <br /> DEPTH TO FIRST WATER 35 (FI)BELOW SURFACE <br /> DEPTH OF STATIC <br /> WATER LEVEL 21 52123.15 (FI)A DATE MEASURED ApEil <br /> TOTAL DEPTH OF 80RING 30 ESTIMATED YIELD (GPM)d TEST TYPE <br /> (Feet) TEST LENGTH (Ws)TOTAL DRAWDOWN IFI) <br /> TOTAL DEPTH OF COMPLETED WELL 3-Q—(Feet)_ (Feet) •May not be rtprtrentativr ofa Tpell'r long-term yield <br />' DEPTH BORE CASING (S) DEPTH ANNULAR MATERIAL <br /> FROM SURFACE HOLE TYPE() FROM SURFACE TYPE <br /> DIA s MATERIAL/ INTERNAL GAUGE SLOT SIZE CE BEN. <br /> Ft to FL IMdres) DIAMETER OR WALL IF ANY FILTER PACK <br /> GRADE MENT TONlTE FILL <br /> {Inches] THICKNESS {Inches) Ft to fl (�) (�) (�) (TYPFJSIZE) <br /> 0 1 35 8 ✓ PVC 2 Sch 40 0 I 29 ✓ <br /> 35 , 50 8 IV PVC 2 Sch 40 0 020 29 I 33 ✓ <br /> 0 n 75 8 ✓ PVC 2 Sch 40 33 I 51 ✓ #3 Sand <br /> 75 1 80 B ✓ PVC 2 Sch 40 0 020 51 , 73 ✓ <br />' r 73 1 80 ✓ #3 Sand <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 CDnsvuctlon Diagram N"E CascadeDrilling Inc <br /> ON FIRM OR <br /> Geophysical Log(s) (PERSCORPORATION) UYPED OR PRINTED) <br /> SoMater Chemical Analyses 3632 Omec Circle Rancho Cordova CA 95742 <br /> Other ADDRESS CITY STATE IIP <br /> ArrACH ADDITIONAL iNFOpMATTON iF tr Exisrsargr,edA June 18,2003 717510 <br /> rlEEl IU.ERIAVFHORIIEO R NTAIIVE DATE SIMV C 57 LICENSE NUMBER <br /> D1%R 188 REV 111T`r IF ADDITIONAL SPACE IS NEEDED, USE NEXT CONSECUTIVELY NUMBERED FORM <br />