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STATr OF CALIFORNIA AWR )RE ON—�Y DO t0 I <br /> ORIGINAL tL ,J�t-..�' '- <br /> File with DWR WELL COMPLETION REPORT STATE WELL H0,10TATION NO. <br /> Refer to Inetn40At' Pomphllel <br /> Page—of No. 0992604 4 1---� 1. I L 1� <br /> Owner's WeR No, LATITVbE LONGITUDE <br /> Date blrork Ended 81 Ft -- 1 I I I I ti I I I I I l I <br /> TJoeal Pernitt Agency APNfTRa/OTHEFI <br /> Permit No. Pennil Date June 80 �10 0 _, <br /> GEOLOGIC LOG ,• ,;, LL OWNBB <br /> ORIENTATION (4) �_�tVERTICA4 HORIZONTAL ANGLE tSPECIFY) Nand � <br /> DRIIJUNa ,•:;,MailiJ)A es , <br /> METHOD MAId rOtOry _FLUID ` ^ <br /> DEPTH FROM DESCRIPTION �.• Lr <br /> S RFACE L�.::C, , ATE 9P <br /> Ft. Iwo <br /> FL De.srrihe»rriarlal, PT'aln size, color, Rf!:.'•\. �. '�.� � 'W• 'L ,LO ON <br /> 0 z I 3 re cla ``-' ".A�,41 ee 5S Tn '017 <br /> 9 , <br /> IR <br /> t �` { PN Book�° Fage X'arcel—4:21 Tptvris Range—5ecu" — <br /> > <br /> Ile, <br /> . N Tung i yr <br /> MIN, SEC. DEG. MIN, SEC. <br /> LOCATION SKETCH ACTIVITY (v) — <br /> t NORTH NEW wK4L <br /> :\���•' %..:'�t;\ il'� MOOIFICATIONIRSPAIR <br /> 1 D—pan <br /> Olher(SDgc11Y) <br /> ✓- \' ,.•'r3;`;`^iJ- —.._ DESTROYiPuucdbo <br /> � Pro00dOMe And MOteNeb <br /> -��� <'•,` i• >� Under"GEOLOOM LOG") <br /> USES(=) <br /> WATER SUPP4Y <br /> OOtneello PUNIC <br /> a <br /> IIlIAAllan indUelfipl <br /> MONITORING <br /> TEST WELL <br /> CATHODIC PROTECTION_ <br /> HEAT FXCHANOE <br /> . e DIRECT'PUSH_ <br /> INJECTION <br /> t i <br /> t-•�" VAPOR EXTRACTION— <br /> SPAROINO <br /> SOUTH REMEDIATION _ <br /> INuslrPte or Describe 91wnee of WeN(�M Rpads,Bulfdlnpr <br /> oes <br /> Fen ,A(aen,etc,tit akaeh d Otapp,(Ise eddlHmtal ppaper'rr OTHER(SPECIFY) <br /> nMusary.'PLCASE BE ACCUArt7'x&COMF19T6r S <br /> NATER Z•EVEL h YIELD OF COMPLETED WELL ' <br /> DEPTH TO FIRST WATER -- (Fl.)BELOW SURFACE <br /> t UERTH OF STATIC JYy �J <br /> t - WATER LEVEL r / (Fl.)d,BATE MEASURED /y— QN- <br /> ------------ <br /> ESTIMATED YIELD (OPM)&TEST TYPE a i-r - <br /> TOTAL DEPTH OF BOBINC 4Z(U (Feet) TEST LENom a _(mm)TOTAL DRAWDOWN_(FI,) <br /> TOTAL DEFTH OF COMPLETED�Vf t„L, 4 6 0 (Feet) 'Mqy not be re-errw4tive of a well's loo -rcrni yield. <br /> DEPTH CASING (S) DEPTH ANNULAR MATEIRTAL <br /> FROM SURFACE BORE_ FROM SURFACE TYPE <br /> HOLE TYPE(—) <br /> DIA. INTERNAL CiAUOE SLOT 81Zt3 OE• SEN• <br /> (Inchon) Y Meq p�Lt DIAMETER OR WALL IF ANY MFJJT TONITE FILb FILTER PACK <br /> FL t0 Ft. (Irtehee) THICKNESS (Inch9e) FL, to FL t�) (✓) (_) (TYPE/SiZ� <br /> vcf460 6 ,sdr2l 0. 5 x <br /> sdlr21• .035 554601 IF 148 —6 460 x . <br /> , t <br /> ATTACHMENTS (.�L) CERTIFICATION STATENIENT <br /> I,the undersigned,certify that this report Is complete and'accurate to the bast of my knowledge and belles, <br /> — oeolo&Log W��} ��{ <br /> _Wgll C,,engtruMon DlaprAtlt NAME(P eSDrt'Fl M I&Ci�APGR1fII&) A#i mfi)g <br /> _ Geophyalcal Lag(s) r <br /> _SoIIIWrterChernleal AnAlySOS d.—$Q Z &g+! point <br /> N70NE5 <br /> Other nrY "ATF, IIP <br /> .-._ C`� <br /> ATTACH ADDITIONAL INFOAMATlON, IF IT EXIOT5• Slpn 7 L E tRAACTO OA Ea' ��HQ1dt3EH <br /> Dwn 188 BEV,rw.na IF ADDITIONAL SPA& IS NEED , USE NEXT CONSECUTIVELY NUMBERED FORM W cap OR 791 <br />