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QUADRUPLICATE STATE OF CALIFORNIA Y _ N T FILL IN <br /> For Local Requirements WELL COMPLETION REPORT E1111111111111 <br /> Page I of I Refer to halm non Pamphlet STATE WELL NOI .ISTATION NO. <br /> Owner's Well No. 95337 No-e0317433 - -L-1IL. ❑ <br /> Date Work Began 6/3/2016 Ended8/182016 LATITUDE LONGITUDE <br /> Local Permit Agency FrrdmnmwntalHaaNh - __ _.__ I I I I I I I I I I I I I I I <br /> Permit No. 74832 Permit Date 5/102016 APNRRSADTHER <br /> GEOLOGIC LOC WELL OWNER <br /> ORIENTATION(3�) -.(-VERTICAL —HORIZONTAL — ANGLE —(SPECIFY) Name Chris VanGroningen <br /> DRILLING <br /> DEPTH F-"- METHOD ROTARY - FLUID Mud__-. Mailing Address 9851 Hutchinson <br /> DFSCREMON Manteca_-- _. CA--- --95337_ <br /> FL to Ft Deuribe nwterkd grain, size, color, etc. Cm STATE ZIP <br /> 0 6 Sand <br /> _ � 1 HutchinsonW L LOCATION— <br /> Address A <br /> _ 6 13 Shale - __..._- City.Manteca CA 95337 <br /> 13 17 Sand CountySan Joaquin - -- <br /> 17 26 Clay - -- -__- APN Book_... Page , Parcel __- ---. <br /> 26 <br /> .Sand - Township--- Range <br /> ._ 32 _401 Shale _- ---. latitude _---- -...- __ <br /> 40 48 Sand DEG. Mw. sEc. Dec. MIN. (v) <br /> _. _._.._. _._ _ -. -- LOCATION SKETCH —ACTIVITY (i <br /> 48 61 Clay_ _ - __ NORTH ✓ NEW WELL <br /> 61 65 Sand ,- MODIFICAMONIREPAIR <br /> 65 89 Clay —Deepen <br /> 89 112 Sand - - _- 011IN` (sP"l <br /> 112 136 Clay DESTROY (Dewltfe <br /> _-. - -- - - <br /> 136 145 SandPm W GE seesGIIC 0 <br /> UWrt 'GEOLOC LOG G <br /> 145 161 Clay - PLANNED USES(t) <br /> 161 176. Sand WATER SUPPLY <br /> --- ----_----- 0 DaaraBP— Pa <br /> 176 230.Clay/Shale 1 oWb <br /> Clay <br /> _ - ...._._ mgMw <br /> 230 258'-Blue <br /> MONITORING-... <br /> 258 272 Fine Sand TEST WELL_ <br /> 272 281 Clay ATHODIC PROTECTION_ <br /> - -- - <br /> __ 281 - 299 Sand HEAT EXCHANGE— <br /> 299 315 Blue Shale DIRECT PUSH._ <br /> INJECTION <br /> 315 320 Sand <br /> VAPOR EXTRACTION <br /> 320 331 Shale SPARGING <br /> 331 345 Sand -_ - .__. ---.. _.--- SOUTH -- _-__ REMEDIATION_.. <br /> ff.>m.. .fwdljrt R-k BWkU .. <br /> 345 362 Shale Paw Riven,ac. n W. ,m.P. UP:.mhwml M If OTHER <br /> PLEASE BE ACCUR (SPECIFY) --. <br /> ATE A COMPLLTE. <br /> - 362 395 Sand -- <br /> 395: 400 Shale WATER LEVET.&YIELD OF COMPLETED WELL <br /> - -) -_--- - DEPTH 10 FIRST WATER (FL)BELOW SURFACE <br /> _---- - - DEPTH OF STA-gp <br /> WATER LEVEL 6 _. .._.....(Ft)8 DATE MEASURED 7202D16 <br /> _ .. . ESTIMATED YIELD ' _ (GPM)& TEST TYPE <br /> TOTAL.DEPTH OF ROBING 400 (Feet) TEST LENGTH (H.) TOTAL DRAWDOWN In) <br /> TOTAL DEPTH OF COMPLETED WELL400 (Fat) May nor be re m entanee o a well's lm -lean yield, <br /> DEPTHCASINGS) DEPTH ANNULAR MATERIAL <br /> FROM SURFACE BORE- <br /> HOLE :TYPE__O I FROM SURFACE <br /> -._---.- DIA y Z d MATERIAL I INTERNAL GAUGE SLOT SIZE - CE. i AE . <br /> Ft b FL (IUtlNe) CK <br /> 5 m pu GRADE DIAMETER OR WALL IF ANY Ft. b FI MEN1�' <br /> FB.L FILTER <br /> y pa ItmJws) THICKNESS Gnaws) <br /> 00 <br /> 180 _ 24 d -STEEL _ 16 114! 0 7 -- <br /> 180 <br /> 200 —(- _✓`_ __ _ 50 _ - LST� L <br /> �200: 280 .. __— <br /> ATTACHMENTS Iel CERTIFICATION STATEMENT <br /> .__ G.W9. Log I,aw uxivs gee .osmry t11M B88 Mew b oontpbto Y acarate to gw ant W my ImowleUpe led WWI <br /> __. "I CwstnrJblf Diagram NAME MASELLIS DRIJUNO INC 411-C-Ru <br /> GeoPYeKW Lop(8) (PERSON,FIRM,OR 1 IG.0,PW X Cnsrlkal ANyaia 119 A ERS N esto __... CIA _ 953@7SouWaOttla ADDRESS ( CITY STATE ZIP <br /> ---- I 08/18/16__ 60622 <br /> ArrACHADDMONALRUFORMAnON.IFITDOSTS ---- _-..WELL DRILLERAIfTHORIIED REP JDATE SIGNED GS]LICENSE NUMSEI <br /> DWR IN REV.1147 IF ADDITIONAL SPACE IS NEEDED,USE NEXT CONSECUTIVELY NUMBERED FORM <br />