Laserfiche WebLink
�t Owrrr s Copy WELL COMPLETION REPORT <br /> STATE WELL No.lSTATION NO. ` <br /> Refer to Instruction PamphletPage ❑ <br /> I <br /> Owner's Well No No 525288 I <br /> LATRUDE LONGITUDE <br /> Date Work Began t2,, Ended i <br /> Local Permit Agency APNITR5/OTHERtj <br /> Permit No. Permit Date <br /> GEOLOGIC LOG WELL OWNER <br /> ORIENTATION (!} _.., VERTICAL _HORIZONTAL T ANGLE —(SPECIFY) Name <br /> DEPTH TO FIRST WATER (FL) BELOW SURFACE Mailing Address 874 ISS <br /> DEPTH FROM <br /> SURFACE DESCRIPTION <br /> e S <br /> Ft. to Ft. Describmaterial,grain size,color,etc. WELL LOCA <br /> C A T I O N <br /> 0 4 soil Address Mossda lel Rd <br /> 4 10 SSE rldY clay City Manteca- } <br /> 10 ; 57 ' SAnd County San loactui n <br /> S7 ; 90 ; C aY APN Book Page Parcel <br /> 90 93 SAn Township Range Section <br /> 93 110 ! Clay LatitudeNORTH Longitude <br /> 110 , 139 SAnd DEG. SEC. DEG. MIN. SEC. <br /> LOCATION SKETCH ACTIVITY f <br /> 139 145 Clay —NORTH X NEW WELL <br /> 145 ' 347 Sand MODIFICATIONIREPAI <br /> 147 185 : Fine Sand: —Deepen <br /> 155 170 ; Clay ,Other(SPE <br /> 170 188 ! Sand <br /> DESTROY(Dasa <br /> Procedurea and A <br /> - under"GEOLOG; <br /> ti <br /> i— PLANNED US <br /> ' I tL W MONITORIN( <br /> WATER SUPPLY <br /> Dames <br /> i <br /> Public <br /> i Irrigati 1 <br /> 4 <br /> - Intluatr ' <br /> , <br /> ..TEST WELL <br /> _ CATHODIC F <br /> f SOUTH TION <br /> Illustrate or Describe Distance of Wel!from Landmarks OTHER(Spe <br /> such as Roads,Buildings,Fences,Rivers,etc. <br /> a PLEASE BE ACCURATE & COMPLETE. <br /> DRILLINGROTARY FLUID WATER <br /> METHOD <br /> WATER LEVEL & YIELD OF COMPLETED WELL <br /> DEPTH WATEROLEVEL ATICIO (Ft.) & DATE MEASURED y( <br /> ESTIMATED YIELD (GPM) & TEST TYPE 99 <br /> TOTAL DEPTH OF BORING 188 (Feet) h TEST LENGTH (Hrs.) TOTAL DRAWDOWN (Ft.) r <br /> TOTAL DEPTH OF COMPLETED WELL (Feet) "May not be representative of a well's long-term yield. <br /> CASING(S) DEPTH ANNULAR MATERI: <br /> DEPTH BORE- FROM SURFACE TYPE <br /> FROM SURFACE HOLE TYPE — <br /> DIA. C z ,o MATERIAL/ INTERNAL GAUGE SLOT SIZE CE- BEN- <br /> DIA. <br /> = W =� GRADE DIAMETER OR WALL IF ANY HENT TONITE FILL FILTER E <br /> Ft. to ft. <br /> (inches) m H _ (inches) <br /> THICKNESS (Inches) Ft. to Ft. (TYPE/E, <br /> 0 168 t PLASTIC 6 160 0 t44 X <br /> 168 188 X .045 140 188 X 6R1lYEL <br /> ATTACHMENTS ;(�} CERTIFICATION STATEMIr_NT ! <br /> I,the undersigned,Certify that this report is complete and accurate to the hest of my knowledge and 1 <br /> _ Geologic Log <br /> Well Construction Diagram NAME MASELLIS DRILLING. INC . <br /> (PERSON. FIRM, OR CORPORAT(ON) (TYPED OR PRINTED) <br /> Geophysical Log(a) Modesto CA 953 <br /> Soil/Water Chemical Analyses 11.4 Aiders Rd. <br /> ADDRESS CITY STATE 73P <br /> OtherC-57 LICENSE <br /> 01/15/97 66862 <br /> Signed_ <br /> ATTACH ADDITIONAL INFORMATION, IF IT EXISTS. WELL ILLEA/AUTHORUED REPRESENTATIVE DATE SIGNED <br /> DWR 188 REV.7-90 'IF ADDITIONAL SPACE IS NEEDED, USE NEXT CONSECUTIVELY NUMBERED FORM <br /> I <br /> M. <br />