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I DUPLICATe •. Job-#: 41141 STATE OF C.ILIFoRNIA DwRi USE gNLY - DO NOT FILL. IN <br /> l _ Driller'a dopy WELL COMPLETION REPORT <br /> Pare __Iw Arjar to lrlrlrurflon FaIIII ll(el ZTATE t141-N T <br /> +� �+ u <br /> 7 <br /> Owner s ell NTT. _W811 43 No. I �V�1 1 ILJ <br /> Date Warkj Began 2/12/00 _.Endad 2/15/00„ LA I(Tu E . <br /> Loc a!Pcnit Aenvy O t <br /> APN/T RSIOTH�CR r <br /> PerRT(1j No. 211111 Permit Date <br /> tom— GEOLOGIC LOG WELLap <br /> ORIENTA N (�) —XVERTWOAL _._,FIORI20NTAL _ANGLE ISPs a1ne vJ� _ t ad Water <br /> GRILLINGI[y, <br /> ' <br /> DEPTH OM METHOD Mud Rotary FLUID Mailing Address <br /> SURF DESCRIPTION eIaR»IIt& C A 05!!23 ' <br /> I Ft. to Ft. vt!RL rIbC InfiltTr(Ql, gYrtfTt&1:8, color, etc. CITY ZIP <br /> t <br /> I <br /> o sad with ClayAddress WEL Loc <br /> Rd <br /> 1Silty <br /> iClay city Loat <br /> I I -Rut I a County Son 30aunin <br /> 1 ` 1a APN Book Page--Parcel — .. <br /> I ■ Township Range_ Section + <br /> 1 1C;Lay Latitude I I NORTH Longitude VMEST <br /> 240 1 210 I Gravel DEG. MAY. SEz. DEG. MA sac. <br /> LOCATION SKETCH ACTIVITY { } <br /> NORTH ,Z NEW WELL <br /> MO DWI CAT I O N!RE',P AI R <br /> I 1 1 ,f <br /> 1 V A tILD Other(Specify) <br /> i DESTROY(Dv=lbe <br /> h <br /> I I Pmeear"pod Aworlefe <br /> I I �4� 7s's trnaeraptroLDorcloo'7 . <br /> t PLANNED USES (4) <br /> JO WATER SUPPLY <br /> I I Owes* FLWIQ <br /> Iregtlfan Indu <br /> MOMTORM <br /> 11 I .1 <br /> TEST WELL <br /> CATHODIC:PROTECTION <br /> I ' _ N HEAT ExCFWTGE <br /> PEREGT PUSH <br /> W I ' f�1 �,;�� K INJECTION <br /> YAPOR ExTRACTION <br /> ! �l 11PARGING <br /> 1' r SOUTH I REMEDIATION <br /> !flesemfe ar Dmcr1&Ulslerrcr of Welifrom Aaeds,HNI&L'n,a <br /> Fentea.Afcrrs,etc.and atlodl a rltap 1�atldNkrnnf flet fj OTHER(SPECIFY), <br /> f nnxaary.PLEASE BE ACCURATE b CO3fpLErE, <br /> 1 1' WATER LEVEL & YIELD OF COMPLETED WELL <br /> 1 1 DEPTH TO FIRST WATER (FT,)BELOW SURFACE <br /> I DEPTH OF STAT)V <br /> WATER LEVEL_ TO&DATE MEASURED <br /> ' ESTIMATED YIELD' (OPMi T1 TEST TYPE <br /> TOTAL UPTH OF BORING _ 2f 0 {Feet} TEST LENGTH (Nn,)Tp7AL DRAWDOWN_ <br /> TOTAL D PTH OF COMPLETED WELL IFI.)—�5D IFeei1 'Mar not be rsprerrntative 'o mell'tlaly -terra yield. <br /> ! l' <br /> FROM 5 FACE BORE' CASING (S) ANNULAR MATERIAL <br /> HOLE TYPE(—) DEPTH <br /> D(A. FROM SURFACE TYPE <br /> _ T5j MATERIAL/ INTERNAL GAUGE SLOTafm <br /> FI. Ft. ( IIS) GRADE OUVMETER OR WALL IF ANY CE BEN- FILTER PACK <br /> - " (Imm") THICKNESS itnat ee) Ft. to FL MEM TONITE FILL mpEl ae) <br /> k <br /> 1240 ' <br /> n <br /> 1 <br /> IL <br /> 1 <br /> 1 <br /> 1 <br /> ATTACHMENTS CERTIFICATION STATEMENT <br /> 4- Geob9k L'9 1,lite undersignetl,cerllfy tat this report)s+ Tnplele and accurate to the best tN my knoWiedge and belief, <br /> Well ComttuatVon DfaWam NAmE Don Stratton for BB lik Drilling, Inc. <br /> Gewhys"I Log(s) I—wri,RAM.DR CORFURATMID (TYPED DA PAIKTEDI <br /> SDII/WaterChemical Anelyses B1 I a Habra � 90631 <br /> Other ADDRESS Gf1Y STATE ZIP <br /> ATTACH mt]NAL NvFOAMATWk fF 1T Exfsra Sl~11 INE11D E IQ43 1 <br /> DATE SIGNED C.57 LICENSE NUMBER <br /> Du7t 18$t�V 11-97 IF ADDITIONAL SPACE IS NEW <br /> SE NEXT CONSECUTIVELY NUMBERED FORM <br />