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ORIGINAL STATE OF,CA_IFORNIA DWR USE ONLY — DO NOT FILL IN <br /> File with DWR WELL COMPLETION REPORT <br /> Page_of <br /> Refer to In.v(rurtiun Pamphlet STATE WELL NO./STATION NO. <br /> Owner's Well No. No. �1 7 O <br /> Date Work Began 8-28-00 Gndcd 9-9-00 1 / LATITUDE LONGITUDE <br /> Local Permit Agency San Joaquin County <br /> APN/TRS/OTHER <br /> Permit No. 23720 Permit Date <br /> GEOLOGIC LOG ` 'WELL OWNER <br /> ORIENTATION (!) —VERTICAL —HORIZONTAL —ANGLE —(SPECIFY) I <br /> DRILLING <br /> DEPTH FROM <br /> METHOD FLUID <br /> SURFACE DESCRIPTION - <br /> Ft. to Ft. Describe NI/ItC I-!t/l, grain Size, Culor, etc.�\ C - <br /> �. <br /> WELL LOCATION <br /> 0 13 � T �A�ldhess Same ' <br /> 13 18 Clay <br /> I I San 20 52 Clay <br /> `` /"-'',`1+ APN Book Page Parcel <br /> Sand - r. <br /> - To+vlisht <br /> 6dRan e Section <br /> ' 70 Clay ��Laiife 1 I NORTH Longitude I I WEST <br /> 7 0 C a n ,,1,`,` DEG. MIN. SEC. DEG, MIN SEC.' <br /> J J+ ', '` '� LOCATION SKETCH ACTIVITY (2!L) <br /> 73 86 <br /> C; .a \`•_;. \ �\ NORTH <br /> NEW WELL <br /> 86 88Sand' , <br /> MODIFICATION/REPAIR <br /> U Ja; — Deepen <br /> libb 242 B tae C 1 ayt, — Other(Specify) <br /> 242 244-, -B ue sand <br /> r�•\ � DESTROY(Describe <br /> I ,i. I B, ue e l-a L• Procedures and Materials <br /> Under"GEOLOGIC LOG') <br /> 246 257, Blue sand","&-t-lay streaks PLANNED USES-257 (�) <br /> 0 "CI a ` WATER SUPPLY <br /> __3bU 365 Shale w- sand streaks Domestic _ Public <br /> 365 <br /> Sha 1 e w _ Irrigation Inc uslrlal <br /> ' 3 w MONITORING <br /> 42/ 434 Sand TEST WELL <br /> 434 4bb Clay CATHODIC PROTECTION_ <br /> i <br /> HEAT EXCHANGE <br /> DIRECT PUSH <br /> ' INJECTION _ <br /> ' VAPOR EXTRACTION <br /> SPARGING_ <br /> SOUTH <br /> I i REMEDIATION_ <br /> 111-1rate ur Describe Di.stancc rl IVcll(rum Noor/r,Nuilrliirrv, <br /> Fences,Riots,etc.and attach a ma). se nrlrlitiounl,'n(ter if OTHER(SPECIE)') <br /> necessnny.PLEASE BE ACCURATE v COAIPLET'. <br /> I I <br /> WATER LEVEL & YIELD OF COMPLETED \YELL <br /> • I I <br /> i DEPTH TO FIRST WATER 160 (Ft.) BELOW SURFACE <br /> DEPTH OF STATIC <br /> WATER LEVEL (Ft.)&DATE MEASURED <br /> ESTIMATED YIELD ' (GPM) & TEST TYPE <br /> TOTAL DEPTFI OF RORINc 455 (Feel) TEST LENGTH (His.)TOTAL DRAWDOWN (Ft.) <br /> TOTAL DE"1711 OF COMPLETED WELL 440 (Peet) 'Allay not be representative•of a'well's lon -teiwipeld. <br /> DEPTH CASING (S) DEPTH ANNULAR N(ATERIAL <br /> FROM SURFACE BORE- T!TYE(�L FROM SURFACE TYPE <br /> HOLE <br /> DIA. a MATERIAL/ INTERNAL GAUGE SLOT SIZEC7NTT((.I <br /> EN- <br /> (Inches) ��- a GRADE DIAMETER OR WALL IF ANY MNITE FILL FILTER PACK <br /> Ft. to Ft. OU (Inches) THICKNESS (Inches) FL to Ft. (TYPE/SIZE) <br /> o S —�) <br /> 0 100 1211 II ifin 0 200 _ X <br /> X PVC 6" 200 200 440 <br /> 300 420 12" X PVC 611 160 <br /> 0 440 1211 11160 <br /> ATTACIINIENTS (zL) 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 Construction Diagram NAME Hennings Bros. Dri l ling Co.-Inc. <br /> Geophysical Log(s) <br /> (PERSON. FIRM, OR CORPORATION) (TYPED OR PRINTED) <br /> Soil/Water Chemical Analyses 3525 Pe l anda le..A <br /> Other ADD SS CITY n!1 STATE ZIP <br /> ATTACH ADDITIONAL INFORMATION, IF IT EXISTS. SignedadLh9—�i_f l i t <br /> WE L LER/UTHORIZED REPRESENT E DATE SIGNED C-51 LIC NSE MBER <br /> D4YR 188 REV..11.97 IF ADDITIONAL SPACE ISN USE NEXTODNSECUTIVELY 61 <br /> BERED FORM <br />