FIELD DOCUMENTS - Laserfiche WebLink

Home Browse Search

`The free Adobe Reader may be used to view and complete this form. However,software must be purchased to complete,s- and reuse a saved form. File Origin t with DWR State of California DWR Use Only—Do Not Fill In Well Completion Report Page OfRefer to Instruction Pameh/et State Well Number/Site Number Owner's Well Number BH-2-2014 No. e0237749 I INI I I Iw Date Work Began 08/25/2014 Date Work Ended 9/2/2014 Latitude Longitude Local Permit Agency San Joaauin County Environmental Health I I I I 1 1 1 1 1 1 1 1 Permit Number Permit Date APN/TRStOther Geologic Log Well Owner Orientation O Vertical O Horizontal OAngle Specify Name City Of Stockton Drilling Method Sonic Drilling Fluid Mailing Address 425 N EI Dorado St 2nd Floor Depth from Surface Description Stockton CA 7i 95202 Feet to Feet Describe material, rain size,color,etc Cit State p 0 28 Silty sand Well Location 28 39 Sand Address 1320 W Weber Ave. 39 44 Silty sand with fine gravel City Stockton County San Joaquin 44 52 Clay with sand Latitude N Longitude W 52 55 Sand with silt Deo Min. Sec. Dea. Min. Sec 55 1104 Clay with sand Datum Dec. Lat. Dec.Long. 104 118 Sand with silt APN Book Page Parcel 118 124 Clay Township -Ran a Section 124 148 Sand with silt Location Sketch Activit 148 219 Silty Clay Sketch must be drawn by hand after form isprinted.) O New Well Orth O Modification/Repair 219 243 Sand with silt O Deepen 243 252 Gravel O Other 252 263 Sand O Destroy Describe procedures and materials 263 271 Clay under*GEOLOGIC LOG' 271 277 Sand with silt Planned Uses 277 300 Sand O Water Supply ❑Domestic ❑Public 3 w ❑Irrigation ❑Industrial O Cathodic Protection O Dewatering O Heat Exchange O Injection O Monitoring Drilled with 9"casing to 100' &then switched O Remediation to 8" O Sparging South O Test Well Illustrate or describe distance of well from mads.buildings,fences. O Vapor Extraction rivers,etcand attach a map Use addl anal paper if necessary Q Other Please be accurate and complete Water Level and Yield of Completed Well Depth to first water (Feet below surface) Depth to Static Water Level (Feet) Date Measured Total Depth of Boring 300 Feet Estimated Yield" (GPM) Test Type Test Length (Hours) Total Drawdown (Feet) Total Depth of Completed Well 254 Feet May not be representative of a well's long term yield. Casings Annular Material Depth from Borehole Type Material Wall Outside Screen Slot Size Depth from Surface Diameter yp Thickness Diameter Type if Any Surface Fill Description Feet to Feet Inches Inches Inches Inches Feet to Feet 0 1244 9"&8" 1 Blank PVC Sch 80 4 0 1232 1 Cement Portland 244 1254 8" Screen PVC SCh 80 4 Slot 0.010 232 239 Bentonite Chips 239 258 Sand 1/20 258 300 Bentonite Chips Attachments Certification Statement ❑� Geologic Log I,the undersigned,certify that this report is complete and accurate to the best of my knowledge and belief ❑ Well Construction Diagram Name Cascade Drilling. L.P. Person,Firm or Corporation ❑ Geophysical Log(s) 3 ututh St A West Sacramento CA 95691 ❑ Soil/Water Chemical Analyses city State zip 0 Other Site Map Signed 10/22/14 938110 Attach additional information.if it exists. C-57 Licensed a. r Neu Contractor Date Signed C-57 License Number DWR 183 REV.1/2006 IF ADDITIONAL SPACE IS NEEDED,USE NEXT CONSECUTIVELY NUMBERED FORM