FIELD DOCUMENTS - Laserfiche WebLink

Home Browse Search

'The free Adobe Reader may be used to view and complete this farm. However,software must be purchased to carnplete,save,and reuse a saved form. File Original with DWR DWR tJso O DRo Noe dill in_ — 1 State olCaliflirnia ��- Well Completion Report Page 1 of Paler 10 InshactionPamphlet State Well Numberf5ite Nu_m_ber o. N W h 107016 �� Owner's WEt3 Number MVV-1 e4 - J`- Longitude Date Work Began 02!25!2010 Date Mork Ended 2!2512 _ Latitude Local Permit Agency n Joa in Co.EHD j -_l_ — ! _ ...,•.APNifRSlOther - ___ I Permit Number SR# 059329 Permit Date 2112110 - 1 - - .._ Well puvnt;r --- - - Geolo is Lo. - - Orientation D Vertical O HorizontalO Angle Specify Nerve Coni ental Grain.Go I priding Method __ _. �- onliing Fluid - Mallin ,Address,Aon Center 200 R ndol h Suite 400 S.._ Depth from Surface - IL I 66601 escrlptton CIt Chico o 5tate_�� Feet to... Feel __ Describe.materiei- rain size_coter ate t' . .Pressure Grout Abandonment Procedure: _ _Well Location_ Remove cover,insert trEmie pi a to well bottom Address 805 Fla�bor Street', ... Y .._neat cement grout 6_6.901!94#bag_mix of__ Cit,,Stockton - County San Joaquin um Type.IV Portland Cement) displacing water_out Latitude - = ; N Longitude;_ .. _ - ent,is at surfapB,Pressurize Mln,, Sec. OBU. Mv4 SEA_ of well neat.cem__ ..Datum NADas Decimal let 37.948432 Decimal Long.-121.315 well,at25 PSI for 5 minutes and tap off neat A u cement as needed Cutoff a portion Df-2"PVC _ PNB t ok Page Par I 14502005 to be below grade allowing neat.aement to=pe t North Range B Township 1 East- -. Section, over the PVC as a R'iushroorn-cap.Removejnslde i Location Sketch Active a Skatch�muelt�e'drawn•b-handetlerformie�rinW. New'Well' ring,of manhole and cement,to ere flush witFs _ _ O N :- -- -- iQ ModificationlRepair 0 Deepen ,North surrounding asphalt paved surface. Other Tata#Volume of Neat Cement=17 Gallons y ; t ex.IPapMetl a d - - ' - I Planned Uses Water Supply: Monitoring Well-KW-1 Installed 08112/199$ . -_ DomesttC 0 Public t w Abandoned 02f25f20,74._ _. __ f ❑Irrigation ❑Industrial ` ron - �;�•• Q Cathodic Protech " U. _ i Q Dewatering 10 Heat Exchange > IQ Injection iQ Monitoring I , 1 „ 1 'Q Remediation �,.: .. parging l _ Soviet @ Test Well _. . _ .. O i Vapor Extraction - -- - — -- - -•- -'--'-- - 'i'taGsloaee ar Aeeuibe dVslexe of Nell hom road6 66Id rxn W17, lrvm.a4c,a d mw=n a meP uee atl�ro1rel paper rr eeceaexr Q Other abandoned _ - - _ - ater.Leveliand Yield of Coin :leted Well, DepthDepth t first water�,>-- --__- ,(Feet below surface), to Static Water Level 11 (Feet) Date Measured 03!0512009 Total Depth of Boring 28 __ _ Feet Estimated Yield' (GPM) Test Type —•. _- t, = Test Length -- •- (Hours) Total Drawdown (Feet) W 'Total Depth of Completed Well,28 .- —,Feet-1 " -_ Ma �tot,be:re resentative;ota well's ,terrri,geld. - Casin s _._. ..Annular Materia!. j -Depth from - -Borehole. Type Material Wall Outside Screen Slot Size Depth from- --- - Surface Diameter yp. Thickness Diameter Type I[Any surface Fill Description i Feet to Feet _ (Inches)- _ _-_: ._.. Inches-,-:Inches„ [.inches Feet. to Feet_., i 0 8 8.3 Blank I?VC Sch 40• _ 0.154_ 2:0 0 .16 Cement; cement over bens, 8: 48 8,3 Screen PVC Sch,40 0.154` '210 Milled Slots 1'0.020 6- 28' Filter Pack �,SRI Supreme No.8 - --- Attachments_ Certification Statement 1 the undersigned,certif that this re off is corn'lefe and accurate to the ties[of kntiwfed a and'Deliaff t ❑Geologic Log 9 P p Y g ❑Well Construction Diagram Name:.Titan N u e -..-resident Person.Firm w r rpormion - ' ❑Geophysical Log(s) 1238 Alice St..Su,te.A._. Woodland- ... .._ CA_ =95776 i ❑Soil/Water Chemical Analyses ss cl state 'Zip ❑ Signed Other - 906899- . Atlgefid+tiwrallnronnalic _ _ _ - a! Si nerd C 57 License, i DWR 168 REV,if266G IF AOnITIONAL SPhCEIS ,115E NExT CONSECf171VELYNl1MBERE FARM ' T i.