FIELD DOCUMENTS - Laserfiche WebLink

Home Browse Search

' 7 'The free Adobe Reader maybe used to view and complete this form, However,software must be purchased to complete,save,and reuse a saved form: ..._ ,.. - .._.._...-..._•—...ter+ - ..-.-._..._. -, File Original with DWR State of California _.__._pWR;UseOnIY"z06 Nbti #:lti___ Well Completion Report _ --- i i Pae 1 of 1 I_ _ ---' - g ReWlo losfrucrlon Pamphlet Slate Well NumberlSite Number Owner's Well Number-MW-6 No. e0107038 I I I N W _ I Date Work Began 02/25/2010 Oate Work Ended 212 Latitude Longitude Local Permit Agency San joaguin Co.EHQ Permit NumbersaB#0059330 Permit Date 2/12/10 ..APNIIRSlOther. eolo is Lo ; - _ ,W$ll oW06r G -- _ Orientation OVed€Cal OHorizontil OAngle Specify:.. !1 Name Continental Gratn Co. Drilling Method - _-_ -?nlling F€uld ma€lin Address Aon Center-.200-E..Randolph.Spite 400 _ -. -. depth from Surface taescriptlori IL - 60601 1 i, Feet to _ Feet _ Describe material raid size color,etc 1, Grt Chlca d State.�Zi Pressure Grout.Abandonment Procedure: -_ Well Location i' Remove cover,insert tremie .ipe.to well bottom Address -1805 Harbo Street(City ROW along N Side of St) pum-,;neat cement grout-5 6 gall94#bag mix of Cit Stockton County San Joaquin y- __ Type,IV eortland,Cement,displacing water_out - `:Latitude N Longitude u of well until.neat,cement is.at surface Pressurize Dee, Min., sew Dec; Mlr4 sad: I= - well:at.:25 PSl.fdr 5 minutes.and_top�ofi neat_ Datum NAo83 Decimal Lai. 37.94864 Decimal Long. 121.314 Ril' I - cemerit as needetl Cut off a portion of-2'-PVC {I{ APN Book Pageg__-_-____ Parcel - to be below grade allowing,neaf cement toae 1€ Touvnsht 1-North Ran a 6.East section, .over fhe PVC as a mushroom cap.Remove entire T Cut ation'Sketch Activity, ---. - Sketch must be drawn h hand after form Is 'n(ed.) Or:NOW Wefl cemented well box,return grade to surrounding Noah_._ -- -_ _ _... Q M odificationlRepair � soil Conditions(unpaved area in Harbor St.., r 0 Deepen I Shoulder along N.side.of Harbor St). a O Other _ _ t7 destroy i Total Volume of Neat Cement 21 Gallons r oa,� �dm�len i __carer �LaG' I; Planned Uses . Wupp Ater S ti �l Monitoring Well MW-6 jnstatIeA(3613012000 DDomestic ❑Public $'Abandoned 021.2512014-. ❑Irrig alien ❑Industnall " r � 1 O Cathodic Protection O Dewatering i 0,Heat Exchange - r 4 b Injection Q Monitoring Remediation l 0SpTest i l , h '`0 e s Well - - — -� -- - �-'• IElust:alemdac3be rslsla ice ofwel}rem reals,6didlBs.fences .O VapExtraction r - I aha n e map,r so sddii anal pacer A-5900' . 0 Other abandoned �.._ .- "---._.__ - ------ _:._.. ... .,-- .- :I 3•INio lie lir4utklaenB cnm : ` afar LeveCand Yleid of Com lilted Well; - - - FeDepth tofrst atef. ebelowsuae] Depth to Static - Water Level 9 (Feet) Date Measured 12/1012008 Total Depth of Boring 25 Feet Estimated Yield" (GPM) Test Type: Total Depth of Completed Well 25___. Feel 'Test Length -l...�.(Hours)Total Drawdown (Feet) - y - ,Ma :noi:be:re tesentatve=of-a;weirs,lon term,yield.- Annular Materia! Depth from Borehole' '"' material Wall Outside Screen 'Slot Size ! Depth from Surface Dlameter Typo Thickness Diameter Type if Any SUFfaee Fill Descr[ption Feel to-Feet Inches - —: :- - -inches Inches Inches Feet-to.Feet 5 83_ 61ank pvc sch ao 0.154 I nt. -0 _ ...„i 0 5 - '5 25 6-3. _- ,'Screen . PVCSch.4t}„ 0.'154 .2.0 Milled slots 1:0.020 5 25 F�iereloack SRI Supreme No 8 _ - „ I e I ! _Attachments Certification Statement - EI Geologic Log 1,the undersigned;certify that this report is complete and accurate to the best of my knowledge and bel of ❑Well Construction Diagram ago P nt.....- - c;ly State Name Tuan-Nouyen: reside Person,Flnn or corporation ❑Geophysical Log(s) .1238.Alice..St.-Suit -A Woodland-- , _957.76- ❑Soil/Water Chemical Analyses Z'P t Other .Sign 906899 -- — - 7-ucens or C6nlracror,._' iateviaed'nia9ei;nt . ,Etln�sis,. ... _. ate i ned ....C=57.1.1cense.Number.,.- _ DWR 188 REV,112DOG - IFADDITIC) ALSPACEISNE .b1 E'NExTCONSECUtiVELY't4UMBEREDF6RM - k r