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<br /> File Origin:with DWR State of California _ _ [}WR;Wse Qidy.- SNdffM dh
<br /> Pa1 of 1 Well Completion Report
<br /> Page Rorer to tnshuchon Pamphtel
<br /> Owner's Well Number,rMW-11 -- No• e010702 Siato Wdt Numbeil5de Aluml�er:
<br /> !N r W
<br /> Date Work Began 02125/2010 Date Work Ended 2/25/2010 t atttude _ t o dude -
<br /> Local Permit Agent; �S Joaauin.Co:, . : - -- --- - - -- ,� 3 ",'
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<br /> _ .-. _ r-
<br /> Permit Number SR#0059329 Permit Date 2112110 = -= APN Other -..--'•_ =- '.
<br /> " Geolo`"l.c .o is We11OiKt4er_-
<br /> f Orientation: OVertical- - Q Horizontal OAngle Specify_: iI Noma Conttnental.Graln_Co -
<br /> Drilling Method Dnllinp Fluid"
<br /> Mailing Address Aon Center 200`E.Randoloh'Sulte 400
<br /> Oapttt'frottfrStCKa`ci+-: I]et3trfp#lad: Chicago IL 60601
<br /> Feet In Feet... Describe matenai rain size-,color,etc �It -State
<br /> Pressure Grout Abandonment Procedure:
<br /> Remove::caver insert trerrlie, tpe f6;well,bpttom' Address 1805 Harbor Street
<br /> --pump neat cement rout(5-6 (t94#ba m€x of City Stockton County San Joaquin_
<br /> T pe:lV'F?orElanclCement) dlaptacing waSe"t6utr Latitude N Longitude
<br /> of well until treat cement is at surface.Pressurize DOG, Mln., sec. Dep. MirL sac
<br /> Well at 25 PSI,for,5 minutes and top off neat rOatum NAUB3 Decimal Lat. 37.9488708 Decimal Long.-121.314
<br /> rd
<br /> .I cement as_needed Cut off_a ortion-of.2"PVC APN Book Page Parcel 14502005.
<br /> t to be.below,grade,allowing neat cement to_be Townshi North Ran e'6 l est Section =
<br /> oyer_the PVC_as.a mushrwm,rap-_Remoye_inslde Loca#IoftSketchf A't5tivi
<br /> { :,' - of.manhole.and cement to be.flustt with,_ tskatehmirstbodMrpC trar ,;fiei4rret� 1 New Well
<br /> ring.. ModificationtRepaif
<br /> surrouliding"asph'a�t paved utiace TM =f 0 Deepen
<br /> - 1 OOther '=
<br /> Total Volume of Neat Cement='17 Gallons s is 11� tf` O Des�tr�oyw nd
<br /> =urbcr GE9LW14ad-10� _
<br /> _ � E Plaflneol U§es
<br /> MenttoriR WeIIINW-11 InstalledQ2J19l200B ( I i O Water Supply
<br /> - -- '
<br /> Abandoned 02125/201 p. € I s ©Domestic Public
<br /> i, - - s ❑Irrigation ❑Industrial
<br /> _-.: __ — --- O Cathodic Protection
<br /> s, i
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<br /> . O�. De t EIerihg
<br /> _ _-_ O Heat Exchange t
<br /> O Remediation ;
<br /> 1 .
<br /> 0p
<br /> arg
<br /> ing
<br /> 0 Test Well l
<br /> Vapor Ext
<br /> raction
<br /> aryOther abandone
<br /> d
<br /> 8tfirLevel,and.Yleld.of_Com leted_Well-_-,T
<br /> fh;t0r0iistive er;.�4 ,(Fee.
<br /> � t below surface)"
<br /> Depth of Bann Feet
<br /> Water
<br /> ted Yield 4. (GPM) Te5t7 ee ufed'Q8I19/2�08:'----1
<br /> Total Dep g 28_ yp
<br /> Total Depth of Completed Well 28 Feet
<br /> lest t ersgth (Hours)Total Drawdown (Feet)
<br /> : ___ _41, ria ,ndt;6elre"re§gttt8$vg.a=8,we1t°Stan t8rm: .eld'
<br /> t]epth froth, 9or©holtS 'Walt Qtttsltta Screei+ $lot9ize, t3Bpth'fr"ffai'
<br /> 1Hatailafl
<br /> "Surface t]fsmo(er rhl ika0sssbiamettlr `Type if Rny l4iiaoe' jFlil tCscriptlon
<br /> ...Feat to Feel Triches .. _ Inches frltfies' __ :inches':. _Feet to`l dot,
<br /> & 8.3 t�irik pVisctttgtx:
<br /> 0.154 .J 20; 1_ (1, 6 I ceiee>}t, ceflli311t+5s�er It
<br /> 8;3 i scresin nuc Sort Ai) (1,154 r 2{3, Miffad
<br /> r Slots 002{3 6'l ; 28 Flher,Petk _ fQo,3'-,LrorlesE`ar _ t €
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<br /> " 'l1'#tachmerti#s Gettffica�,on,5#atetti'teii# s
<br /> "❑Gell ri LO -- .T ' , Parson Firm nGo Corporation
<br /> P �•• _- !" - _ g
<br /> Geologic g i;the undersigned-eertif that this-re ort is cam lets and-accurate to the best of my k6YWled a"and heliaf
<br /> Name.Tuan Nauyen P�estdent ,
<br /> ❑Well Construction Diagram —
<br /> " p Y tC) 1238-A€ice St,Suite A Woodland CA 96776_ >_
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<br /> ©'Geo.h slcaELo s
<br /> ❑SoiMater Chemical Analyses u u Ca slate zip
<br /> , ❑Other- ,
<br /> v7 license_ gr
<br /> Attachndd?smrairtftrrhziw'twaeawa: _.b'at Si ned:. C:57L'tcense.Numher_.._
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<br /> DWR tae REV:�,t$DOB It=ADDIT ?JAL SPACE 15 NEEDED,IJSE:NEkI'CON5EBUTNELY rJi,`MREREr]�FORM""' - ----- -- `-�'—"
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