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'The free Adobe Reader may he used to view and complete this form:;However,software must be purchased to complete,save,and reuse a saved farm: <br /> File Original with DWR State of California _ �Wft'i3se CAI -.DallotFgllri� <br /> Well Completion Report , �,<_ , _, ) p;; 7:: <br /> Pae 1 of 1 sf-t-, <br /> Owner's Well Number,-.MW-12 No. e0107035 N Ho limper. <br /> Refer ro fnSirudion Pamphlet i a e V4r&€t NUrntferl$ <br /> ,coca Permiit Agen 02S5n2010 I o Date Work Ended,2/25/20'10.- <br /> ,Local <br /> 125!2010 ' P <br /> Y' ' <br /> Permit Number SR#9059 _29 Permit date 2112110 _ '� Ou7ef <br /> <. Geoio ic:L`o-•- - .- _, i __ iytfellfl'ainer' ___ <br /> -. . <br /> 3`Name Continental Grain Co <br /> Orientation OVertical' Horiz0-1 t Q-q9-e 'Specify= <br /> Drillim Methad Drilling Fluid. <br /> t ---s - Mailing Address Aon Center 200 E. Randolph Suite 400 <br /> L IDopth frarri Sutfaca? [7escrlptlon ^ <br /> Faot ;f8 FkAE QesciGatrraterllt! n'elz'e'061or etc ' .Gil Chicago <br /> ----State-ILT�i <br /> _ 60601.. <br /> P_ressu[ea,Cr3ut''Ptartdo>4iisenti?rocedure <br /> Remove cover, insert tremie I e to well bottom Address 1805 Harbor Street <br /> i <br /> i►trtp',neat cement rou#:5 6 aV94#ba mix of I, SanJoacjiifn <br /> g { 9 _ City, Stockton _ Cuunty,�. -. <br /> t; C e 1V Poittand Gement dEs taciCi water out' y <br /> Yp _ ). R 9 Latitude: Dee, Mm Sec. <br /> Longitude Dan rn9 s <br /> l of well until neat cementis at surface Pressurize Datum niAosa ec <br /> Decimal Lat.37.9487991 Decimal Long. 121.3 <br /> ! f, weli,at 25,P51-for 5 minutes and to off neat r M 14 <br /> cement_as,needed_Gut off a portion of 2°PVC_ <br /> 'APwiibok Page.;„_ ._.. Parcel 14502005 <br /> to.be.below grade„al lowing neat cement to-be To+"mshl1a:th. Rao e,6 East dun --- <br /> i i;aver the.PVC.as,a Muqhr(?pm..cap,.RqMpvtinsidel. l acattoneSk�fch �4ett6t' q <br /> _ eteff rnuat he 4rawri d,end:�Res"bio as 'fed S <br /> - nn of marihote,and cement to.be flush with- _ -- New Well <br /> Northdification ir., <br /> surroUr ding asphalt„payed.surface,. !O Deepen:. <br /> k.A.lher' <br /> Total Volume O'Meat'Cemerit=20 Gallons Q:'Dasiroy <br /> ascribe n acewrre a n mxHia e 3 <br /> i��f lf� ,il�[I CEOI.e)Clctea - !. <br /> � Y+ <br /> Plantied•Us'gs <br /> �':Manitorlo Well MVV-1.2 Installed 02!1912008} ',^, waomestier E] <br /> hc <br /> . _ - ---_ ,. Domestic Pub <br /> Abandoned 02/2512010 ?'` ❑Irri ation ❑Indusirial <br /> -,..- - - . <.. die Protection <br /> Q Catho <br /> i <br /> HHeat Exchange <br /> Injection <br /> O Monitoring <br /> O Remediation <br /> 5parging r <br /> .lir OTest <br /> W <br /> w _ a,_ 5rstdh <br /> Extraction <br /> Po tate or desalcedalasce grweP <br /> _._ eIc.90d ail on rRay.U.ee adda-A parer if naaenearYF' �. Q Other abandoned _ E <br /> j;rrvas„ <br /> - _. ... ._�. . -. .__: - -,;_ - . ..- .-._ - iH'•iu{aslatnli lh3m,ale. -_.. _ _ <br /> aferlerrei aitd-Y,tetd 6f-tntsi ]eted,'Welt-= <br /> -- - er:=14 {Feet below surface) <br /> -- '• - - <br /> Depth to first wet � = 4 , <br /> i Depth to Static <br /> Water Level 1'4' (Feet) Date Measured 0811912008.. i <br /> Total Depth of Boring ,_35 _ Feet Estimated Yield” }GPM) Test Type <br /> fest f en'gih {Hour`s) Total Drawdown (Feel) <br /> 3. <br /> Tata!Depth o Completed a ._3-5 . ............-- <br /> -�. .• _ -•� s�Ma ;not�bere �esentatlVe.;of8well'sad �tertn, eld -;- -�- <br /> �Gaslii`-s: _ AiartuEar�Maferlaf�_ _.. <br /> Depth Borehole T. <br /> Thickness <br /> VVall Cutside inches screen Slee. r�ii t t <br /> P __. meter, Y Type L_ rf Any Surface FIi1 Descr[pt[on <br /> I T o Matariall <br /> i : eat to Feel inches <br /> Surface, Diameter Thickness la <br /> 0 _)8,3; t IBianlc PvcSch..aU= 0:157! 2 0': :' i 0_--.!28_-;i Cem3nt: ct3tiiet f oVor,IJ <br /> 30. 35 <br /> W.3: 0 154 2 0 iod slots .,0:020 28 35 l iztar,Pr Ifo. 3,Lone`st i1 . <br /> T: i t ) <br /> .. .. _-.. <br /> _ - — - - <br /> Certification Statement <br /> Attachments ' <br /> -Geologic-1-6g 'I',the undersigned certify that this report Is complete and accurate to th best of my knowledge and tSelief <br /> Name.Tuan l Liven_Prasidenl i <br /> C1 Well Construction Diagram -- <br /> ❑Geophysical Lo s Person,Firmlt Coryoratlan <br /> ` 9O .__ .238 Al'ce St.S i e A --_ -Woodland- _ �... iCA 95776 --.-- _ <br /> r ❑Soii/Waler Chemical Analyses I ICP slate zip <br /> gne � <br />' Sim 906899 <br /> ❑Other dread d }G <br /> c Ati¢ah addilianal informatann d if ebsls_._... m - - '' 57 i.lcenaed er eIlContr&clor _ - <br /> _. ate i ne 57 License Number` <br /> r.. — _.. 6 <br /> DNR'1e8;REb.172f10a "IFADDI t]NALSPACE EEDED,-USENEXT'CONSECl1TIYELYNL1MaEREDFORhhW- <br /> y <br /> i <br />