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y *The Adobe Reader may be used to view and compic- his form. However,software must be purchased to complete,s end reuse a saved form. <br /> 1 State of California <br /> File Orig nal with 1 <br /> Well Completion Report l` <br /> Page Of Refer to Instn OM Pamphlet State Well NumberlSRa Nuf�rber <br /> Owners II Number VW-5 No. 80148211 N w <br /> Date W Began 82/87/2072 Date work Ended�217t2012 — ; Latitude LisrT Rude <br /> Local P it Agency <br /> Permit mber Perm$Date ,1/18/12 . <br /> ori' ntation O Vertical O Horizontal OAngle Specify Name Areadis <br /> Drilling athod Auger Diving Fluid Maili FoA�dm s 950 Glenn Drive Suit Ste a ft <br /> h 95fi30 <br /> Overdrill 2°well to 35'with 12"Augers and rout 's ' <br /> Address 1612 W di mmer a <br /> City S 'n , t j San Joa uin <br /> Latitude '3 " pgitud ' °_ W <br /> 1 <br /> - s eq <br /> Mh.pep. Min. S „ <br /> . <br /> DeclmalngDatum Decimal <br /> APN Book i PARle <br /> Townshi a SoMon <br /> i d _ N&Well <br /> Malfication/Repair <br /> r = O Deepen <br /> O <br /> =� oth*;r <br /> ` 'S Destroh= <br /> ; <br /> l)esalbe V adraes end mareAab <br /> under'GE LOGfI Ll%i <br /> B <br /> FDn Supply <br /> ,. estic ❑Publiction ❑Industrial <br /> wdic Protectionei7ngExchangeon'yringdiation <br /> O Spargin§ <br /> '- <br /> Ii- So <br /> air <br /> uth 0 Test Well <br /> a mw"ft W deaadbe dlanmoe ofwil*M rood..Wkf pa,fen., 0 Vapor EktradiOn <br /> rlvm.etc,and atMdi a map.Use admww pepm d necesamy. O Other i <br /> t xc�,. .i"� Pkaae 6e ecmeaEr ind a Nei. <br /> Depth to flrst�water -; (Feet beloV+ surface) <br /> Depth to Static <br /> fi' Water Level i, (Feet) Date Measured <br /> Total D' th of Brs rr6:`'. _� Feet Estimated Yield' <br /> p g (GPM) Test Type <br /> �.. *. r Test Length�� (Hours) Total Drawdown (Feet) <br /> Total D pth of'Completed Well Feet <br /> *May not be re reseniative of a well's longterm yield. <br /> ;`&. 3n'* '°'' �N^:i 3u�.a.;. .A1^u•& 3k,:ir 4NLCNsYx- <br /> :..- <br /> De morn tsorehoie :' wall outside screen slot size De from <br /> Su ca Dail 4l. Y�Ylaterial Thickness Diameter Type If'Any Surface Fill Description <br /> Feet Feet Inches (Inches) Inches) (Iniihesj Feet to Feet <br /> 1 <br /> i <br /> J:R <br /> 1101 <br /> oiogic Log I,the undersigned,certify that this report is complete and accurate to the best of my knowledge and belief <br /> Name Cascade DHlling.L.P. <br /> II Construction Diagram <br /> Person•Firm orCorporalion <br /> ophysical Log(s) it i i' n h Cor v CA 957421 <br /> /Water Chemical Analyses Ada ,} city state zip <br /> er§ MaD Signed 03/20/2012 938110 <br /> Attachaddanal Int'or MUon If R exists. C-57 UoerletrWaW well tractor I Date Signed C-57 License Number <br /> OwR 1138 REV.1!2008 IF ADDITIONAL SPACE is NEEDED,USE NEXT CONSECUTIVELY NUMBERED FORM <br />