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'The rm.Adebn Reader may.be used to view and v '1a Mie ram. Heaver,aeRware meat do purchneod w corn plvla r and mum n nmad(enn. <br /> File Original with DWR Stale of California - VWR Use Dnlu—tle Net In <br /> Well Completion Report <br /> IPage 1 of 1 Rrer(P lmtnanonrt+mphr.+ SUMMIN lnvmboosue wombs <br /> Owner's well Number MW00-1X No. WOMB 1 W <br /> Date Work Began ON1612010 Date Work Elated"LZQI,Q �—•• Lemude r tan was I ` <br /> Locai Parmk Agency_$,g)y,.iA..9wAi rmanw.EnyironmonteL(;IRBlfh <br /> Permll Numbe, SR59332 PP,mllt Dale 2L1 2110 APNrFRSOUIW II <br /> Oeol Ic l: Wall owner <br /> Odentadon -OVerflcal 0HorizontAll OAngto Spedry. Name DaWrider Dhoot <br /> Ornlhm MatMR praing Fluid Mailing Address 15600 South FI@flan Reed <br /> Depth Fmm Surface : . . Descrlpllon. .. ty Laihroo Stale CA 95330 <br /> Fool ro Feat' Deecdbe melMAl' M1tia nRe cmnr,ere CI <br /> Well Location <br /> Pressure grout with neat cement Addmss 15600 Sou81 Harlan Road - <br /> • Remove vault box - : City Lathrop County San Joaquin <br /> Remove upper 3(cut of well materials Latitude _�, N Longgude�_�.....___wPatch ground Surface pen. Min, elle. pec Nn Dec <br /> Dahmr Decimal Lai. Decimal long, <br /> APN Book 196 Page 400 Parcel 79 <br /> - Tovmsh Ra Section <br /> . . : LocaUon-Sketch AcdvjtV <br /> 9aa be dlaan INnn en N New Wsll <br /> Norm O Modification/Repair <br /> O Deepen <br /> O Other <br /> --. O DDwmv <br /> ® t oe.am.rae.mm niemnmea <br /> Y110M l➢aICILP <br /> Planned Uses <br /> - Owater Supply <br /> ❑Donwatic❑Public <br /> []IrtigMPon ❑Indmulat <br /> O Cathodic Protection <br /> ODevratedng <br /> (Stapp O Hear Exchange <br /> 0 bledlon <br /> O Monitoring <br /> O Remediatlon <br /> O Sparging <br /> ...` South O Test wag <br /> mmmnca.easnneanmtearssn nemmea..Mmdmw,arim, O Vapor E.xkacuon <br /> rmn,me..ml.ran.rnourcneaammseen nneeeaeiy O Other <br /> rNa.nneeevimle.sea <br /> -� Water Level and Yield of CoMelated Well <br /> Depth to prat water (Feet below surface) <br /> - - Depth to Stakc <br /> Watar Level (Feat) Dote Measured <br /> Total Depth of Boring - Fed Eallmateel Yield (GPM) Test Type <br /> Tblal Depth of Completed Well FSM Text Lengtn (Hours)Total Omwdown_„_(Feat) <br /> �May not be resema diva of a wall's LMN teen Vield. <br /> .. . .. Casin la;:... .. . . ., Annular GAatoriai <br /> Depth frau Borehole wall oulsme Serena statsiza Depen feelSurface* DlamTyM <br /> nlor Malarial Thickness Diameter Type IFARV Surfece Fal bncriplion <br /> Feet b Feel Reba ehea Onchml (inches) Feet M Feel <br /> Attachment. :. .. - Cenification Statmnerd .. <br /> 6e to Log I,the undersi�ggnned,certify that this report is Complete end accurate to the bent of my knmedge and belle( <br /> E3 well Conatrudon Diagram Name RSI.Drilling C=pgnv _ <br /> Pe nde <br /> s❑Geophysical Logs) 220 North EaStIt'r;=r <br /> _W�dIgDR_ L 95778 <br /> ❑SdtNVater Chemical Analyses _ " pry sloe all <br /> ®Other SRO Plan Signets o,rLmamao wm.rwm o�amcler 1 O 802334 <br /> AIIacT aaeln el katlen - - Date Slimed Go?License Number <br /> 5WRIUe REV.wood IFAQUTIONAL SPACE 1a NEEDW,WE NEXT CONSEMU LY NUMDIiaCO FORM <br />