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'The free Adobe R , f <br /> nMer mny De used ro vbw and c1 .ro m�P term, Hevmnr,FefAvArc moat bit purchased ro cemPlAro, ?amt rouge a saved farm. <br /> ' <br /> Fila Original V4111 OM Stale of California DWR We OnIY-on.Nm.F - <br /> page t or 1 Well Completlon Report , <br /> Rcarre lnsNleMat PempMet Sime well Nambl«l9aa fhlmher <br /> Oerlters Wen NuMt er MW-3 No. ao107550 <br /> Date Work Began 02116!2010 - Date Work I=nted 2LL80SatO LagludR Lo e <br /> Local Permit Agency can JDag lin C0UIruV EDW nmmental H_ealNt DeAt. _ I I r��� <br /> Pewit Number SRS9332 Permit Dale 2/12110 A <br /> Well Owner <br /> Orientation OVerlical 0H01`17013t8l OAngID specify Name_pawl derOhoot <br /> orming Mathcd DnAing Fluid <br /> Depth trmn SurfaceDaacdp0on MaiFng Address 1560D Sou! Haden Road <br /> =1 Fcat. to Fnct' neeedbe mmMbl" " etre rldet ea Ci Lathrop Sreha CA__Zp 95330 <br /> Well Location <br /> .r Pressure grout With neat cement" Address 15600_Soum_H81`120 Road <br /> Remove vault box throb San Joaquin - <br /> ' Cdy (aQ County <br /> Remove Upper 3 feet of well materials <br /> Lallllyde N Lortgilude_ Jny <br /> Parch round surface '� 9110. MM See. Dec hfin at, <br /> Datum - Decimal Let. Dedmal Long. <br /> APN book 190 Page.200 „^ Parcol 79 <br /> Townshlp-Ralwe Seddon <br /> Location Sketch Activl <br /> bid,cites be drflanb,h nd M Q New Well <br /> Norm O ModificalloMRepah <br /> OOther <br /> DeRtroy <br /> n: cac <br /> 1 Planned Uses <br /> l O Water Supply <br /> ❑DomCSnc ❑Publlc <br /> ©Mlganor, ❑iMiAtflel <br /> O Camaft Preledlon <br /> a O Dewatering <br /> O Heel Erzchaare <br /> �( --- <br /> V5 WO <br /> r OINeWon <br /> O Monliormg <br /> O Remedlellon <br /> O Sparging <br /> South O Test Well <br /> maaaro«aevaw aauwa«aene.°re.er,ea�Awren. O Vapor Fxrimetgn <br /> rNee,la.me.mm nae..wn.seeemlPro«nnreer+«I. 0 Offer <br /> sw.w wa<eunt.wie.a <br /> Water Level and Yield of Completed Well <br /> Depth to first water (Feel below surface) <br /> Depth to Sletic <br /> Water Levo! (Feel) Date Mads ured <br /> Total Depth of Boring Feel FSlrrmtP.d Yield' (GPM) Test Type <br /> Total Depth of Completed Well 21 Feel Test Length (Hours)Total Dfawdam_(Feeu <br /> May.not herepresentative of a weirs lunq term yield. <br /> Casings - Annular llaaterlal <br /> Depth tram Borehole 'Well Outside screen Spot size Depth epm <br /> Surface Dlnmetar material°I nlalmrse Diameter Type deny Surfeas - Fla description <br /> Font to Fool Inchon roehoa "Chea 1,10" Fern m Four <br /> S <br /> Attachments Certification Statement <br /> ❑Geologic Log 1,the undemned,certify that this report Is complete end accurate to ne best of my knoWedge and belief <br /> 13 Well Construction Diagram Name_RSI rilling Corrtoerly <br /> PeNen;FMa MCelpnroagt <br /> ❑Geophysical Log(s) 22?0 ( et - o ,CLA A5778 <br /> SOIWalerChemical AnalysesOoher Site <br /> Plan S19rwd �� d 80233¢ <br /> n .ante . a nue C4r 4cnMeawmer Icmuanar Dete sl rte0 C-5T Lkeltee Number <br /> ONR tee REV,100a IF ADDITIONAL RPACEIR NFFr1ED.USE rnExTCCNSECUTw YNUMaERW FORM ! <br /> k <br /> { <br /> f <br />