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i <br /> "Trio nee name aegdar nary no WrA m Wmv and eL�a thM fmm, Haww.er,tionMo a moat be mrmhawd m wmplate,* - d muse n care0lain. <br /> File Daginal with DVVR Slate.of California ovm't VneO 1 -Pe Not Fm In <br /> Page 1 of '1 <br /> Well Completion Report <br /> tI RnM.wresrRnurrrwnnar wmmsummum_e� <br /> Owner's wen Number MW-10 No, c8107555 <br /> bate vWegan 02I16f2010 Date work Ended�� Le Ln awn 1_w <br /> \W*b <br /> Local Permit Agency an gWpuin.County Environ W ntal Heath Dant- <br /> Permit Number SRS9332 Ferri 2112/10 APNITRBrOMw <br /> '.. Geolg ie L's Well Owner <br /> Orinrrtenon Overtica 0Horizon7OAngle sperkry Name Dalwinder Dh= <br /> emu g Method Prmmp Fluid Malling Address 15600 SW1h Harlan Road <br /> Depth from Surface .. ... . .'OBsedpIs <br /> Fen m Fain �doecdba mRteHOI,'' rn�n mY,o Lelor el city Lathrop StateXI 95330 <br /> 7-7777—:. .. .Well Location <br /> Pressure grout with neat cement Address 16690 Sout. Harlan Road <br /> Remove vault box City Lathrop County San Joaquin <br /> Remove upper 3 feet of well materials Latitude N Longaede _�N <br /> Patch ground Surface Deo. Nht. Sm. pea MIrt Sea <br /> Daturri Declined Let. Decimal Lang. <br /> '— APN Book,], Page 2(O Parcel _79 <br /> Township_Ran Section <br /> Location Sketch Ad"I <br /> eeMt muelae bpUll elrorevmis Q New Weil <br /> Natal <br /> Q MadincallimlRepak <br /> O Deepen <br /> 0 Other <br /> Q Destroy <br /> owns nmmwrwmememm <br /> Planned Uses <br /> O Water Supply <br /> C mZ4 []oameeno OPubnc <br /> 3 [Qlldplion 01ndustrLN <br /> O cathodic Prbleslton <br /> Q Dewatering <br /> O Heat Fxcrbinga <br /> �Sboa O irtlectlon <br /> 7 O Momtodng <br /> O Rerrefttion <br /> O Spaminic <br /> _ South Q Test Well <br /> '• au.r macer+mwemnlmmm.ene.mrowm.ewimee..ma... O Vapor Emotion <br /> rran.MneMenMnmm.leeeamml pnpernmemrer, OOther <br /> mmwme maw <br /> LAf <br /> ater.Level and Yield of Com eted Well <br /> Depth to first water (Fast Wait,surface) <br /> Depth to Stalin <br /> water Level (Feat) Dale Measured <br /> Total Depth of Boring Feel Estimated Yleld (GPM) Test Type <br /> Total Depth of Completed Wen 15 Feet Test Length (Hours)Total Orawdbvwn_(Feel) <br /> -54my not bore aantative of a well's to term Id <br /> . 'Casings . . Annular Material <br /> dpporMcom Wrehole Dlametar Typo Malaria 7hielmeart 011 net. aoTypen SItAny 13019"t Size Rom <br /> FIN beeeapdon <br /> Forst m Fen Imhm Inches linchein linchool, Fee m Feet <br /> Attachments . . ." . . ' , . .. . Certificatlon Statiament <br /> ❑ Geolegis Lag 1.theondenigned.ceniy,that this mpod is complete and aocu ate to the best of my knowladga and ballet <br /> ❑well Constnnilon Dlsgmm Name RSI Drilling jQmpany <br /> ❑Geophysical I F Fereen,Flrmmeurpmvnen <br /> fNa emit 0 rth s Stre WpyaJaq.�_ 96776 <br /> CJ SoinWalar Chemical Anrttyses clry sine zip <br /> ed <br /> ©Other Site Plan Sign11�' 'taxa 802334 <br /> rib rims Wit ed.M. Data Slimed C-57 License Number <br /> mW In REV,1,Itopo IF ACOFIONAL SPACE R 14EE0E0,USE NEM CONSECtmVELY NUMMEO FORM <br /> e ' <br />