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'Trye free Adobe Reader my be used to view end k.;ta this rdrm. Havreuer,ranpam muEl pn puahaeaTl to camplela,�aM rauan w eevad form. <br /> File Original with DWR State of California Dllln use Orn –Do NIqIh <br /> PNP 1 of 1 Well Completion Report <br /> R02rre l01075r5mealai Marc NumaeaSilp Number <br /> Date Wen Nrrn O MW-13C No. e0107585 F-`T�n <br /> Data)Mork Began 09,/1612010 Date Work Ended 2J19/201 10 <br /> Local Permit Agency San unLv JpaDDin CoEnv'lnnmant I Hewhin Dent, <br /> �Larnutlel ' Lon e } <br /> Permit Number„SR59, 35 Permit Data 2J17J10 APNRRa/Olher I <br /> . <br /> Geologic Log Wall Owner F <br /> Onernatlon O Vertical O Horlkontal OAr151ie- spccey Name Dalw(nder Dhoot f <br /> DptramWhuDrillingDrillingAviduitl MaI"Address 16800 South Har I <br /> Deeptth tram Surface : "Doadription . ' <br /> Feer Iw FW Drueoibc material gnur,elm color,Mc CI lathmp Sla(e C,A 95330 <br /> Wen Location <br /> Pressure wilut with neat cement Address-Center of Read-near 15550 S Henan Rogd <br /> Remove vault Cox. _ city LemCpuay San Joaquin <br /> Remove upper 3 feel of well materials Latitude <br /> Patch ground aurfBcepee Min. sm N Longitude oma, tris. <br /> Datum Dedmel IAA. Deymel tang. <br /> APN Book Page Perces <br /> " Tcunrshl Rene SDcuon <br /> Location Sketch <br /> Yradr NwAOoAwnn tuna aver lemN OQ Act <br /> W <br /> i <br /> Md. NwWn <br /> North O Mudlfallon <br /> Repalr <br /> Deepen <br /> rO Othe <br /> _ .1 Q Destroy <br /> Planmd Uses <br /> O Water Supply - <br /> _ ❑Donlastic ❑PIIbec <br /> 151 ❑Irrigation ❑Industrial <br /> O Cathodic Protection <br /> tv I O Dewatednq <br /> O Heat ExChancte <br /> O ln)Pceon <br /> ��p'� ISben O Monlorkrg <br /> a{ Q RCmanialion <br /> .. O sto"Ing <br /> South Q Teo WDII I <br /> nxsxxwn.xx.exx..ai.m.,..a..mt.A...�w.x�amm�.rnwu.. Q Vapor Eldradlon <br /> �Nw.,tee mxwxnx.n„uxx wtNMiwlgxer Rnwnxmy. QOther <br /> - - niroreY xeewMxmrx. qx. <br /> ---- Water Level and Yield of Completed Wall <br /> Depth to first water (Fast aelow surface) <br /> Depth to static <br /> Water Larval (Feeg Dale Measurad <br /> Total Depth of Boring Feet Estimated Yield• (GPM) Test Type <br /> =Total Depth of Completed Well 75 Feet Test Length (Hours)Tafel Dra njown_(ttmq <br /> not be ne tathra or a weirs torso term 4eld. <br /> . . Annular Material <br /> Depth from Borehole 'type Material wall outside, screen Slot size Doom from <br /> SUWaeF Diameter ,Thickness plpmsler, Type Ifarry S mace FIR IHmxipean <br /> Fnnl m Fuel IMflas Incher) Inehan tincture eel re Fest <br /> Attachments Certification Statement <br /> Cl Geologic Log 1,the undelslRSl OneAfld, mlh{s report Is complete and accurate to the beat of my krmwtodge and belief <br /> ❑Well GonNiruptlOn Diagram Pwrrn.Run orCerpmmaan <br /> DGeophyslcalLog(s) 20 r( 3 Street and CA X5778 <br /> ©SvWMlor Chemkai Analyses qqy amro - <br /> L ©Other%.�0 Signed r . t. n 'Wry 802334 <br /> IFelAIMMd INe f eft 1Cur Lr 0Im l Cam a Data f ned G57 Lieut*Number I <br /> t[rM lee REV,1/pWa IFAOgTIDNAL 909 EIS NEEDED,Lae ITNmIMRE <br /> NEXTC&,;rCtE�Y REDMkq r <br /> `Y' <br /> I <br />