Laserfiche WebLink
ORIGINAL STAT;:: OF CALIFORNIA <br /> File with DWR WELL COMPLETION REPORT <br /> Page of 1 Refer to Instruction Pampblet STA I M WELL NO ISTATION NO <br /> Owner's Well No 1 No 468064 <br /> ❑ <br /> ate Work Began 04/29/96 Ended 05/04/96 LATnum LONGITUDE <br /> Local Permit Agent <br /> Permit No Permit Date <br /> GEOLOGIC LOG WELL OWNER <br /> ORIENTATION (�} X VERTICAL _._.HOR1ZOtrrAL _ANGLE — (SPECIFY) Name Ed Keaster <br /> ' DEPTH TO FIRST WATER (FL) BELOW SURFACE Matting Address 4460 Marfargoa Dr . <br /> DEPTH FROM <br /> SURFACE DESCRIPTION Stockton CA 95215 <br /> Ft to Ft Derenbe 7ttRtertal,ram Stu color,etc CITY STATE ZIP <br /> WELL LOCATION <br /> 0 :4 :Soil Address 3016 Munford Lane <br /> 4 i14 'Sandy Clay -city 'Stockton <br /> 14 ;18 :Sand County San Joaquin <br /> 18 ,55 ,Clay APN Book'I r age tQ ,r,el ' <br /> 55 62 Sand ° Township Range Section <br /> 62 185 'ClayLatitude i I NORTH <br /> Longitude WEST <br /> 85 :89 :Sand � � , � ,✓� y� DEG MIN SEG DEO MM SEC <br /> 89 X110 .Clay - <br /> LOCATION ONN SKETCH �-NORTH xACTIVITY <br /> NEW WELL <br /> 110 '116 !Coarse'Satkd_ MODtFECATIONIREPAiR <br /> 116 ;155 ;Clay'-. ,tDeepen <br /> 155 ;170 ;CoarseSand" Other(Specily) <br /> ' 170 '171 'Clay <br /> 171 1173 'Sand " —DESTROY(Ov$ende <br /> 173 :200 :Clay ProceduresandMater,als <br /> Under GEOLOGIC LOG, <br /> PLANNED USE(S) <br /> co <br /> w a {!1 <br /> uI MONITORING <br /> ' WATER SUPPLY <br /> Domestic <br /> — <br /> Public <br /> Irrigation <br /> Industrial <br /> TEST WELL <br /> SOU — CATHODIC PROTEC <br /> TH TION <br /> Illustrate or Descnbe Distance of Well from Landmark. — OTHER(Specify) <br /> such as Roads Buildings Fences Rivers etc <br /> PLEASE BE ACCURATE ✓s COdfPLETE <br /> METHOD ROTARY FLUID WATER <br /> WATER LEVEL h YIELD OF COMPLETED WELL <br /> DEPTH OF STATIC7o <br /> WATER LEVEL (Ft) 8 DATE MEASURED <br /> ESTIMATED YIELD (GPM) A TEST TYPE; <br /> TOTAL DEPTH OF BORING 200 (Feet) TEST LENGTH (Hrs) TOTAL DRAWDOWN (Ft) <br /> ' TOTAL DEPTH OF COMPLETED WELL 176 (Feet) *May not be representative of a well's long-term yield <br /> DEPTH CASING(S) DEPTH ANNULAR MATERIAL <br /> FROM-SURFACE`--BORE <br /> BOLE TYPE FROM SURFACE' TYPE <br />' — <br /> INTERNAL GAUGE SLAT SIZE <br /> DIA z a MATERIAL! GE BI=N <br /> Ft to Ft Drtcheal a w 1 GRADE DIAMETER OR WALL IF ANY MENT fONITE FILL FILTER PACK <br /> m s, m Qnchea) THICKNESS (lrtches) Ft To Ft (TYPE/SIZE) <br /> 0!) <br /> 0 35 PLASTIC 6 160 0 100 <br /> ATTACHMENTS (�) CERTIFICATION STATEMENT <br /> — Geologic Log <br /> I,the undersigned certify that this report is complete and accurate to the beat of my knowledge and belief <br /> -- Welt Construction Diagram NAME Tei_4El f T� TI t T f- + 4-; <br /> (PERSDi't FIRM PD 1 N) ( Y D N tTED � <br /> — Geophysical Log(s) <br /> Soil/Water Chemical Analyses 57 <br /> Co STATE 7JY <br /> ADDRESS <br /> — other r <br /> r 05��P/96 668622 <br /> ATTACH ADDITIONAL INsigned <br /> FORMATION !F 1J EXISTS WELL RILIE AUTHD aeoESENTAMEDATE SIGNED _Z57 LICENSE NO MBER <br /> DWR r4 REV 7110 IF ADDITIONAL SPACE IS NEEDED, USE NEXT CONSECUTIVELY NUMBERED FORM <br />