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. ORMUAL <br /> File with DWR STATE OF CAI ORNVIA Ra o _ a T <br /> WELL COMPLETION REPORT r `� �■ <br /> page?Of? Refer to Instruction Pamphlet STATE WELL N .teTATION No. 5 <br /> Owner's Well No, No. /),���(� �1_ ❑ <br /> Date Work Began Ended 7/93 '�► I <br /> LATITUDE LONGITUDE k <br /> Local Permit Agency - I <br /> Permit No. 93--1130 Permit Date— 6-18=9, <br /> GEOLOGIC LOC <br /> y _ -;W,ELL <br /> ORIENTATIDN {✓} OWNER <br /> 1)_VERTICAL -�HORIZONTAL ANGLE <br /> ,.�(SPECIFY) Naln Qt. - _ <br /> DEPTH FROM <br /> Ft. DEPTH TO FIRST WATER (FL)BFIAW SURFACE .•, Mai)iTig Address 5 ` <br /> SURFACE DESCRIPTION n 3 <br /> to Ff. Describe material,ltrairr siza,color etc. E! 617Y , "' <br /> 548 STATE ZIP <br /> 561 r Brown cls ' wELL•�.dzcATloN <br /> `Address'�peC ,Ve,- axvest Estat es We11 10 <br /> 561 ' 574 " cls and sand streaks <br /> 574 ; 750 ' cls17 <br /> �Y -,8in <br /> 750 842 ' Blue cls : s'ale 'County <br /> r <br /> E 842 F 854 " aizd'sand:streaks. ' APf�Hook '� _'Pageb Farce) <br /> s�Ia1@'' or <br /> 854 1000 cls `. k Townshl!j <br /> I r tT - or - _Range Section <br /> .i. ' ''• NORTH <br /> mm Longitude—_ r , E9 <br /> WT . <br /> < e• OEe. MIN. SEC. DEQ, MIN. SEC. <br /> LOCATION SKETCH ACTIVITY (t) <br /> `• I ,` • 4 - NORTH -.NEW WELL 1 <br /> MODIFICATIONIREPAIp F <br /> Other(spacrio <br /> � �` � .�•• 1 .�6EaTROY(Deacrtba , <br /> Praceduras end MgteAaJs <br /> Uadar"QEOLOGICLOG'7 <br /> F <br /> PLANNED USE(S) <br /> MONMORINQ <br /> WATER SUPPLY <br /> r J �. DomasUa ' <br /> PablEa k <br /> I r F <br /> � r � rrrl4alian II <br /> , Ndwlrral 1 <br /> r "TEST WELL" <br /> SOS CATHODIC PROTEC- I <br /> TION <br /> Illrutrate or Describe Distance of Well from Landmarks ^OTHER SSpedfyy <br /> such as Roads,Buildings,Fences,Rivers,etc <br /> t PLEASE BE ACCURATE&COMPLETE <br /> DRILLING <br /> METI40D Mud rotary FLUID Water <br /> ' ' WATER LEVEL It YIELD OF COMPLETED WELL i <br /> t DEPTH OF STATIC r <br /> t WATER LEVEL (FL) &DATE MEASURED ; <br /> ESTIMATED YIELD' (GPM)&TEST TYPE <br /> TOTAL DEPTH OF BORING ]aoo (Feet) TEST LENCiTtt (Firs.)TOTAL DRAWDOWN (FL) <br /> TOTAL DEPTIJ OF COMPLir'i'ED WELL 4A52 _(Feet) 'May not be repretemadive of a welh long-term yield. <br /> DEPTH CASINGDEPTH <br /> S) ANNULAR MATERIAL <br /> FROM SURFACE TYPE V FROM SURFACE I <br /> TYPE <br /> DIA, MATERIAL! INTERNAL GAUGE SLOT SIZE CE- BEN <br /> (Inches) d GRADE DIAMETER OR WALL IF ANY FILTER PACK <br /> Ft, to F!. m (inches) THICKNESS (Inches) Ft, to Ft. MENT TUNITE FILL <br /> (4) (TYPE/SIZE) <br /> 29 302 28" Steel ]8IF 5 1 " ' <br /> la PCI 91 <br /> 302 312 " 11 " 060 <br /> 312 ' 350 <br /> 350 362 x <br /> 362 r 444 " IF It <br /> 444 ' 452 .060 ► <br /> ATTACHMENTS E _ —CERTIFICATION STATEMENT <br /> — Georoglo Lou I,the undarefgned,certify that thla report is complete and accurate to the best of my knowledge and belief. <br /> — wetE Construction Diagram A1AMSil�ri <br /> I <br /> _... Goophyalcal Log(a) ( ttlthl,OR CQRPORATIONI(TYF D QR PRI FD) <br /> 3oiV Waler Chemical Analyses 300 S. Kilroy Turlock, [A. 95380 <br /> ._ <br /> ADD <br /> ffm CITY STATE ZIP <br /> Other �/ <br /> ATTACH.ADDmONAL 7NFORMATitNJ. tFrr r wsrs. stanad (Qdlaoe2 <br /> a6&,. ,,Bkkpr. <br /> 8-20-93 434218 <br /> s <br /> VlEL!QRILLFR A(1rN0RF7FA R RES DATE UGNEU G57 LICENSE NUMBER <br /> DWR las REV,7-90 IF ADDITIONAL SPACE IS NEEDED, USE NEXT CONSECUTIVELY NUMBERED FORM <br /> I <br />