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ORIGINAL STATE OF CALIFORNIA DWR USE ON Y — D NOT FILL IN <br /> File with DWR WELL COMPLETION REPORT <br /> Page--I_of,i Refer to Instruction Pamphlet STATE WELL NO/STATION NO <br /> Ownee's Well No S -6A No 749250 <br /> Work Began FEBRUARY 14.2002 , Ended FEBRUARY 14,62 <br /> Weal <br /> LATrruDE LONGITUDE <br /> Permit Agency San Joaquin County Public Health Services-Environmental Health Div APNITRSIOTHER <br /> Permit No 28821 Permit Date FEBRUARY 8,2002 <br /> GEOLOGIC LOG WELL OWNER <br /> ORIENTATION (_) ✓VERTICAL —HORIZONTAL —ANGLE —(SPECIFY) Name UNOCAL CORPORATION <br /> DRILLING Hollow Steam Auger - NONE Mailm Address 8788 ELK GROVE BOULEVARD BUILDING 3 STE 15 <br /> DEPTH FROM METHOD q FLUID g <br /> SURFACE DESCRIPTION ELK GROVE CA 95624 <br /> Ft to Ft Describe material grain she color etc CITY STATE ZIP <br /> WELL LOCATION <br /> 0 + 0 5 1 CONCRETE OVER BASE ROCK Address 437 FAST MINER AVE. (SIDEWALK 308 N.CAI-IFQE3NIA ST.Z <br /> 05 1 14 I SILT City STOCKTON, CALIFORNIA <br /> 14 + 24 I SILTY SAND County SAN JOAQUIN <br /> 24 34 + SANDY SILT APN Book Page Parcel <br /> 34 I 44 I SAND WITH SILT Township Range Section <br /> 44 I 81 .5 I SANDY SILT / SILT l.atilude 1 I NORTH Longitude I t WEST <br /> 81 5 84 I SILTY SAND DEG MIN SEC DEG MIN SEC <br /> LOCATION SKETCH ACTIVITY (z�,) <br /> 64 , 91 , SILT NORTH ✓ NEW WELL <br /> 91 , 100 , SILTY SAND C)EW <br /> MODIFIGATIONlREPAkR <br /> 100 , 104 , 51L7 — Deepen <br /> 104 , 111 , SILTY SAND Other(Specify) <br /> DESTROY(Describe <br /> /// Procedures and Materiats <br /> finder GEOLOGIC LOG") <br /> I I 11l�ICJ� PLANNED USES { ) <br /> WATER SUPPLY <br /> Domestic Public <br /> I I ' F �, Irrigation __ Industrial <br /> MONITORINGLli <br /> _ <br /> TEST WELL <br /> CATHODIC PROTECTION <br /> HEAT EXCHANGE_ <br /> 1 F <br /> DIRECT PUSH <br /> LAST i NSR y� <br /> INJECTION <br /> 1 r VAPOR EXTRACTION <br /> SPARGING <br /> + <br /> so UTH REMEDIATION <br /> Illowrate or Describe Ihaiance<f Wen front Roads Buildings <br /> t Fences Rn,en etc and attach a nu+p (!se addrtfanrtt Yeper if OTHER(SPECIFY) <br /> aecessrtnf PLEASE BE ACCURATE&COMPLETE <br /> WATER LEVEL & YIELD OF COMPLETED WELL <br /> DEPTH TO FIRST WATER (Ft) BELOW SURFACE <br /> DEPTH OF STATIC <br /> I I WATER LEVEL (FI)E DATE MEASURED <br /> I + <br /> ESTIMATED YIELD ' (GPM) 8 TEST TYPF <br /> TOTAL DEPTH OF BORING 111 (Feet) TEST LENGTH (Hrs)TOTAL DRAWDOWN..._._(FL) <br /> TOTAL DEP'T'H OF COMPLETED WELL 110 (Feet) "May not be representative of a welPs Jon -term yield <br /> DEPTH BORE CASING (S) DEPTH ANNULAR MATERIAL <br /> FROM SURFACE HOLE TYPE('') FROM SURFACE TYPE <br /> DIAx w f MATERIAL I INTERNAL GAUGE SLOT SIZE CE- BEN• <br /> (Inches) w z w d GRADE DIAMETER OR WALL IF ANY MENT TONITE FILL FILTER PACK <br /> Ft to Ft c5 {Inches) THICKNESS Tim-ma) FL 1a FI } (^} (✓) (TYPEISIZE) <br /> 0 + 107 5 8 ✓ PVC 075 0 + 100 ✓ <br /> 1075 + 110 8 ✓ MICRO 100 1 105 ✓ <br /> SPARGING 105 t 11l ✓ 2112 LONESTAR <br /> SAND <br /> I <br /> I <br /> I <br /> ATTACHMENTS (=i) CERTIFICATION STATEMENT <br /> I the undersigned certify that this report is complete and accurate to the best of my knowledge and belief <br /> — Geokapls tog <br /> well Construction Diagram NAME WOODWARD DRILLING <br /> (PERSON TIRM OR CORPORATION) (TYPED OR PRWEM <br /> _ Geophysical Log(s) <br /> Soil/Water Chemical Analyses P O BOX 336 RIO VISTA CA 94571 <br /> ADDRESS CITY STATE IW <br /> Olher <br /> ATTACH ADDITIONAL INFORMATION IF IT EXISTS Signedr&I6,%,-K MAY 16 2002 710079 <br /> ELL ORILLE ORIIED REPRESENTATIVE DATE SIGNED C 57 LICENSE NUMBER <br /> D\\R 168 REV I1 97 IF ADDITIONAL SPACE IS NI_E D USE NEXT CONSECUTIVELY NUMBERED FORM <br />