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`The free Adobe Reader may be used to view and complete this form. However,software must be purchased to complete,save,and reuse a saved form. ' File Original with DWR • State of California DWR Use On —Do Not Fill In Page of Well Completion Report Owner's Well Number MW-2166 Refer O- e0 677 Pamphlet State well Number/site Number Date Work Began 11/07/2012 1/8 e0167738 N ww 9 Date Work Ended alth 12 Latitude Longitude Local Permit Agency San JoaaNin t'ol_nhr Environment^I Health Permit Number 66103 Permit Date 11/7/12 AP111I Other Geologic Log Well Owner Orientation OVeftica1 0Horizontal OAngle Specify Drilling Method sonic =ArcadisDolling FluitlDepth from Surface Descriptionowell St 7th FloorFeet to Fast Describe material rain size,color etc State ('+A Zi 94608 0 10 Sand silts,some cla 10 18 Well graded Sand,fine to coarse,some Siltyclayey Well Location Y Y Address 455 W Lincoln Road sand City Stockton 18 23 No recovery County San Joaquin 23 27Sand,well graded,fine to medium Latitude oep, rain. sic N Longitude Dec. Min. Se 27 26 Sandy silts with ockets of thick black clay Datum Decimal Lat. Decimal Long. 28 31 No recovery APN Book Page Parcel 31 32 Sandy silts with some clay Township Ran a Section 32 38 Well graded gravels with Sandy silts Location Sketch Activity 38 40 Silts and very fine sand Sketch must bednewn by hand aflerform isrimed. New Well 40 41 Poorly gradedgravels with fine sand and silts North O Modification/Repair 41 46 Silts with heave offine sand O Deepen 46 48 SiltyyO Other — 0 thick O Destroy 48 51 Sandy sils,trace of small gravel °mgfpepioCedunaaammeknals Mx'GEOLOGC LOG' 51 55 Claye silts/silty clays Planned Uses 55 59 Sand silts,ve hard p water Supply 59 62 Sandy clay,moist _ ❑Domestic ❑Public 62 66 Clayey silts,very hard 3 w ❑lrigabon [Industrial 66 73 Fine to medium sand,Some silts O Cathodic Protection 73 78 Silts O Dewatering 78 82 Sandy clay/sandy silts O Heat Exchange 82 93 Sand,fine to metlium with trace coarse O Injection 0 Monitoring 93 96 Thick sandy silts with trace small gravel O Remediation 96 98 Clay with some silts O Sparging 98 101 Sand,fine to medium,poorly graded south O Test Well 101 102 Silt ivatamad®=needau—oywne^m,oam,ema��as,f , O Vapor Extraction 102 105 '"°'•.a°.•^^an•ma m•o.u>e edam^^ai wns'a oaessery. O Other Sand with some smaller gravels P1^ ^°u '•^^d= •" 105 120 Silty clay/claye siltsWater Level and Yield of Completed Well 120 125 Sandy Silts - Depth to first water (Feet below surface) 125 132 ClayeySilts Depth to Static Total Depth of Boring 32 Water Level (Feet) Date Measured Feet Estimated Yield` (GPM) Test Type Total Depth of Completed Well 95 Feet Test Length (Hours) Total Drawdown_(Feet) *May not be re resemative of a well's long term yield. Casings Depth hAnnular Material Size Depth fromorn Borehole Wall Outside Screen Slot Surface Diameter Type Material Thickness Diameter Type If Any Surface Feet a Feet Inches Inches Inches Fill Description 0 80 6 7Inches Feet to Feet /8 Blank PVC Sch 80 2 0 75 Neat Cement 80 95 6 7/8 Screen PVC Sch 80 2 Slot 0.010 75 78 Bentonite Pellets 78 132 Sand 2/12 Attachments Certification Statement LJ Geologic Log I,the undersigned,certify that this report is complete and accurate to the best of my knowledge and belief ❑ Well Construction Diagram Name Cascade DrillinD L.P. ❑ Geophysical Log(s) 3632 Omec C icle corporation ❑ Soil/Water Chemical Analyses �. Ada Rancho Cordova CA 95742 aJx11lE1 Ci State Lp O Other Site Mao Signed ro 01/08/13 938110 Attach additional 112006 Bon if it exists. G57 Ucensed Water Wall contractor Date Si ned C-57 License Number DWR 188 REV.112006 IF ADDITIONAL SPACE IS NEEDED,USE NEXT CONSECUrIVELY NUMBERED FORM