FIELD DOCUMENTS_2008-2015 - Laserfiche WebLink

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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 Dr Well Completion Report Refer to Instruction Pamphlet State Well Number/Site Number Owner's Well Number MW-2178 No. e0167739 I IN] I--� Date Work Began 10/08/2012 Date Work Ended .10/10/2012 Latitude L—L—t—Lon ituded Local Permit Agency San Joaquin County Environmental Health Permit Number 65628 Permit Date 10/3/12 APNrrRS/Other Geologic Log Well Owner Orientation O Vertical O Horizontal OAngle Specify Name ArCadis Drilling Method Sonic Drilling Fluid Depth from Surface Description Mailing Address 2000 Powell St 7th Floor Feet a Feet Describe material rain size color,etc City Emeryville State CA _Zip 94608 0 Ill I Silt with Trace Clay Well Location 11 119 Sandy Silts Address 555 W Benjamin Holt 19 120 Fine grained sand with silts and trace clay City Stockton county San Joaquin 120 22 Silty sands and thick clay Latitude N Longitude 22 24 Hard sandy clay Dec. Min. Sec. Dep. Min. seo_ 24 25 Sandy clay with trace silt Datum Decimal Lat. Decimal Long. 25 34 Clayey Sand APN Book Page Parcel 34 40 Thick clay with some silts R fine sand Township Ran e Section 40 55 Sand,wet Location Sketch Activit 55 63 Sandy silts Sketch must be draib hand after form is printed.) QNew Well North 63 66 Silty Sand with Clay O Modification/Repair O Deepen 66 68 Clayey sand O Other 68 76 Sand,wet O Destroy o�nbe pmoedimat am masenaks 76 80 Clayey siltstsil sand amerGEOLOGIC loc- 80 83 Sand,wet Planned Uses 83 91 Clayey silts/silty clays O Water Supply 91 94 Clayey sand ❑Domestic ❑Public 94 99 Clayey silts 3 ❑Irigation ❑Industrial 99 106 Sandy clay W O Cathodic Protection 106 109 Sands O Dewatering O Heat Exchange 109 110 Clayey Silts O Injection 110 113 Sand O' Monitoring 113 117 Clayey Silts with packets of fine sand O Remediation 117 128 Clayey silttsilty clay O Spangling 128 130 Silt with trace clay South O Test Well Ieashateord�nhedinhoe aof.,eiirmmmads.buiei O vapor Extraction 130 135 Sandy silts/silty Sands ns mc,and atach a map.use addhmai paper a n�sy:' OOther 135 140 Clayey silts PTB...tmaO rstanndoo'ei Water Level and Yield of Completed Well Depth to first water (Feet below surface) Depth to Static Water Level (Feet) Date Measured Total Depth of Boring 140 Feet Estimated Yield (GPM) Test Type Total Depth of Completed Well 96 Feet Test Length (Hours) Total Drawdown_(Feet) Way not be representative of a well's long term yield. Casings Annular Material Depth from Borehole Type Material Wall Outside Screen Slot Size Depth from Surface Diameter Thickness Diameter Type If Any Surface Fill Description Feet to Feet Inches Inches Inches Inches Feet 0 Feet 0 81 16 7/8 1 Blank IpVC Sch 80 2 0 76 Neat Cement 81 96 167/8 1 Screen jPVC Sch 80 2 Slot 0.010 76 79 Bentonite Pellets 79 140 Sand 2/12 Attachments Certification Statement ❑ 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 Drillina,L.P. 13 Geophysical Log(s) Person,Firm or Corporation 3632 Omec Circle Rancho Cordova CA 95742 ❑ Soil/Water Chemical Analyses — city 1_ state zi p ❑+ Other Site Mao Signed_�j`,h i ��a .� Iv 01/08/13 938110 Attach additional information flit exists. C-57 Licensed water well Contractor Date Signed C-57 License Number DWR 188 REV.1/2088 IF ADDmONAL SPACE IS NEEDED,USE Ni CONSECUTIVELY NUMBERED FORM