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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. <br /> • File Original with DWR • State of California <br /> DWR Use —Da Not Fill In <br /> Page of Well Completion Report <br /> Owner's Well Number MW-129A Rereno maWCGon Pampmer <br /> No. e0167745 Stale WelllNNumber/She Number <br /> Date Work Began 11/27/2012 Date Work Ended 11/29/2012 �_�_J__L__L_J__L�� �Lw <br /> Local Permit Agency San JDaaUln Cot inty PUiEgaMpntal Health Latituee Longitude <br /> Permit Number.B6095Permit Date 11/7/12 APN/TRS/Other <br /> Geologic LollWell Owner <br /> Orientation OVeriical OHorizonfal OAngle Specify <br /> Name ATCadIS <br /> Drilling Method Sonic <br /> Drilling Fluid <br /> Depth from Surface Description Mailing Address 2000 Powell St 7th Floor <br /> 5 <br /> 0 <br /> Feet to Feet Describe material rain size color,etc city Emeryville State CA i 94608 <br /> Sand <br /> 5 8 Silty clay Well Location <br /> 8 10 Sand cla Address 351 Quincy <br /> 10 15 Silty sand,some clay city Stockton County San Joaauin <br /> 15 18 Silty Dlay Latitude N Longitude ____w____wDeo. Min. Sec. Dee._ Mn. See. <br /> 19 19 Sand Clay Datum Decimal Lat. Decimal Long. <br /> 19 34 Sand APN Book Page Parcel <br /> 37 50 <br /> 34 37 Sandy silty clay Township Ran e Section <br /> Clayey Silt Location Sketch Activit <br /> 50 52 Sandy silt Skawnmustbedrawnb hardafterfonnis dntetl. O' New Well <br /> 52 54 Silt Norih <br /> O New Well <br /> 54 56 Clay,some silt O Deepen <br /> 56 57 Sand,some silt O Other <br /> — <br /> 57 Destroy <br /> 57 59 Sandy silt Ow•1la P•aMa�•M m.eMla <br /> uMv GEOLOGICLOW <br /> 59 62 Sand Planned Uses <br /> 62 63 Silt O Water Supply <br /> 63 65 Clayey silt _ ❑Domestic ❑Public <br /> 65 67 Silt 3 w []irrigation ❑Industrial <br /> 67 68 Clayey silt O Cathodic Protection <br /> 68 69 Fine sandy silt O Dewatering <br /> 69 77 Sand O Heat Exchange <br /> O Injection <br /> 0 Monitoring <br /> O Remediation <br /> O Sparging <br /> South O Test Well <br /> In.u,aaa,aaxebaawncawwall ua,,,o•a•.MIal,sa,rw,�, O Vapor Extraction <br /> •�e,narna• 1 auaa Manw•al <br /> P% Pape,rcn«ess•ry O Other— <br /> Water Level and Yield of Com feted Well <br /> Depth to first water (Feet below surface) <br /> Depth to Static <br /> Water Level (Feet) Date Measured <br /> Total Depth of Boring 77 Feet Estimated Yield' (GPM) Test Type <br /> Total Depth of Completed Well 75 Feet Test Length (Hours) Total Drawdown_(Feet) <br /> 'Me not be ntalive of a well's long term ield. <br /> TCasings Annular Material <br /> Depth from Borehole Wall Outside Screen Slot Size Depth from <br /> Surface Diameter ye Material <br /> Feet to Feet Thickness Diameter Type if Any Surface Fill Description <br /> Inches Inches Inches Inches Feet to Feet <br /> 0 70 6 7/8 Blank pyc Sch 80 2 0 61 Neat cement <br /> 70 75 6 7/8 screen pvc Sch 80 2 Siot 0.010 61 64 Bentonite Pellets <br /> 64 77 Sand 2/12 <br /> Attachments Certification Statement <br /> ❑ Geologic Log I,the undersigned,certify that this report is complete and accurate to the best of my knowledge and belief <br /> ❑ Well Construction Diagram Name Cascade Drilling L.P. <br /> ❑ Geophysical Log(s) Person,Fm or corporation <br /> ❑ Soil/Water Chemical Analyses 3632 Omec Circle Rancho CordovaCA 95742 <br /> ❑+ Other.Site Mao Signed n n I�`.-� zip <br /> �� city <br /> 01/08/13 936110 <br /> Attach additional information hit exists. C-5] tensed water <br /> ell onaac$ wr Date Si ned C-57 License Number <br /> DWR1B6 REV.12006 IF ADDITIONAL SPACE IS NEEDED,USE NFXT CONSECUTIVELY NUMBERED FORM <br />