Laserfiche WebLink
j `The free Adobe Reader may be used to view and compler^-'his form. However,softwere must be purchased to complete,sa1and reuse a saved form. <br /> File Original with DWR State of California o ira <br /> Well Corripletlon Report <br /> Page Of Refer to lnsmaion Pamphlet <br /> Owner's Well Number MW-14 No. e0157768 State Well Number/Site Number <br /> N W <br /> Date Work Began 07/26/2012 Hate Work Ended 7/26/2012 Latitude n Longitude <br /> Local Permit Agency San Joaauin County Environmental Health <br /> Permit Number 65313 Permit Date 7/13/12 ?ji <br /> APNfTRS/Other <br /> Orientation OVertical 0Horizontal OAngle Specify Name Olympian;JV _ <br /> Drilling'Method Auger Drilling Fluid <br /> Mailing Address 1300 Industrial Road#2 <br /> i� Ci San Carlos` State CA �i 95602 <br /> Overdrill to abandon 4"well to 35'and grout ' I I - - <br /> through Augers Address 1022 Frontage Road <br /> - = <br /> city Now San Joaquin <br /> Latitude w gitu �nr <br /> .. Dec. Mm. Sec { Nim. isec. <br /> Datum Deinial La. Decirna4'Ln <br /> g. <br /> APN Book P e a ffl$arcel <br /> Townshipi; a a on <br /> QII <br /> h O NI. Well <br /> IModification/Repai'r <br /> O Deepen <br /> 01 O Other <br /> .. <br /> Destroy <br /> est oy <br /> De cdbe procedures and matedata <br /> under`C3EOL06,yyi�0}tsL�tOG' <br /> e Water <br /> .. � OSupply <br /> fr . <br /> o est c Public <br /> ` m ❑irrigation ❑industrial <br /> ^� w <br /> �.. O Cathodic Protection <br /> } O Dewaterin <br /> ' - - O Heat Exchange� <br /> O Injection <br /> gAl 11�� � O Monitoring <br /> O Remediation <br /> " `' O Sparging <br /> South O Test Well <br /> vale«desal6e mstance`of wetl tram roam,huitdirrge,lencee, O Vapor Extraction <br /> .,?•.c',,•e 11, <br /> ven,ate.and Bench a map.t'Uee add'mW paper Mnecesaary. O Other <br /> L..': r kasa 6e accurate mid c <br /> r i Depth to first water (Feet below surface <br /> ' Depth to Static <br /> Water Level (Feet) Date Measured <br /> Total Depth of,"XA f t ' ; Feet Estimated Yield` (GPM) Test Type <br /> Test <br /> Length (Hours) Total Drawdown (Feet)Depth ol Om leted Well Feet <br /> k TA AD `Ma not be re resentative of a well's lon term field. <br /> Depth from holes. Wall Outside­V'.Screen Slot Size: Depth from <br /> Surface gpr �fi w t late 81 Thickness Diameter Type if Any f f Surface <br /> Fill_ Description <br /> Feet to Feet (InchetI Inches Inches inches I Feet- to Feet <br /> ❑Geologic Log I,the undersigned,certify that'ttlis report is complete and accurate to the best of my knowledge and belief <br /> 11 Well Construction Diagram Name Cascade Drilling.L:P. <br /> Person,Finn or Corporation <br /> ❑ Geophysical Log(s) 3632 Om Ci a Rancho Cordova CA 95742 <br /> © SollANater Chemical Analyses city �— state zip <br /> I]Other Site Mar) sign L2QA,. 08/01/2012 938110 <br /> Attach additlonal information Mit exists. C-57 Licensed water II contractor Date Si ned C-57 License Number <br /> DWR 188 REV.12008 IF ADDITIONAL SPACE 15 NEEDED,USE NEXT CONSECUTIVELY NUMBERED FORM <br />