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• ORIGINAL ^;: ,. T STATE OF cAIdFORNIA — P <br /> File With DWFj WELL COMPLETION REPORT <br /> 4Page 1 of 2 Refer re I>Rreruetron Pamphlet STATE WELLNOISTATLON NO <br /> Owner's Well No No. <br /> _ 426321F ❑ <br /> Date Work Began Nov. 12. 199?ndDd r LATtrime LONGITUDE <br /> Local Permit Agency <br /> Permit No 9 2-010 2_permit Date <br /> y�/ GEOLOGIC LOC �T -WELL OWNER <br /> ORIENTATION (�} x x VERTICAL —HCRIMNTAL —AWLE _.(SPECIFY) Navge`l` <br /> DEPTF{FROM DFP77�TO FIRST wA'rFrt,—,S.�i(x�L]sErow sunrrAc� _MatEtng-�dc� s t <br /> MACE DESCRIPTION `',': lI L �a " ` 95240 <br /> Ft to Ft lkYcrrba trrarerlal, In size color ar, _ <br /> \ T t 1 ' WELL STATE 21P <br /> 0 3 r To 501 1 , • s 1 LOCATION <br /> r 1 .Sand Lil ' y 0 d J f <br /> r I <br /> r r { <br /> H APN Beok Page 16 C},_Parcel -- a t n <br /> r r `"`` •`' - ` ' TOwnsrtfip Range Sac tion <br /> r r Clay'- <br /> ""� <br /> �' �` �'� Esatltucl NCFTIF( <br /> r , f ; LCliltUae— r _ r WEST <br /> 1 r t I _ s Mo. 9EC. DES. MW BFC <br /> r e "• "; t ,✓' r LOCATION SKETCIi ACTIVITY (4)- <br /> 114 <br /> , 123x.ti_ S <br /> NORTH )L NEW WELL <br /> L <br /> , MODIFICAMONMEPAIn <br /> r r s <br /> 1 r .4 s �„Deepas <br /> ` e (-,�+ ^Olher(t3paalfY) <br /> DESTROY(neecND <br /> -1FIQ Goad <br /> r <br /> r r , �•^' PrnoaaMgaadAtaladala <br /> t �1 'Sand PLANNEDtr�afota)- <br /> i214 , inn (Z-) <br /> r , MONITORIA101 <br /> 155 i <br /> r r WATER SUPPLY <br /> r238 ' Clay <br /> Daeastro <br /> r243r <br /> 12461 09 — , Public <br /> 1 1 � Irflaslim <br /> Clay <br /> r l <br /> r r __ lilduatrfal <br /> r _ `TEST WELL' <br /> _260 261 '. Flu sand r , _CATHODIC PROTEC <br /> r rClay SOUTH TION <br /> lEfuatrate or Dean&Dblance of Well from Londwwkr —OTHER(S"CITY) <br /> r r P cl E B�A0 <br /> CdflRd2ST 9M7t91 <br /> r <br /> M lin Mud Rotary <br /> FLUID—Water_!Bf?nton 11e <br /> ' 1 WATER LEVEL & YIELD OF COMPLETED WELL <br /> r -10r SAnd DEPTH OF STATIC <br /> � a <br /> WATER LEVEL (Ft) d DATE MEASURED <br /> Clay ESTIMATED YIELD' (apM) A TEST TYPE <br /> TOTAL DEFTII OF BORING 3 7 n (Feet) TEST LEN(17H (Kra)TOTAL DRAWDOWN (FI} <br /> TOTAL DEPTH OF COMPLETED WELL 2 Q 7 (Feet) "'May mm Le reprasmitmot of a well's long tura yreW <br /> I DEPTH BORE CASING(S) DEPTH ANNULAR MATERIAL <br /> FROM SURFACE HOLE TYPE ✓I FROM SURFACE <br /> DIA. d g+ MATERIALI INTERNAL GAUGE SLOT SIZE TYPt <br /> ac GRADE DIAMETER OR WALL IFcfiANY CE BEN <br /> Ft t0 Ft B as) Qnsay 7}�CKNES$ Daahan) FI W (TYPE/eIZE) <br /> FI mExT T0NITE FILL FILTER PACK <br /> (^} (�) (^) <br /> r <br /> rPyr 1011 160 r <br /> 167 247 2n 1 n 111 An Sr <br /> h_SrrOPn247 <br /> 1 r <br /> , r <br /> ATTACHMENTS (Z.) CERTIFICATION STATEMENT <br /> Gooloolo Lou f,the undaraignod,certify that thla report Is complete art"courate to the best of my knowledge and belief <br /> Wan Caastraetlon Dlaoram NAME H E N N I N G S BROS. DRILLING CO. , INC. <br /> ..� GeophYaleal Lapts) (SDN, Ft R1a Da CeRPail*TLON)(TYPED OR PRINTED) <br /> . %IiWaterChamloalAnabses 3525 PELANDALE AVE. MODESTO CA 95356 <br /> 011mr AMKSS <br /> CRY STATE IIP <br /> ATTAC;HADt7TMAL &FORMATION,tFlrEXISTS Signed FEB.23,1993 290813 <br /> WE! Oral IWTHL7RIIED REPR E AT D GST UCEME NEIMBFR <br /> DWRtan REV 7.80 IF ADDITIONAL SPACE IS NEEDED, USE NEXT CONSECUTIVELY NUMBERED FORM/ <br />