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r <br /> i <br /> ORIGINAL STATE OF CALIFORNIA WA USE <br /> N V TFILL_ <br /> File with DWR WELL COMPLETION REPORT M1111 <br /> STATE WELL NDJSTA111 1- 11 <br /> No <br /> Page_Lof�_ Refer to Instruction Pamphlet ❑ <br /> Owner's Well No _MWA5 — No 533684 <br /> Date Work Began May 21.2001 ..- Ended May 21.2001 LATITUDE IDNGIMME <br /> Local Permit Agency San Joa urn County Public Health Services <br /> Permit No 2§208 _Permit Date May 18,2001 APHlTRSlOTHER <br /> GEOLOGIC LOG WELL OWNER <br /> ORIENTATION (✓) _!L—VERTICAL —HORIZONTAL _ANOi r —{SPECIFY) Name Unocal CorDOCAU913 <br /> DRILLING Maihn Address Id <br /> DEPT){FROM METHOD FLUID <br /> a-3—Sude 15 <br /> SURFACE DESCRIPTION Elk Qrove <br /> FL to Ft Desenj)e Inatenal grain sL'e Color etc CITY STATE ZIP <br /> WELL LOCATION <br /> r , Well not logged installed 5 feet east of well MW-16 Address 1 RBS Fac,fic Avanua <br /> a City <br /> ' County San Jnanusn <br /> r APN Book 13Z Page 20 Parcel 11 <br /> Township Range Section <br /> r Latitude._ I t MD- Longitude r I WEST <br /> DEQ MIN, SEC DEG. {AMI. SEM <br /> ' LOCATION SKETCH ACTIVITY (_) <br /> I r <br /> NORTM <br /> ✓NEW WELL <br /> MODifICATIKWREPAIR <br /> OthM(Spselgr) <br /> DESTROY(0680ra6P <br /> ' PiOCedIMM Mad Aeslerrets <br /> UntlW-GEOLOGIC LOG 1 <br /> PLANNED USES(=) <br /> a a W PLNV"� <br /> WATER SUPPLY <br /> ' a ,Dominic PrOAe <br /> lrswiso l InAstnal <br /> O <br /> a I # ►1p-IS MTORING-L0' <br /> a a 1 TEST WELL <br /> a a +1 1AI r`N LJS CATHODIC PROTECTION <br /> HEAT EXCHANGE <br /> DIRECT PUSH <br /> I ` MUECTION <br /> r r VAPOR EXTRACTION <br /> SPARKING <br /> r SOLIDI REIMMA ION <br /> 111asfrae or Describe Distance of Well from Roads BrnldlnEs <br /> i I Fences Raurs etc and M04M n nvaa� [Ise adduhennl yrr�tr a� 07MA{SPECIFY{ <br /> nrrr ani PLEASE RE ACC[JRATE C', <br /> COUPfETE <br /> � a I <br /> WATER LEVEL 8t YIELD OF COMPLETED WELL <br /> ' DEPTH TO FIRST WATER (Ft)BELOW SURFACE <br /> ` <br /> DEPTH OF STATIC <br /> WATER LEVEL 22.86 (FL)6 DATE MEASURED May 23-2001_ <br /> ' I ESTIMATED YIELD (GPM)d TEST TYPE <br /> TOTAL DEPTH OF BORING 460 (Feet) TEST LENGTH (1irs.)TOTAL DRAWDOWN _,(FL) <br /> TOTAL DEPTH OF COMPLETED WELL L (Feet) 'May not be represenratrve s melt i Jori -trrm yield <br /> DEPTH <br /> CASING (S) DEPTH ANNULAR MATERIAL <br /> FROM SURFACE HOLE- TYPE ,! FROM SURFACE TYPE: <br /> DIA. MATERIAL INTERNAL GAUGE SLOT SIZE CE Fo <br /> EN FILTER PACK <br /> 1411DETER OR WALL IF ANY MEMItlTE FILL <br /> F! to Fl (Indssl GRADE (xaehss) THICKNESS (haws) Ft !o Ft (�) �) (^) (TYPElSIZE} <br /> 0 I 50 8 ✓ PVC 2 Sch 40 0 a 45 ✓ <br /> 50 60 8 ✓ PVC 2 Sch 40 0 020 45 -7-48 <br /> ✓ <br /> 48 I 60 #3 Sand <br /> a <br /> r ATTACHMENTS CERTIFICATION STATEMENT <br /> I,the undersigned certrty that this report is complete and accurate to the best of my knowledge and belmd <br /> Gookoc Lop <br /> won Construction DLS� MOME Cascade Drilling <br /> tP WAK fIRK OR CORPORATION (TYPED OR PRINTED} <br /> Ga01311va al taps) <br /> Soiuwrter Cheriftal Analyses DRM OmeC Rancho Cordova 95742 <br /> ADDDRESS CRY STAN <br /> Zr <br /> ..._ Othm <br /> ArrACH ADDfTIo�1AL 0*0RMATKN IF JT EXISTS Slynsd June 14,2001 717510 <br /> WELL"IN. E DATE SIGNED C-SJ tICERSE IiUw," <br /> DWR 168 REV 119T IF ADDITIONAL SPACE IS NEEDED, USE NEXT CONSECUTIVELY NUMBERED FORM <br />