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ORIGINAL. STATE OF CALIFORNIA owR sF � <br /> File with DWRWELL COMPLETION REPORT <br /> ELL NOlSTATIDN NO <br /> Page 1 of I Rrfer to Instrucuen Pamphlet STATE W ❑ <br /> Ownees Well No. - NO 749255 <br /> LATITUDE L4NGnUDE <br /> *te Work Began_ MARCH 7.2002 _, Ended <br /> MARC 2UU <br /> Tj <br /> Local Permit Agency SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES-ENV DIV APNrTRS/oTNER <br /> Permit No 28881 Permit Date FEBRUARY 22.2002 <br /> GEOLOGIC LOG WELL OWNER <br /> ORIENTATION (_) VEFITICAL _HOFUONTAL —ANGLE _(SPECIM Naffl UNWAl, <br /> METIiD Hollow Steam Auger FLUID NONE Mailing Address 87B8 ELK GROVE BLVD BUILDING 3 SUME 1$ <br /> MOM OM ETIOCA 95824 <br /> SURFACE DESCRIPTION E R VE <br /> CITU STATE ZIP <br /> F+_ Io Ft Describe material, graln size, color, etc <br /> WELL LOCATION <br /> 0 30 1 WELL BORING WAS NOT LOGGED OR SAMPLED Address 1685 PACIFIC'AV"E_ <br /> 1 I Qty STOCKTON-CA <br /> 1 I County SANJOAQUIN <br /> r , APN Book Page Parcel <br /> I I Township Range Section WEST <br /> I 1 Utstade DES MIN. sac, Longitude DEG MIN 1 SEC. <br /> ' LOCATION_SIKETCH _ ACTIVITY 0-1 <br /> NEW WELL <br /> ` MODIFICATIONIREPAIR <br /> Deepen <br /> other(SPeclq) <br /> DESTROY(Dea <br /> Procedures <br /> rMnfau <br /> pets <br /> UMW 'GEOLOGIC <br /> LraG <br /> PLANNED USES {zt.) <br /> Fa1Nt �� i/7t WATER SUPPLY <br /> eha!•, W->u ■SF17 Domealle Pu01k <br /> 1 I '� Falmlr 1 rwaff <br /> [ Baa : tnleation induairild <br /> + , Ism s .• '�Yle{ ` MONITORING.....r <br /> r <br /> TEST <br /> 1 1 s , YrYr _ ;^ VYELL+ Yfw1� \ •fl}IVf1F7 1 1 CATHODIC PROTECTION <br /> i 1 111 KimKimaMs 1\ ,1 NEAT EXCHANGE— <br /> 1 1 r\MTT.1E ,FSA1 <br /> ,� � DIRECT PUSH_ <br /> e I 1e % �Farmd YYTS1 1 INJECTION <br /> sL Sprell # = Ifaria Iia1 <br /> 1 1 t Ika�dr9 '� Tank VAPOR EXTRACTION <br /> ti "Im SPARGiNG JC <br /> REMEDIATION <br /> amrda OTHER&SPECIFY)_.,_ <br /> 1 WATER LEVEL do YIELD OF COMPLETED WELL <br /> + + DEPTH TO FIRST WATER (Ft.)BELOW SURFACE <br /> 1 1 DEPTH OF STATIC <br /> ' I WATER LEVEL (FL)E DATE MEASURED <br /> I I ESTIMATED YIELD • (GPM)a TEST TYPE <br /> TOTAL DEPTH OF BORING 30 __(Feet) TEST LENGTH (His.)TOTAL oRAWDOWN__(PL) <br /> TOTAL DEPTH OF COMPLETED WELL 30 ^l Feet) 'May not be rrprerrntatme of e Welps!on -rerm reAL <br /> CASING (5) DEPTH ANNULAR MATERIAL <br /> DEPTH BORE_ FROM SURFACE TYPE <br /> FROM SURFACE HOLE TYPE <br /> DIA W ' MATERIAL! INTERNAL GAUGE SLOT SIZE CE SEI- FILTER PACK <br /> it OW$) d GRADE DIAMETER OR WALL IF ANY MENT Fill_ (TYPESUM) <br /> FI to FL V11911011) THICKNESS (Inch-) FL to FT (f) (�) ( ) <br /> 0 1 275 8 ✓ PVC 075 Sch 40 0 + 20 ✓ <br /> 275 I 30 8 rt 2 Microsparge 20 + 25 ✓ <br /> 25 I 30 ✓ 1 2112 Lonestar <br /> I Sand <br /> � I <br /> 1 ' <br /> ATTACHMENTS (z) CERTIFICATION STATEMENT <br /> I the undersigned,candy that this report is complete and accurate to the best of my knowledge and belief <br /> Geo:9C Log <br /> L <br /> onsWnron Diagram NAAfFWOODWARD DRILLING <br /> [PENS�1 FUtIL OR CORPUAATIOiq (TYPED OR PR°1MED1 <br /> ysics Lama}eter Chamicel Analyses 550 RIVER AD/P O BOX 336 RIO VISTA CA 94571 <br /> ZIP <br /> RDDREit CRY 4TATE � <br /> t]Mher <br /> ATTACH.4AA1T'OA1Ai INfbRIWtTiQN 1F rT EJrISTSer, JUNE 13 2002 710079 <br /> 5 <br /> lYEll DfAII OAf2En REPRESENTA7rvE HATE SIIiIED C-ST LICENSE fMUMBER <br /> DX%R IM REV 1147 IF ADO]T10N/LL SPACE 15 NEE Et], USE NEXT CONSE cvnVELY NUMMRED FORM <br />