Laserfiche WebLink
'The free Adobe Reeder may be used to view and compis fern. However.software must be Gurchased to complete,sa*d reuse a saved form. <br /> File Original with DWR State of California DWR Use Only-Do Not Fill In <br /> Well Completion Re ort __ <br /> p P 7 T._Numb <br /> Page 15 Of 16 Refer roInstruction Pempnat State Well Number/Site Number <br /> Owner's Well Number OW-11 No. e0150684 <br /> Date Work Began 03/26/2012 Date Work Ended 4/3/2012 _ - Latitude on nude <br /> Local Permit Agency San I,.......:.,roual„ Environmental Health DP.Oartment I I I I <br /> gpN1T I Other <br /> Permit Number NA Permit Date 3/5/12 <br /> Geologic Log Well Owner <br /> Orientation O Vertical O Horizontal OAng(e Specify. Name Pensco Trust Cc Cust Etal <br /> Drilling Method Hollow Stem Auger Drilling Fluid Bentonite mud Mailing Address PO Box 144 <br /> Depth from Surface Description Linden CA 95326 <br /> Feet to Feel Describe material, rain size,color,etc C t State i <br /> 60 0 Drill,Sample and Install Well to 30'using Well Location <br /> well materials listed below. Address 1601 Turnpike Road <br /> C ty Stockton County San Joaquin <br /> Latitude N Longitude _ <br /> Deo. Min Sec. Dec. Min. Sec. <br /> Datum Decimal Lat. Decimal Long. <br /> A PN Book 165 Page 040 Parcel 13 <br /> 7)wnshi Range Section <br /> Location Sketch Activit <br /> Sketch must be drawn by harts after form isprinted) (D New Well <br /> North 0 Modification/Repair <br /> O Deepen <br /> O Other <br /> - <br /> 0 Destroy <br /> o.salbe,..dwn end tn.terbb <br /> ,nde,'GEOLOGIOLOG' <br /> Planned Uses <br /> 0 Water Supply <br /> A, -1 []Domestic []Public <br /> UJ ❑Irrigation [:]Industrial <br /> Cathodic Protection <br /> 0 <br /> O Dewatering <br /> 0 Heat Exchange <br /> 0 Injection <br /> 0 Monitoring <br /> 0 Remediation <br /> 0 Sparging <br /> South 0 Test Well <br /> Is Store or de.onee m:iance m.eu eom r..M.bmmme..rend... (I Vapor Extraction <br /> em.n <br /> . d....h.mov. u.e.dmdnn.l a.ae�nnea...rv. 0 Other <br /> n•,a.....em..ttrorrd .at.. <br /> Fater Level and Yield of Completed Well <br /> Lepth to first water (Feet below surface) <br /> Cepth to Static <br /> V`later Level (Feet) Date Measured <br /> Total Depth of Boring 66 FeetEstimated Yield' (GPM) Test Type <br /> Test Length (Hours) Total Drawdown_(Feet) <br /> Total Depth of Completed Well 60 Feet May not be representative of a well's long term yield. <br /> Casings Annular Material <br /> Depth from Borehole T Material wall Outside screen Slot Size Depth from <br /> Surface Diameter Type Thickness Diameter lrpe If Any Surface Fill Description <br /> Feet to Feet Inches Inches Inches Inches Feet to Feet <br /> 60 58 8 Screen Sparge Point 1 13/4 Microporus 60 56 Filter Pack #2/16 <br /> 58 0 8 1 Blank PVC$ch.40 3/4 1 56 54 Bentonite Chips <br /> 54 0 Cement Portland type I/ll <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 All Well Abandonment <br /> Person Firm or Corporation <br /> ❑ Geophysical Log(s) 9245 Beatty Drive Suite A Sacramento CA 95826 <br /> ❑ Soil/Water Chemical Analyses Address - city State zip <br /> ElOther Site Map Signed J 4/25/2012 848359 <br /> Attach additional Intimation if it exists. $ Icensed)sataryae co nractor Date Signed C-57 License Number <br /> OWR 188 REV.12006 IF ADDITIONAL SPACE IS NEEDED,USE I EXT CONSECUTIVELY NUMBERED FORM <br />