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<br /> ' File Original with DWR State of California DWR Use Onl -Do Not Fill In
<br /> Pa1 of 5 Well Completion Report
<br /> Page Refer to tnsftakw Pamptdet State Well Number/Site Number
<br /> Owner's Well Number AMW-29 No. e0106872 Q�i-� W
<br /> Date Work Began 01/27/2010 Date Work Ended 02/02/2010 Latitude Longitude
<br /> ' Local Permit Agency San Joaquin County
<br /> Permit Number SR 0059146 Permit Date 1/12/10 APN/TRS/Other
<br /> Geolo-gic Log Well Owner
<br /> Orientation 0 Vertical 0 Horizontal OAngle Specify Name Forward Incorporated
<br /> Drilling Method Mud Rota Drilling Fluid Bentonite mud Mailing Address 9999 South Austin Road
<br /> Depth from Surface Description Manteca CA
<br /> Feet to Feet Describe materia rain size color,etc Cit State __Zip 95336
<br /> ' 0.0 5.5 No sample taken. Well Location
<br /> 5.5 6.0 TOPSOIL,clay rich,highly plastic,soft,saturated, Address 27011 South Austin Road
<br /> very dark grayish brown(10YR 3/2). city Ripon County San Joaquin
<br /> 6.0 6.5 SILT,dry,very stiff,brittle,dark yellowish brown Latitude 37 53 29.12 N Longitude -121 10
<br /> ' (10YR 4/6). Deq. Mm. sec. Deo. Min. Sec.
<br /> 6.5 10.0 1 SILT. Datum WCS 84 Decimal Lat. 37.8914 Decimal Long.421.1791
<br /> 10.0 10.5 CLAY,wet,soft,highly plastic,grayish brown APN Book 181 Page 16 Parcel 7
<br /> 2.5YR5/2). Townshi 1Range 7E Section 35
<br /> 10.5 11.5 SILT,wet to damp,medium stiff,moderately Location Sketch Activity
<br /> plastic,grayish brown(2.5YR 5/2). sketch must be drown by North aW form Is 'kited• G)New Well
<br /> 11.5 15.0 SILT. O Modification/Repair
<br /> O Deepen
<br /> 15.0 15.3 CLAY,wet,very soft,highly plastic,very dark O Other
<br /> grayish brown(2.5YR 3/2). See attached O Destroy
<br /> Describe prooadmes and mmenab
<br /> 15.3 16.5 SILT,dry,stiff,slightly plastic,yellowish brown Figure 1 undet'r'EO1Oe1CLOG�
<br /> (1OYR 5/6). Well Location Map Planned Uses
<br /> ' 16.5 20.0 SILT. O Water Supply
<br /> 20.0 21.5 SILT,dry,stiff,slighdy plastic,yellowish brown ❑Domestic ❑Public
<br /> (10YR 5/6). ❑Irrigation Dindusthal
<br /> ' 21.5 25.0 SILT. O Cathodic Protection
<br /> 25.0 25.5 SAND,wet,loose,medium grained,subangular, O Dewatering
<br /> O Heat Exchange
<br /> dark yellovWsh brown(10YR 4/6). O Injection
<br /> 25.5 26.5 SILT,dry,stiff,slightly lastic,yellowish brown U Monitoring
<br /> (10YR 5/6). Trace caliche veins,very pale brown O Remediation
<br /> 10YR 7/4). O Sparging
<br /> 26.5 30.0 SILT. south O Test Well
<br /> idwlmte or deacnbe distance of me ko n roads,bwldm p.fenm. O Vapor Extraction
<br /> 30.0 31.5 Sandy SILT,dry,hard,slightly plastic,dark "ms.ek.endapachamap.Useadddionalpapmifneoess" O Other
<br /> ellowish brown(10YR 416). Sand is subangular, Pbaabaaocurabmrdeaa""
<br /> medium grained,with trace mica. Water Level and Yield of Completed Well
<br /> 31.5 35.0 Sandy SILT. Depth to first water (Feet below surface)
<br /> Depth to Static
<br /> Water Level 70.13 (Feet) Date Measured 06114/2010
<br /> Total Depth of Boring 171.5 Feet Estimated Yield" (GPM) Test Type
<br /> Total Depth of Completed Well 170 Feet Test Length (Hours)Total Drawdown (Feet)
<br /> *May not be representative of a well's long term yield.
<br /> Casings Annular Material
<br /> Depth from Borehole Type Material Wall Outside Screen Slot Size Depth from
<br /> surface Diameter Thickness Diameter Type if Any Surface Fill Description
<br /> Feet to Feet Inches inches inches Inches Feet to Feet
<br /> 0 150 18 Blank PVC Sch.80 0.375 2.75 1 0.0 144.0 Cement Portland
<br /> 150 170 8 Screen PVC Sch.do 0.375 2.75 Milled Slots 0.010 144.0 146.6 Bentonite Pellets
<br /> 146.6 170.0 Filter Pack #2112 Sand
<br /> Attachments Certification Statement
<br /> ❑✓ Geologic Log I,the unde the ra etc d A e to the best of m know)
<br /> Well Construction Diagram Name ( Y edge and belief
<br /> ❑Geophysical Log(s) Flrm o iia,
<br /> D Soil/Water Chemical Analyses rens � car - g� ���
<br /> 13 Other Signed sta ., 0�Q-a'�l
<br /> A ch adds conal mformalion if it wdsta. Water We0 Contractor Date Si ned C-57 License Number
<br /> DWR 188 REV.12006 IF ADDITIONAL SPACE IS NEEDED,USE NEXT CONSECUTIVELY NUMBERED FORM
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