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ORIGINAL STATE OF CALIFORNIA nanUECLM File with DWR WELL COMPLETION REPORTPage. of 2 Refer to Instruction Panrpblet <br /> Owner's Wel),7r No. /� 6'7°� <br /> Date Work Began f , Ended J `� ) LATITUDE El El= <br /> LONC07� <br /> Local Permit Agency SAN JOAQUIN COUNTY PUB. HEALTH <br /> Permit No. 6341 Permit Date 06/14/95 APNrTR§/QTHER <br /> GEOLOGIC LOG <br /> Na e mrJ f :�KLL OWNER <br /> ORIENTATION (!) �vERTICAL _HORIZONTAL —ANGLE _(SPECIFY) iN''TERESI <br /> DEPTH TO I?= <br /> DEPTH FRO (FL)BELOW SURFACE Mallin Address � <br /> WATER 0 � J): �, i BOX 1270 <br /> M R� 4 •�^ <br /> SURFACE DESCRIPTION k` 't i ,110D1 CA 95241 <br /> Ft. to Ft. Dereribe material,grain tete-kGc.••. t` CITY <br /> % 1 i WELL (}CATION STATE zIP <br /> D 39 BROWN SANDSTONE WITH.'XE SES `Address' :168 6"E.•JiMEY LANE <br /> 31 OF GRAY CLAY <br /> 39 44 WAXY GRAY CLAY% Co <br /> SAN--,:JpAQUIN <br /> 44 52 BROWN AND ORAY�'CLAY. �- -` ,.- unity ,��- <br /> ,dPNBook�Yage Parcel© -'�- <br /> 4T 53 AND SANDS='T`ON Tq�vnslsip�3N Range SE Section 21 <br /> 52 6 SOFT -,SA OY BROWN. 'frl AlF L-atihLde' t NORTH LongitudeWEST <br /> 52 68 AND,SANDST,Q E„ SEC. DEG. Miff. sEc. <br /> A y LOCATION SKETCH ACTIVITY (✓}— <br /> 6$ 73', ROWN CLIA Tt W SANDSTONE: NORTH X NEW WELL <br /> 7 74�.PINK 'CLPLY, `SHALE � ^'�' � •^ MODIFICATION(REPAIR <br /> 76{ 84 BgQWN -SANDSTeNE._A D ;CLAY <br /> 84 90 :8LAC $AND, t k <br /> —Deepen <br /> Other(Specify) <br /> 9 . 9 MILD' PINK .�I: Y "� _ p <br /> 94 1. '11 -SAND" A,N.D '�L:ACK _DESTROYMes"Me <br /> 95 114 CEMENTi Q 'SAND Procedures andMeferiah <br /> • Undar"GEOLOOICLOW, <br /> 116 BR WIV'••CL'AY WITH SOME t- f- PLANNED USES) <br /> 116 1,3§ GRAVEL _ MtT(2!:) iNQ <br /> 135 137, BLACK SAND AND WATER SUPPLY <br /> 135 137 GRAVEL P Domestic <br /> 13 16 BROWN CLAY AND SANDSTONE <br /> 164 184 BLACK CEMENTED SAND AND s Public <br /> 165 184 GRAVEL `In <br /> _ Idesdustree <br /> trial' <br /> 186 192 BROWN CLAY <br /> 191 151 TOUGH FINK CLAY — 'TESTWELL- <br /> CATHODIC PROTEO- <br /> 19!� 22!) BROWN CLAY AND CLAY SOUTH TION <br /> 22 243 BLACK SAND AND Illustrate or Describe Distance of well from Landmarks _OTHER(Specify) <br /> such as Roads,Buildings,Fencer,Rivers,etc. <br /> 229 244 GRAVEL AND ROCKS PLEASE BE ACCURATE&COMPLETE. <br /> 243 284 BROWN CLAY AND SANDSTONE OETHOD MUD ROTARY FLUID WATER <br /> 283 285 TOUGH PINK CLAY SHALE WATER LEVEL & YIELD OF COMPLETED WELL <br /> 28 29 MILDER BROWN CLAY AND DEPTH OF STATIC 0 f <br /> WATER LEVEL—(Ft.) a DATE MEASURED <br /> 285 297 SANDSTONE ESTIMATED YIELD° 0(GPM) a TEST TYPE <br /> TOTAL DEPTH OF BORING '35D(Fwt4O TEST LENGTH O (Hra.)TOTAL DRAWDOWN O (Ft.) <br /> TOTAL DEPTH OF COMPLETED WELL (Feet) 'May not he representatiare of a well's long-term yield. <br /> DEPTH CASING(S) DEPTH ANNULAR MATERIAL <br /> FROM SURFACE HOLE TYPE ✓ FROM SURFACE TYPE <br /> DIA• MATERIALI INTERNAL GAUGE SLOT SIZE <br /> (TYPEISIZE) <br /> DIAMETER OR WALL IF ANY CE- BEN- <br /> Ft. to Ft- (inches) y$ GRADE �� THICKNESS Onches) FL to Ft. MENT TONRE FILL FILTER PACK <br /> ,� ✓ ✓ <br /> Q 12 Y STEEL 6. w , 28C Y <br /> 280 <br /> 3 , <br /> , <br /> t ' <br /> t <br /> � D <br /> 1 , <br /> ATTACHMENTS (✓) CERTIFICATION STATEMENT <br /> — Geologlo Loo I,the undersigned,certify that this report Is complete and accurate to the best of my knowledge and ballet. <br /> PUR'VIANCE DRIL INC. %� <br /> Well Construction Diagram NAME )OYP OR INTED)- <br /> _ GeophysIcatLog(a) (PERSON. FIRM OR CORPORATWN <br /> Sou/Water Chemical Analyses P. 0 BOX 64, EN, CA 95236 <br /> Other <br /> ADDRESS CITY STATE ZIP <br /> ® <br /> ATTACH ADDITIONAL INFORMATION. IF er EMSTa Signed 377923 <br /> WELL D LER/AUTHORiZED R ENTATWE DATE SIGNED 0.57 UCElis ZBER <br /> DWR ISS REV.7.90 IF ADDITIONAL SPACE IS NEEDED, USE NEXT CONSECUTIVELY NUMBERED FORM <br />