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ORIGINAL STATE OF CALWORNIA D !j IJJSE !2t!L 9 N 9*1—�LL <br /> File with DWR WELL COMPLETION REPORT aL–LJ4 <br /> Fage—L of I Refer to Instruction Pasupblet STATE WELL NO.ISTATION NO. <br /> Owner's Well No. No.. 475410 1 1 1 1 R I I =E <br /> Date Work Began 10 ,Ended 11 1 LATITUDE LONGITUDE <br /> It Agencylq bozl r I <br /> *1 • <br /> APHITRS/OYHER <br /> Permit DAte. d�la <br /> GEOLOGIC LOG <br /> V---- — ER <br /> U 1P 103IEQTA%042�� 1L—VERTICAL —HORIZONTAL —ANGLE (SPECIFY}' "1 1 0, <br /> Aso I GN,Z <br /> DIM TO FIRST WATEI1L5%5-!2(FQBELOW SURFACE <br /> C7 0 <br /> i J-• <br /> NCL)j. I <br /> OL <br /> DESCRIPTION <br /> CITY.. e- <br /> i STATE Oa <br /> Ft. to Ft-11 Describe waterid, color,etc, WELL: OC TION <br /> Address <br /> 4 <br /> LN <br /> %) <br /> b2dj C.A,A <br /> Wp' �ook 6 <br /> N I -6,�'�jage -1-1-C) arci <br /> 'Lo's I I S CLAV TQN7rIsh1pj2:3L( Range 0 <br /> ection <br /> 10 • & DEB. MIN. I SEC. NORTH Longitude DEG. 1: MIN. I SEC. WEST <br /> 11.1— 1 ot 9Al, 30\15 i vrl 8i ir� 'zil'.- '\,- ' <br /> . <br /> LOCATION SXETCH ACTIVITY (xL)- <br /> NORTH <br /> S ep'A J, g. 'i NEW WELL <br /> 10).5 137.5 i SIM & eN "ilrr%4 Ltx^,- MODIFICATION/REPAIR <br /> lotl- Deepen <br /> A, 4'4a,"YS'n=d Other(Specify) <br /> Q A <br /> 1 0 DESMOYfD@Rcrffie <br /> 'g2.01' -1 N 'A eanj Procedures and Materials <br /> i . No ir�k flader"GEOLOGICLOG-1 <br /> ;-�Iqrvl�sqljt, L�g-w-,Y-Lf-, 4-.'Jk kp, -��NED)USE(S)- <br /> MONITORING <br /> il (3 kzv PAjc.L 1 10 G-3WATER SUPPLY <br /> e'a V DomealPc <br /> e--L)W2 — Publ*c <br /> 00 a' t)3,0,'Silt-V SAN n v--�) <br /> Irrigation <br /> Industrial <br /> 113.0;Its 540W 5 -.-V Lrn <br /> 'TEST WELL" <br /> SOUT!" TiON <br /> V nea C <br /> CATHODIC PROTEC. <br /> Illustrate or Describe Distance of Well from Landmarks OTHER(Specify) <br /> such as Roads,Buildings,Fences,Rivers,eta <br /> PLEASE BE ACCURATE it 170bfFLErE. <br /> 0,12 .4 SIL:1-V�A�Jb KA rl.;,j METHOD DRILLING <br /> C'01drH Lk&Ims.�ZU-16t -044%. <br /> WATER LEVE TYd YIELD-OF COKPLETtD WELL <br /> DEPTH OF STATIC <br /> WATER LE (Ft.) &DATE MEASURED to <br /> Mo,0 11 12Q.6 ul�jkv S11 5 1 LW 0 Al11 0 ESTIMATED YIELD* (GPM)&TEST TYPETOTAL DEPTH OF BORING 1-)0-0'(Feet) "J <I"-;4 TEST LENGTH (Firs.)TOTAL DRAWDOWN (Ft.) <br /> TOTAL DEPTH OF COMPLETED WELL (Fee) May not he rep-resewtative of a well long-term yield. <br /> DEPTH CASING(S) DEPTH NLAR MATERIAL <br /> FROM SURFACE BORE- I-- - <br /> HOLE TYPE FROM SURFACE LU"l L!:�ftt' TYPE <br /> 1 CE- BE <br /> N•u MATERIAL/ INTERNAL GAUGE SLOT SIZE <br /> anches) DIAMETER OR WALL IF ANY FILTER PACK <br /> TYPE <br /> GRADE MIENTITONW, FILL <br /> Ft. to Ft. 153 (inches) THICKNESS onass) Fl. to Ft. (TYPE/SIZE) <br /> 12-7,6 13.-25 A 1 15 V ^ I <br /> i 0 e-r <br /> 11*9.0: (13.0 <br /> 12,3-0:110, -z e, <br /> —z <br /> ATTACHMENTS CERTIFICATION STATEMENT <br /> — Geologic Log 1,the undersigned,certify that this report is complete and accurate to the beat of my knowledge and belief. <br /> — Won Construction Diagram NAME PC EXPLORATION, INC. <br /> — Geophy3loal Log(a) (PERSON,FIRM.OR CORPORATION) (TYPED OR PRINTED) <br /> — SollfWater Cheinical Analipses 178 VERNON STREETt STE. 31 R6SEVILLE, CA 95678 <br /> — Other ADDRESS QTY STATE ZIP <br /> ATTACH ADDITIONAL WFORMATION. IF IT EXISTS- Stned6 <br /> WELL 7DRILLER IAUTHOR M 9 6E1TA!1 *= DATE SIGNED C-57 LICENSE NUMBFR <br /> DWR 135 REV.7-90 IF ADDITIONAL SPACE 13 NEEDED, USE NEXT CONSECUTIVELY NUMBERED FORM <br />