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"The free Adobe Reader may be used to view and Corer: 'his form. However,saltware must be purchased to complete, i'and reuse a saved form. <br /> File Original with DWR <br /> State of California y <br /> Page 10 of 18 Well Completion Report <br /> Owner's Well Number MW-10 Refer to lnstnxtionpamphlet State Well lVum <br /> Date Work Began 04/10/2012 No 011150780 bedSite Number <br /> N w <br /> Date Work Ended Latitude <br /> Local Permit Agency San Joeauin County-Eavironmen,111,11:1],dealt Deoart Lon itude <br /> Permit'Number 15502OQ4Permit Date 2/29/12 ,, Aviv I'Roknner <br /> Orientation O Vertical O Horizontal OAngie Specify <br /> Drilling Method Au er Drilling Fluid Name Wight Holdin s Inc. <br /> , <br /> f?l Mailing Address'=130 S.Wilson Way, <br /> 4 Cu Stockton ° State CA �i X5205 <br /> 0 75 Overdrill 4 inch well to 75 feet. ry <br /> Address 130 S.'Wilson Way <br /> City Stockton Cott San Joaquin <br /> Latitude fVtngitud <br /> Deo. Min. Sec x «. � <br /> Datum- Decimal LAW Decima ng <br /> APIJ Book P e. arcef <br /> Township a Seion <br /> s 0 N Wel[ <br /> Deepen <br /> a cation/Repair <br /> O Oher <br /> 3 ti 0.M1yV Destroy <br /> '. De—ibe Prooedurea and maiwala <br /> undar'aEOLOGic, <br /> YY a_ <br /> a x. O Water Supply <br /> } ❑Domestic ❑Public <br /> 3. <br /> 3" W 13irrigati6n ❑Industrial <br /> n ' <br /> �r . O Cathodic Protection 1 <br /> O Dewatering <br /> O Heat Exchange <br /> #_ c. 9 I <br /> �'- O Injection <br /> O Monitoring <br /> .. _ <br /> O Remediation <br /> O Sparging <br /> s- <br /> w <br /> South 0 Test Well <br /> ,k,,terms., O Vapor Extraction <br /> or <br /> mak' '�''„',;a,F��1�Ushace or deevlbe tllslance of xeA horn roads.ddltll . <br /> s ”= miters,etc.and attach a maP,llae addbonal paper If neceeamy. O Other <br /> Plaa ba aceurafo and corn <br /> Depth to first water (Feet below surface) <br /> Depth to Static <br /> { Water Level (Feel) Date Measured <br /> Total Depth of t3 itng €,5 Feel Estimated Yield" (GPM) Test Type <br /> Total Depth of ompleted Well %L iv Feet Test Length (Hours)Total Drawdown (Feet) <br /> 'MBY not be re resentative of a well's Iona term 'eld. <br /> Depth from ,chole �a� Wall Outside Screen Slot Size Depth from <br /> aterFal <br /> Surface D Thickness Diameter Type ffArry Surface Fill Description <br /> Feet to Feet inches inches Inches Inches Feet to Feet <br /> .t- <br /> x <br /> ❑Well Construction Diagram R u of my. d� <br /> ❑Geologic Log I,the undersigned,certify that this report Is complete and accurate to the best of my knowledge and belief <br /> g Name Cascade Drilli a.L.P. _ <br /> Person,Firm or Corporation -- <br /> ❑ Geophysical Logs) 3632 mac Cir le Rancho:Cordova CA 95742 <br /> ❑Soil/Water Chemical Analyses Add city Stabs zip <br /> L+ Other Site Map Signed 4/26/2012 938110 <br /> Attach additional Infomeation frit eAsts. Cs7 Licensed W er Well C bacror Date Signed G-57 License Number <br /> DWR 189 REV.V2006 IF ADDITIONAL SPACE IS NEEDE(_)`OS1fNEXT CONSECUTIVELY NUMBERED FORM - <br />