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'The free Adobe Reader may be used to view and coml' is form. However,software must be purchased IG-W'nplate,d nd reuse a saved form. <br /> File Original with DWR State of California <br /> w tri <br /> Page 17 of 18 Well Completion.Report <br /> Rererfo lnsfruWon Pamphlet <br /> Owners Well Number IW-4 State Well NumberlSke Number <br /> Date Work Began 04/16/2012 No- et1150793 N w <br /> g Date Work Ended X11612012 - latitude Lon,nude <br /> Local Permit Agency _ n <br /> Permit.Number 155Q2064 Permit Date 2129/12APwTRSrOther <br /> Orientation O Vertical O Horizontal OAngle Specify r <br /> Dririing Method A er Name Wight Holdings, Inc. <br /> Dulling Flwd <br /> t Y Mailing Address;130 S.Wilson Way <br /> C Stockton Es <br /> I. a � . .... StateCA r r <br /> 95206 <br /> 0 55 Overdrill 314 inch well to 55 feet. - -" <br /> Address f 30 S:Wilson Way <br /> City Stocktont San Joaquin <br /> LatitudeI+I�pfrgrtude� � <br /> Dee.• Mln. Mtn ec. <br /> Datum Deccimal Lata" Decimal,I`ong <br /> APN Book Page paroeW ""... <br /> Township Ran on <br /> Ne Well <br /> MoYfificalion/Re air <br /> Deepen <br /> p <br /> ' Q other <br /> .; Destroy <br /> a Describe procedures and matenab <br /> under'GEOLOOIC LOG' <br /> F7 <br /> O Water Supply' <br /> g 2 p ❑Domestic ©Public <br /> L3Irrigation ❑Industrial <br /> O Cathodic Protection <br /> �. O Dewatering <br /> O Heat Exchange <br /> O Injection. <br /> yi 7 <br /> O Monitoring <br /> `1P O Remediation <br /> O Sparging <br /> South O Test Well <br /> or Dasa{bersstanx M xell rrom roads.bu&dlr�fences, O Vapor Extraction <br /> &-ra,elc.and attach a maµ-Use ad Wmal paper Irfrexseary <br /> r t. Pha be—rate and cam O Other <br /> Depth to'first water Feet below surface <br /> Depth to Static <br /> ' k:di:e Water Level (Feet) Date.Measured <br /> Total Depth ofpin Feet Estimated Yield' <br /> (GPM) Test Type <br /> e a�Fr t Test Length (Hours)Total Drawdown (Feel) <br /> Total Depth o� ompleted Well "` A, Feet ) <br /> +, *May not be representative of a well's long term yield.9 NAM <br /> i <br /> �. <br /> Depth from xBorehole __ l Wail Outside Screen Slot Sizez Depth from _ <br /> Surface f>Inear. Thickness Diameter Type <br /> incif Any Surface Fill Description <br /> Feet to peat Inche hes Inches Inches Feet ro Feet <br /> sQ <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 Casgage Drilling.L.P. _ <br /> Person,Firm or Corporation- i <br /> ❑Geophysical Log(s) 3632 Omec Circle Rancho Cordov CA" 95742` <br /> 1:3Soil/Water Chemical Analyses dare City state zP <br /> �other.Site Man � Signed . 4/26/2012 938110 <br /> Attach addibonar Information If Its sts. C-57 Licensed Water en contra or Date Signed C-57 License Number i <br /> DWR 188 REV.1/2006 IF ADDITIONAL SPACE IS NEEDED,USE NEXT CONSECUTIVELY NUMBERED FORM <br /> I <br /> ' I <br />