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'The free Adobe Reader may be used to view and com• �'this form. However,software must be purchased to complete,r rand reuse a saved form, <br /> File original with DWR ti- <br /> Slate of California <br /> Page 3 of 18 Well Completion Report <br /> Owner's Well Number MW-3 RelerrolnstrutflonPamphlet State Well Numberl5ite Number <br /> Date Work Began 04/17/2012 No, 00450767 N . <br /> Date Work Ended 4/1712012 W <br /> Local Permit AgencyMMenlill Maude Lon nude <br /> Permit Number15502064 T t <br /> Permit Date 2/29/12 APNrrRs<Otner <br /> w <br /> OrientaYIon O Vertical O Horizontal OAngle Specify <br /> Drilling Method Au er Name Wight Holdings,Inc. <br /> Drilling Fluid <br /> R` Mailing Address 130 S.Wilson Way <br /> - C , <br /> _. Stockton State CA�i ' 95205.i <br /> 0 60- Pressure grout to abandon 4 inch wells to 60 feet. <br /> Overdrilled to abandon 3 feet mushroom cap. Address 130 S.Wilson Wav <br /> City Stockton San Joaquin <br /> Latitudegttud :. - �. <br /> Deo. Min. sec.+ Min ,Be <br /> Datum Decimal Lew Decima ohg <br /> APN Book � �Page 4 arcet, "'.1 <br /> Towns Ip Ran ., on <br /> a <br /> '151 <br /> bith O NdW Well <br /> 01WMo iticationlRepair <br /> "'. t ";, 0 Deepen <br /> M O Other. <br /> 'a • Destro <br /> Deeaihe pprooedures and materials <br /> under'GEOLOGIC LOG' .l <br /> O Water Supply <br /> ❑Domestic ❑Public <br /> ❑Irrigation ❑Industrial <br /> O Cathodic Protection <br /> " y s O Dewatering <br /> � <br /> � t� <br /> ^' L� O Heat Exchange <br /> .'?�' & 4 t,, <br /> 0 Injection <br /> O Monitoring <br /> " . O Remediation <br /> r , <br /> O Sparging <br /> South O Test Well <br /> liliw-te a deecrlbe dlatanm of w iM m mads,tulldlrgs,fences: O Vapor Extraction <br /> rNem,etc,and attach a mop Use 2WHonml paper H necessary. O other <br /> ,v.. „�; �-.•. Pham be exureW and tom - 1 <br /> it- <br /> y Depth to first water (Feet below surface) I <br /> Depth to Static <br /> Water Level (Feet) Date Measured <br /> Total Depth of Boring 0 ;, feet Estimated Yield' (GPM) Test Type <br /> Total De th o, om leted Wel! Test Length (Hours)Total Drawdown (Feet) <br /> r <br /> P P - :, Feet May not be re resentative of a well's long term yield. <br /> Mffai -ate <br /> Depth from .°, hole t �I Wall Outside Screen Slot Size Depth from <br /> Surface Dia Yoe 1%,; tel Thickness Diameter Type if Any Surface Fill Description <br /> Feet to Feet Indies Inches Inches Inches Feet to Feet <br /> ff <br /> ❑Geologic Log 1,the undersigned,certify that this report is complete and accurate to the best of my knowledge and belief <br /> ❑Well Construction Oiagram Name Cascade Drilling.L.P. _ <br /> Person,Rrre or Corporation - _- <br /> ❑Geophysical Lag(s) 3632 Omec Circle Rancho Cordova CA 95742 <br /> ❑SoiUWater Chemical Analyses Address city sty zip <br /> E071 Other Site Mao Signed 4/26/2012 938110 <br /> Attach additional Information if It exists. C57 licensed Water ell - Date Signed C-57 License Number <br /> DWR 188 REV.WOW IF ADDITIONAL SPACE IS NEEDED,USE NEXT CONSECUTIVELY NUMBERED FORM <br />