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'The free Adobe Reader may be used to view and comr 'his form. However,software must be purchased to corn ete,s "Ind reuse a saved form, <br /> File Original with DWR State of California <br /> of 18 Well Completion Report <br /> Page fi " <br /> Ownet's Well Number MW-6 Refer tolnsrnnicuonPamphlet State Well NumbeNSite Number <br /> Date Work Began 04/13/2012 N° e0150776 N <br /> g Date Work Ended w <br /> Local Permit Agency San J00auin C r Latitude Lon pude <br /> Permit Number Permit Date 2/29/72 APN/FRSIOtller <br /> Orientation O Vertical 0 Horizontal OAngle Specify <br /> Drilling Method Auger Name Wight Holdings, Inc. <br /> _ Drilling Fluid <br /> e 3 c ' MaAing Address_130 S.Wilson Way <br /> z <br /> city Stockton ' StateGAiD 95205 .1 <br /> • 0 55 Overdrill 4 inch wells to 55 feet <br /> Address 1 0 S, lson W <br /> City Stockton C San Joaquin <br /> Latitudebngitud <br /> - Ded.;. Min. <br /> Datum D mal L =" Decima Lrt .M� <br /> )t- 9 <br /> APN Book P e parcel <br /> Townshi <br /> Ram on -.•� <br /> r <br /> dO N Well <br /> rth Mo ification/Repair <br /> ' O Deepen <br /> s r v <br /> , 5 O Othei• <br /> _ Destroy <br /> DescnLe Procedures and maderals <br /> ' rnder'GEOLOGICLOG' <br /> .. O Water Supply.... <br /> ❑ ❑Pubtic Domestic <br /> m ❑Irrigation ❑Industrial <br /> ,r O Cathodic Protection <br /> O Dewatering <br /> O Heat Exchange <br /> 0 Injection <br /> xa #" O Monitoring <br /> O Remediation <br /> q;. ,Rw« O Sparging40 . <br /> x' South O Test Well <br /> r Ire- <' " 4;Rc; :aUstraee or eescnoe astance orwianham�oada.eundhgs.fences. O Vapor Extraction <br /> rivers,etc and atlan a mop.Use addtdonal Paper r rre a rr. O Other ' <br /> _ ""+. ` Pbeaa he aecurste mrd corn efe <br /> - Depth to first waterFeet below surface) <br /> ) <br /> Depth to Static <br /> z s- Water Level (Feet) Date Measured <br /> Total Depth of Bonng <br /> B r; pet Estimated Yield*s: (GPM) Test Type <br /> om leleck Test Length (Hours) Total Drawdown Depth Weli (Feet) <br /> e <br /> *May not be re resentative of a well's Iona term vield. <br /> Depth from ' "hole °` -taxi Wall Outside Screen '-Slot Size Depth from { <br /> Surface D'i , : Thickness Diameter Type if Any Surface Fill Description <br /> Feet to Feel Inc�iese Inches Inches Inches Feet .to Feat i <br /> i <br /> S II <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 Diagram Name Sir de Dfillina.L.P. <br /> Person,Flrm or Corporatbn <br /> ❑Geophysical Log(s) 36 O ec Circle Rancho Cordova CA '95742, <br /> ❑Soil/Water Chemical Analyses Addre City �— State ' I Zip <br /> IZI Other Site Map Signed 4/26/2012 938110 <br /> Attach additional information if It exists. C-57 License ter wen Co ctor Date Signed C-57 License Number <br /> DWR 188 REV.IPDD5 IF ADDITIONAL SPACE IS NEEDED,U NEXT CONSECUTIVELY NUMBERED FORM <br /> is <br /> ' 'L <br />