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3500 - Local Oversight Program
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PR0545892
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Last modified
9/14/2021 9:40:30 AM
Creation date
7/22/2020 1:29:56 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0545892
PE
3528
FACILITY_ID
FA0003601
FACILITY_NAME
ARCO STATION #826951*
STREET_NUMBER
130
Direction
S
STREET_NAME
WILSON
STREET_TYPE
WAY
City
STOCKTON
Zip
95205-5561
APN
15502064
CURRENT_STATUS
02
SITE_LOCATION
130 S WILSON WAY
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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'The free Adobe Reader may be used toview and com- this form. However,software must be purchased to complete,f %nd reuse a saved form, <br /> File Original with DWR <br /> State of Califamia - <br /> oil _.. „ <br /> Pages of 18 _ Well Completion Report <br /> Owner'SWellNumber MW-9 ReWtofnsfrudionPamphlet <br /> S <br /> Dale Work Began 04/12/2012 <br /> fto, tate Welf NumbedSrte Number <br /> e01 <br /> 50779 N <br /> Date Work Ended w <br /> Local Permit Agency :nvron Latitude Lon itude <br /> Permit Number 15502064 Permit Date 2129112 AFNITRStpther <br /> 0rfentatlon O Vertical O Horizontal OAngle Specify rNe-Wight Holdings, <br /> Drilling Method Auger s Inc. <br /> Drilling Muld <br /> ing Address'13 S.Wilson Wa <br /> SO% <br /> x.. -Stockton ` <br /> 0 75 State C,'4 1i 95205 ii <br /> �verdrill 4 inch well to 75 feet. <br /> Address 130 S.Wilson Wa <br /> City Stockton Cot ty San Joaquin <br /> Latitude }N ngitud" _yyl <br /> Dap Min. Sec,` Min y5ec. <br /> Datum D. vmal Ldp T �.:. Decima song. <br /> APN Book P. a <br /> Township Ra n <br /> fed.. N wWell <br /> Mo.ification/Repair <br /> O Deepen <br /> , O Other <br /> ,Y Destroy <br /> ;t F - <br /> rtprocedures and materlab <br /> unde <br /> under'G GEOLOGIC LOG' <br /> w Q Water Supply <br /> []Domestic❑Public <br /> m ; <br /> "5 - w ❑Irrigation [Industrial <br /> _ Cathodic Protection <br /> Q Dewatering. <br /> h p Q Heat Exchange <br /> �.4.r 0 Injection <br /> ttLk. O"Monitoring <br /> Q Remediation ' <br /> O 5parging <br /> g O Test Well <br /> dlatsrxe ar well hom roads,6urdirge,knowO Vapor Extraction, <br /> rivers,etc.and attach a map.Use addrbpapa If paIf necessary" O Other <br /> A: <br /> 14.11- <br /> ip.` Vleaae ha aacreate era caul <br /> , <br /> me y <br /> Depth to first water (Feet below surface) <br /> Depth to Static <br /> Water Level (Feet) Date Measured <br /> Total Depth of 6.n g Feet Estimated Yield' (GPM) Test Type <br /> � *xr;�F ' r ,,.. Test Length (Hours)Total Drawdown (Feet) <br /> Total Depth aompteted Well � �_ Feet <br /> ar "May not be re resentative of a well's long terns yield. Ip <br /> Depth from "Wpreholeype qk. wall Outside Screen Sint Size" Depth from <br /> Surface �l` BLBr4 Thickness Diameter Type NAny Surface Fill Description <br /> Feet to Feet Indies Inches Inches Inches Feet to Feet <br /> p <br /> ❑Geologic Log I,the undersigned,certify that this report is complete and accurate to the best of my knowledge and belief <br /> Name Cascade_j rt 1i LP. <br /> Dwell Construction Diagram Person,Firm or an, <br /> C3 Geophysical Log(s) <br /> 3632 Omec Circe LRancho Cordova CA _95742 <br /> ElSoiIANater Chemicai Analyses dares City state zip <br /> 0 Other-Site Mala Signed 4/26/21712 938110 <br /> Attach additional Information if it pasts. C-57 licensedr well or - - Date Signed C-57 License Number <br /> DWR 188 REV.1!2006 IF ADDITIONAL SPACE IS NEEDED,u5 NEXT CONSECUTIVELY NUMBERED FORM <br /> J: ' <br />
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