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Geologic Log Well Owner <br />6 T o_ p_S o i I <br />24 Clay <br />0 <br />6 <br />Well Location <br />Address 1246 Fine Rd <br />Sand 40 63 <br />Dog. 79 63 <br />79 <br />92 <br />92 <br />124 <br />124 136 <br />24 40 City Linden <br />APN Book <br />Township <br />Latitude <br />Datum <br />Gravel <br />Sand Gravel <br />Sand <br />Clay <br />sand <br />County San Joaquin <br /> N Longitude <br />roin. Sec Des. Min. Sec <br /> <br />Dec. Lat. Dec. Long. <br /> Page Parcel <br /> Range Section <br />Clay <br />136 166 <br />166 196 <br />196 214 <br />214 236 <br />236 252 <br />252 272 Gravel <br />Shale <br />Sand <br />Clay <br />Sand <br />272 300 Black sand <br />Feet <br />Feet <br />Total Dep h of Boring 300 <br />Total Dep h of Completed Well 300 <br />(Feet below surface) <br />(Feet) Date Measured <br />Depth to first water <br />Depth to Static <br />Water Level <br />Estimated Yield • 20 (GPM) Test Type <br />Material Type Fill Description <br />Depth from <br />Surface <br />Feet to Feet <br />Depth from Borehole <br />Surface Diameter <br />Feet o Feet (Inches) <br />Wall Outside Screen Slot Size <br /> <br />Thickness Diameter Type if Any <br /> <br />(Inches) (Inches) (Inches) <br />1 280 12 <br />280 300 12 <br />Blank <br />Screen <br />PVC Sch. 80 <br />PVC Sch. 80 <br />6 <br />6 118 <br />118 <br />300 <br />Bentonite <br />Filter Pack Grit Sand Gravel <br />'The free Adobe Reader may be used to view and complete this form. However, software must be purchased to complete, save, and reuse a saved form. <br />File Original with DWR <br />Page 1 of 1 <br />Owner's Well Number WP0038808 <br />Date Work Began 09/24/2018 <br />Local Permit Agency San Joaauin <br />Permit Number WP0038808 <br />State of California <br />Well Completion Report <br />Neter to Instruction Pamphlet <br />No. xxxxxxx <br />Date Work Ended 10/1/2018 <br />Permit Date 9/21/18 <br />Activity <br />0 New Well o Modification/Repair <br />0 Deepen <br />0 Other <br />0 Destroy <br />Desalte procedures and matenes <br />under -GEOLOGIC LOG' <br />Planned Uses <br />0 Water Supply <br />fl Domestic 0 Public <br />0 Irrigation 0 Industrial <br />0 Cathodic Protection <br />0 Dewatering <br />0 Heat Exchange <br />0 Injection <br />0 Monitoring <br />0 Remediation <br />0 Sparging <br />0 Test Well <br />0 Vapor Extraction <br />0 Other <br />Tit It <br />Water Level and Yield of Completed Well <br />Test Length (Hours) Total Drawdown (Feet) <br />*May not be representative of a well's long term yield. <br />Annular Material <br />Attachments <br />0 Geologic Log <br />0 Well Construction Diagram <br />0 Geophysical Log(s) <br />0 Soil/Water Chemical Analyses <br />0 Other <br />Attach additional information, if it exists. <br />DWR 188 REV 1/2006 <br />Certification Statement <br />I, the undersigned, certify that this report is complete and accurate to the best of my knowledge and belief <br />Name Points West Drilling <br />Person. Firin or Corporation <br />P.0 Box 162 -. Vy..e0 Point CA 95255 <br />,—/- <br />/'ddrcsir / f- /./;pftY <br /> / <br />/ i <br />State <br />- / Cf nW2018 433493 <br />/ <br />IF ADDITIONAL SPACE IS NEEDED, USE NEXT CONSECUTIVELY NUMBERED FORM <br />Zip <br />Signed <br />,C-5TAicensed Watp-rWell Contractor Date Signed C-57 License Number <br />Name Dwight Mitchell <br />Mailing Address 2812 Pacific Ave <br />City Stockton State Ca 7ip <br />Location Sketch <br />(Ske,ch must be drawn by haca after form is prirted.) <br />North <br />ECEIVED <br />MAR 2 206 <br />N'iiRONMENTAL HEALTH <br />PFP 1 T/SERVICF.S <br />South <br />Illustrate or describe distance ot well from roads, buildings. fences, <br />rivers. elc, and attach a mop Ilse additional paper if necessary. <br />Please be accurate and complete <br />Casings <br />Orientation ()Vertical 0 Horizontal <br /> <br />°Angle Specify <br />Drilling Method Direct Rotary Drilling Fluid Bentonite mud <br />Depth from Surface Description <br />Feet to Feet Describe material, grain size, color, etc <br />DWR Use Only — Do Not Fill In <br />I I [ I T-1 I I <br />State Well Number/Site Number <br /> <br />1__L _LL [NI [ L I I i I W <br />Latitude Longitude <br />I I I <br />APN/TRS/Other