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' TRIPLICATE STATE OF CALIFORNIA DWR USE ONLY - DO NOT FILL__ N <br /> Owner's'Copy WELL COMPLETION REPORT I I I j I I _I—I—I <br /> (rage 1 of 3 Refer to Instruction Pamphirt STATE WELL NO./STATION NO. <br /> Owner's Well No. 1 NO.723443 ❑1 1 1 11 CI <br /> Date Work Began 08/16/99 Ended12/31/99 _ LATITUDE LONGITUDE <br /> Local 1ermit Agency JOAQ IN O EHD - I I 1 _1 1 <br /> Pennit � <br /> No.020259 Pennit Date 08/17/99 APN/TRS/OTHER <br /> GEOLOGIC LOG WELL OWNER <br /> ✓ VERTICAL HORIZONTAL ANGLE (SPECIFY) Name W D O INC. <br /> ORIENTATION O DRILLING Mailing METHOD REVERSE FLUID WATER g Address 23950 S. CHRISMAN RD. <br /> DEPTH FROM TRACY CA 95376 <br /> SURFACE DESCRIPTION - <br /> Ft. to Ft. Describe materia/, grain, size, color. etc. CITY STATE ZIP <br /> SANDY CLAY WELL LOCATION <br /> 0 6 <br /> Address APRICOT LANE <br /> __6_. 10: SAND/GRAVEL City TRACY CA- <br /> _10 14 CLAY County SAN JOAQUIN <br /> 141 _19;SAND/GRAVEL APNBook 2448 Page 07 Parcel 12 _ <br /> 19' 20 CLAY Township RangeO Section 0 _- <br /> 20 22 GRAVEL/ROCKS Latitude <br /> 22 24 CLAY DEG. MIN. SEC. DEG. MIN. SEC <br /> LOCATION SKETCH ACTIVITY L) <br /> 24 47 GRAVEL NORTH _ NEW WELL <br /> 47 49 ROCK MODIFICATION/REPAIR <br /> 49 50 CLAY —- Deepen <br /> 50' 59 GRAVEL/ROCK — other(speciry) <br /> 59, 77__CL Y DESTROY(Describe <br /> 77', 97:GRAVEL/ROCK/CLAY STREAKS Procedures and Materials <br /> Under"GEOLOGIC LOG" <br /> 97' 100PCLAY _ PLANNED USES( c) <br /> 100 101 GRAVEL WATER SUPPLY <br /> - F H __ Domestic_ Public <br /> 101 102 CLAY Cl)w ¢ — Irrigation — Industrial <br /> 102' 106' GRAVEL 3 w <br /> MONITORING <br /> 106 121 CLAY TEST WELL._ <br /> 121 ' 137—G UROCKICLAY STREAKS ATHODIC PROTECTION <br /> 137 -115-2, SANDSTONE/CLAY STREAKS HEAT EXCHANGE- <br /> 162, 168 CLAY DIRECT PUSH <br /> INJECTION <br /> 168. 179: ROCK VAPOR EXTRACTION _ <br /> 179 198 CLAY SPARGING_- <br /> 198' 205 GRAVEL/ROCK SOUTH REMEDIATION— <br /> OTHERSPECIFY Illustrate or DescriheDistance ofWelifromRoads.Buildings. <br /> 205 234;CLAY/ROCK STREAKS Fencm,Rivcrs,etc. and attach a map. Use additional paper if (SPECIFY) <br /> necessary.PLEASE BE ACCURATE & COMPLETE. <br /> 234' _ 23_8' SANDSTONE/CLAY STREAKS <br /> 23- 264;CLAY WATER LEVEL&YIELD OF COMPLETED WELL <br /> 264 2 07 GRAVEL DEPTH TO FIRST WATER (Ft.)BELOW SURFACE <br /> 270 272: CLAY DEPTH OF STATIC <br /> ___ WATER LEVEL (Ft.)&DATE MEASURED <br /> 272; 277'GRAVEL <br /> -- - ESTIMATED YIELD ' 0 (GPM)& TEST TYPE <br /> I OTAL DEPTH OF BORING 970 (Feet) TEST LENGTH— -(Hrs.)TOTAL DRAWDOWN 0 - (Ft.) <br /> IAL DEPTH OF COMPLETED WELL 0 _ (Feet) Mac not be representative o a well's long—leant yield <br /> DEPTH CASING(S) DEPTH ANNULAR NLITERIAL <br /> FROM SURFACE BORE- WTY�PE !v FROM SURFACE TYPE <br /> HOLEDIA. ATERIAL/ INTERNAL GAUGE SLOT SIZE CE- BEN- <br /> FILTER PACK <br /> (Inches) GRADE DIAMETER OR WALL IFANY MENT TONITFILL <br /> Ft. to Ft. (Inches) THICKNESS (inches) Ft. toFt. (TYPE/SIZE) <br /> ATTACHNIENTS CERTIFICATION STATEMENT <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 CALWATER DRILLING CO., INC. _ - - <br /> Geophysical Log(s) (PERSON,FIRM,OR CORPORATION)(TYPED OR PRINTED) <br /> Soil/Water Chemical Analysis 300 S Kilroy Rd. Turlock CA 95380 <br /> ADDRESS CITY STATE ZIP <br /> Other _ 08/06/01 434218 <br /> ATTACH ADDITIONAL INFORMATION,IF IT EXISTS. Signed -- <br /> WELL DRILLER/AUTHORIZED REPRESENTATIVE DATE SIGNED C-57 LICENSE NUMBER <br /> DWR 189 REV.11-97 IF ADDITIONAL SPACE IS NEEDED,USE NEXT CONSECUTIVELY NUMBERED FORM <br />