Laserfiche WebLink
QUADRUPLICATE STATE OF CALIFORNIA DWR USE ONLY — DO M T FILL IN <br /> For Local Requirements WELL COMPLETION REPORT <br /> Page I of I Refer to Instruction Pamphlet STATE WELL NO./STATION NO. <br /> Owner's Well No. 95361 No.e0328879 I I I I j ❑0❑ <br /> Date Work Began 11/2/2016 Endedll/14/2016 LATITUDE LONGITUDE <br /> Local Permit Agency Fnvimnmental Health <br /> Permit No. 76146 Permit Date 11/1/2016 APNrrRS/OTHER <br /> GEOLOGIC LOG WELL OWNER <br /> ORIENTATION(f) VERTICAL —HORIZONTAL — ANGLE —(SPECIFY) Name Bob Brayton <br /> DRILLINGFHOD ROTARY <br /> DEPTH FROM METHOD FLUID Mud Mailing Address 12599 S. Cometa Rd <br /> RFA <br /> DESCRIPTION Oakdale CA 95361 _ <br /> Ft to F[. Describe /Material, grain, size, color, etc. CITY STATE ZIP <br /> O! 6 Sand W LLOCATIO <br /> -- - - - Address 12599 S Cometa - <br /> 6I 20 Clay Cit,Oakdale CA 95361 <br /> 20', 30 Sand _ Count,San Joaquin <br /> 30'', 41 Clay <br /> _ -...---- ------ APN Book— _Page Parcel <br /> 41! 52 Sand Township Range Section <br /> 52: 75 Clay Latitude I I <br /> 75; 78 Gravel DEG. MIN. SEC. DEG. MIN. SEC. <br /> 78: 90 ClayLOCATION SKETCH ACTIVI'T'Y (V) <br /> _. _. _ - NORTH _ NEW WELL <br /> . 105 Sand <br /> 98 <br /> - -' MOOIFICATIDOnPA1R <br /> 105 179 Clay <br /> 179 185 Sand - -- _ - -Ot (Speafy) <br /> 185 218 Clay - _ - - - <br /> 218 221 Sand - DESTROYtea Medals <br /> Under"GEOLOGIC LOG" <br /> 221 230 Clay PLANNED USES(v) <br /> 236, 270 Clay WATER SUPPLY <br /> - r�1g1 Qy Do Ic— Pudic <br /> I��IVMustrial <br /> MONITORING— <br /> TEST WELL._ <br /> ATHODIC PROTECTION <br /> HEAT EXCHANGE <br /> DIRECT PUSH_ <br /> INJECTION— <br /> VAPOR ID(TRACTION <br /> SPARGING_ <br /> SOUTH -'--' REMEDIATION <br /> IDssrmre or fJo. aWxrrorxr oJWellJU.Roads. MuddiasA <br /> Fmws,Ri wL A and AC a T U. WitMETT. if OTHER(SPECIFY) <br /> emmary. PLEASE BE ACCURATE & COMPLETE. _ <br /> WATER LEVEL&YIELD OF COMPLETED WELL <br /> DEPTH TO FIRST WATEn (FL)BELOW SURFACE 1 <br /> DEPTH OF STATIC 11!4/2016 <br /> WATER LEVEL--118 -(Ft.)&DATE MEASURED <br /> ESTIMATED YIELD '-__-__._ _ (GPM)a TEST TYPE._ <br /> TOTAL DEPTH OF BORING 270 (Feet) TEST LENGTH- (HrS.) TOTAL DRAWDOWN (FI) <br /> _ TOTAL DEPTH OF COMPLETED WELL240 (Feet) May not be representative o a well's Ion -term Villet <br /> DEPTH - CASING _ DEPTH ANNULAR MATERIAL <br /> FROM SURFACE BORE HOLE TYPE _) FROM SURFACE PIP <br /> � <br /> DIA. Y n MATERIAL/ INTERNAL GAUGE SLOT Siff CE- BEN- <br /> (Irldlee) 'e O n GRADE DIAMETER OR WALL IF ANY MENT TO FILL FILTER PACK <br /> FL ro FL H U u 011CIN s) THICKNESS Prem) Ft b Ft (!) �) (TYPE/SIZE) <br /> 0'. 220 11 <br /> 220: 240 100 1 2 L <br /> ATTACHMENTS IV CERTIFICATION STATEMENT <br /> Geologic Log I,tna uxlenigned,certify INA alis tapnt is complete ark emeata to gig Eesl of my Mroeledge anti Inset. <br /> Well Construclbn Diagram NAME MASELLIS DRILLING IN <br /> -. Geephyai Logs) (PERSON,R P RA ) ) <br /> -- SoigWater Cnemicel Analysis11 Al ModeSID CA 95357_ <br /> mer ADDRESS CITY STATE LP <br /> ATTACH ADDITIONAL INFORMATION,IF IT EXISTS. Sg°� <br /> WELL DRILLERIAUrHORI PRESE Ann DATE SIGNED Cb]LICENSE NUMBER <br /> DWR las REV.11-97 IF ADDITIONAL SPACE IS NEEDED,USE NEXT CONSECUTIVELY NUMBERED FORM <br />