WP0037875 - Laserfiche WebLink

Home Browse Search

Page 1 of 1 Well Completion Report Refer to Instruction Pamphlet State Well Number/Site Number Owner's Well Number 9P0037875 No. xxxxxxx I I INI I I Iw Date Work Began Ini/94/9n18 Date Work Ended 102/10/2018 Latitude Longitude Local Permit Agency n In Permit Number IWF`0037977 Permit Date APN/TRS/Other Geologic Log Well Owner Orientation OVertical 0Horizontal OAngle Specify Name Rananrin Sntn Drilling Method Direct-Rtary I Drilling Fluid Fresh W ter Mailing Address 149m rata S Depth from Surface Description Feet to Feet Describe material,grain size,color,etc City Ftolakton State Ca Tl 0 4 Top Soil Well Location 4 60 Clav Address AF N Cihlcv 60 80 Sand City County 7an Joa wri 80 102 Coarse Sand Latitude N Longitude _yv 102 123 Clav Dea. Min, Sec. Dea- Min. Sec. 123 160 Sand Datum Dec.Lat. Dec.Long. 160 184 Coarse Sand APN Book Page Parcel 184 208 Clav -Township Ran a Section 208 242 Fine Sand Location Sketch Activity 242 266 Clay Sketch must be drawn by hand after form is printed • New Well North O Modification/Repair 266 283 Sand O Deepen 283 300 Coarse Sand O Other Q Destroy Descnbe procedures and matenals under'GEOLOGIC LOG' Planned Uses @ Water Supply IEC& �+ 0 Domestic [:]Public V W ❑Irrigation ❑Industrial 1l11 Ar� �j �nf� O Cathodic Protection 14� [ V 0 Dewatering ENVIRON O Heat Exchange ENVIRONMENTAL 0Injection PERMIT/SERVICES Q Monitoring O Remediation O Sparging South O Test Well Illustrate or tlescnbe distance of well from roatls,buildings,fences, O Vapor Extraction rivers,etc.andattach a map. Use additional paper if necessary. O Other Please be accurate and conn late_ Water Level and Yield of Completed Well Depth to first water (Feet below surface) Depth to Static Water Level (Feet) Date Measured Total Depth of Boring 1300 Feet Estimated Yield' (GPM) Test Type Total Depth of Completed Well 1300 Feet Test Length (Hours) Total Drawdown (Feet) *May not be representative of a well's long term yield. Casings Annular Material Depth from Borehole Type Material Wall Outside Screen Slot Size Depth from Surface Diameter yp Thickness Diameter Type if Any Surface Fill Description Feet to Feet Inches Inches Inches Inches Feet to Feet 0 JP80 19 Blank PVC Sch.80 SDR21 B 1 208 Bentonite Grout well DF 280 300 12 Screen PVC Sch.80 SDR21 6 208 300 Filter Pack Grit Gravel Attachments Certification Statement ❑Geologic Log I,the undersigned,certify that this report is complete and accurate to the best of my knowledge and belief ❑Well Construction Diagram Name Lastle Colhisiruction& Well Drilling El Log(s) 1 n 1 / Modesto CA 95350 ❑ Soil/Water Chemical Analyses 4d ss City State zip ❑ Other Signed I 11' - 02/15/2018 996768 Attach additional information if it exists C-57 Lice sed Water Well Contractor Date Signed C-57 License Number n1ARJ IRR GFX/ 1/7r is Connc ip•iccncn I— v r.n i.Ioc Dcn rnDu.r