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QUADRUPLICATE STATE OF CALIFORNIA <br />For Local Requirements WELL COMPLETION REPORT <br />Page 1 of I Refer to Instruction Pamphlet <br />Owner's Well No. 95236 No -e0350253 <br />Date Work Began 8/16/2017 , Ended8/21/2017 <br />Local Permit Agency Environmental Health <br />Permit No. wp0036987 Permit Date 8/3/2017 <br />GEOLOGIC LOG <br />STATE WELL NO./ STATION NO. <br />LATITUDE LONGITUDE <br />1 I I I I I I I <br />APN/TRS/OTHER <br />WELL OWNER <br />ORIENTATION (✓) <br />DEPTH FROM <br />SURFACEDESCRIPTION <br />Ft. to Ft. <br />V VERTICAL — HORIZONTAL — ANGLE —(SPECIFY) <br />DRILLING ROTARY <br />METHOD FLUID Mud <br />Describe material, grain, size, color, etc. <br />Name John Dondero <br />CASING (S) <br />Mailing Address P.O. BOX 963 <br />Linden <br />CA 95236 <br />CITE <br />Address 20606 WELL LOCATION <br />Hwy 26 <br />STATE ZIP <br />0 3 Top Soil <br />3 <br />18 <br />Clay <br />City Linden CA 95236 <br />18 <br />41 <br />Gravel and Rocks <br />County San Joaquin <br />7 <br />41 <br />48 <br />Clay <br />APN Book Page Parcel <br />Township Range Section <br />Latitude i <br />DEG. MIN. SEC. <br />LOCATION SKETCH— <br />NORTH <br />U <br />Lu <br />SOUTH <br />Illustrate or Describe Distance of 19e11 from Roads, Buildings, <br />Fences, Rivers, etc. and attach a map. Use additional paper if <br />necessary. PLEASE BE ACCURATE & COMPLETE. <br />I <br />DEG. MIN. SEC. <br />ACTIVITY (✓) — <br />--V—"NEW WELL <br />MODIFICATION/REPAIR <br />— Deepen <br />— other (Specify) <br />DESTROY <br />Procedures a0nd Mes aterials <br />Under "GEOLOGIC LOG, <br />PLANNED USES() <br />WATER SUPPLY <br />__1Z Domestic — Public <br />— Irrigation — Industrial <br />MONITORING— <br />TEST WELL— <br />ATHODIC PROTECTION_ <br />HEAT EXCHANGE— <br />DIRECT PUSH— <br />INJECTION — <br />VAPOR EXTRACTION — <br />SPARGING — <br />REMEDIATION — <br />OTHER (SPECIFY)— <br />48 58 Gravel <br />58 158 Clay <br />158 169 Sand <br />169 217 Clay <br />217 219 Black Sand <br />219 260 Clay <br />260 266 Black Sand <br />266 280 Clay <br />280 285 Black Sand <br />285 294 Clay <br />294 299 Black Sand <br />299 358 Clay <br />358 365 Black Sand <br />365 405 Clay <br />WATER LEVEL & YIELD OF COMPLETED WELL <br />DEPTH TO FIRST WATER (Ft.) BELOW SURFACE 1 <br />DEPTH OF STATIC <br />WATER LEVEL 162 (Ft.) & DATE MEASURED 8/21/2017 <br />ESTIMATED YIELD ' (GPM) & TEST TYPE <br />TEST LENGTH—(Hrs.) TOTAL DRAWDOWN (FL) <br />May not be representative o a well's long-term yield. <br />TOTAL DEPTH OF BORING 405 (Feet) <br />TOTAL DEPTH OF COMPLETED WELL 370 (Feet) I <br />DEPTH <br />FROM SURFACE <br />HORS <br />DIA. <br />(Inches) <br />CASING (S) <br />DEPTH ANNULAR MATERIAL <br />FROM SURFACE TYPE <br />CE- BEN - <br />MENT TONIT FILL <br />Ft. to Ft. ✓ (✓) �) <br />FILTER PACK <br />(TYPE/SIZE) <br />TYPE �) <br />y w a MATERIAL / INTERNAL GAUGE SLOT SIZE <br />Z w p a GRADE DIAMETER OR WALL IF ANY <br />m so v LL (Inches) THICKNESS (inches) <br />Ft, to FL <br />0 350 <br />14 <br />350 370 <br />7 <br />-GRAVEL <br />ATTACHMENTS (.,,, ) CERTIFICATION STATEN <br />— Geologic Log I, the undersigned, certify that this report is complete and accurate to the hest of my kr <br />— Well Construction Diagram NAME MASELLIS DRILLING INC <br />— Geophysical Log(s) (PERSON, F ORPO N) Q' E 0 P INIED) <br />— SoiVWater Chemical Analysis 1 INFEFFF Ff ) <br />— Other ADDRESS CI' <br />ATTACH ADDITIONAL INFORMATION, IF IT EXISTS. Signed <br />WELL DRILLER/AUTHORI EPRE TATIVE <br />DWR 188 REV. 11-97 IF ADDITIONAL SPACE IS NEEDED, USE NEXT CONSECUTIVELY NUMBERED FORM <br />