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'The free Adobe Reader maybe 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 of <br />Owner's Well Number MW -2 <br />Date Work Began 02/23/2007 <br />Local Permit Agency _San Joanuin County <br />Permit Number SR#49714 <br />State of California <br />Well Completion Report <br />Rerer to lnnnni tan Pp.,vUbt <br />No. e062858 <br />Date Wolk Ended 2/23/2007 <br />Permit Date 2/15/07 <br />DWR Use On — Do Not Fill In <br />State Well <br />NumbedSite Number <br />Lade Longitude <br />APN/TRs/Other <br />Geologic Log <br />Well Owner <br />Orientation OVertical O Horizontal OAngle Speciry. <br />Drilling Method Hollow Stem Auger Drilling Fluid <br />Name Arthur Lavagnino <br />Mailing Address 1466 W Madill Ave <br />City Fresno State CA Ztp 93711 <br />Depth from Surface Description <br />Feet to Feet Describe matenal grain size color, etc <br />Well Location <br />See Attached <br />Address 47 East Alpine Ave <br />City Stockton County San Joaquin <br />Latitude N Longitude _ _ w <br />Den. Min. Se, Deo. Min. Sec. <br />Datum Decimal Lat. Decimal Long. <br />APN Book Page Parcel <br />Township _ Range Section <br />Location Sketch <br />Sketch must be drawn bY Using arterrorm Is nteg. <br />Activit <br />O. New Well <br />O Modification/Repair <br />O Deepen <br />O Other <br />O Destroy <br />Describe araaedarea and,natarials <br />under GEOLOGIC LOG <br />North <br />South <br />Planned Uses <br />O Water Supply <br />❑Domestic ❑Public <br />❑Irrigation ❑IntlusMal <br />O Cathodic Protection <br />O Dewatering <br />O Heat Exchange <br />O Injection <br />@ Monitoring <br />O Remediation <br />O Sparging <br />O Test Well <br />O Vapor Extraction <br />OOther <br />IlLslnee ordessrbadetance ofmT pan rvads, buildngs,finee <br />n.amantladaahalnap. use amnane paper aneessearr. s, <br />Pleasebeattursteantl eom INe. <br />Water Level and Yield of Completed <br />Well <br />Depth to first water (Feet below surface) <br />Depth to Static <br />Water Level (Feet) Date Measured <br />Estimated Yield • (GPM) Test Type <br />Test Length (Hours) Total Drawdown (Feet) <br />*May not be re resentative of a well's long term yield. <br />Total Depth of Bodng <br />Total Depth of Completed Well <br />Feet <br />Feet <br />Casings <br />Annular Material <br />Depth from Borehole T <br />Surface Diameter Type <br />Feet to Feet Inches <br />Material Wall Outside Screen Slot Size Depth from <br />Thickness Diameter Type if Any Surface Fill Description <br />inches Inches Inches Feet to Feet <br />Attachments <br />Certification Statement <br />❑D Geologic Log <br />El Well Construction Diagram <br />❑ Geophysical Log(s) <br />❑ SoilMlater Chemical Analyses <br />ED Other Site Mal) <br />Atracn addrtlonallNwmaoon nrteses <br />1, the undersigned, certify that this report is complete and accurate to the best of my knowledge and belief <br />Name Cascade Drilling Inc <br />Parson, mn or Corporafbn <br />3632 qmfgle ancho Cordova CA 95742 <br />dreg= car Spare ZIP <br />Signed 10/12/07 717510 <br />17 1 cahted Wa en convacmr Date Signed C-57 License Number <br />RNR 188 REV. 1200 IFADDITIONAL SPACE IS NEEDED, USE NEXT GUNS Cl IVELY NUMBERED FORM <br />