Laserfiche WebLink
ORIGINAL ST1TC OF CIL[170RNIk OWR USE ONLY — 00 NOT FILL IN <br /> File with DWq WELL COMPLETION REPORT <br /> P Ige J—of-`L_ hr)rI t1 Ins11 u(tioll Purl STATE WELL NO'STATION NO <br /> ONVI"Iet S Weil -\l) N7,17.TAT 0 7 LATITUDE L,� i <br /> Date 1C rip 1. Ber�a11 a Ended a ONG TUOE f <br /> LIIL Il Pelllltt 1�en San Joauin C un P <br /> PeT1111t N'I)0026237t _ ArNIIRSIOTHER f <br /> Pel uut Date 5-22-01 <br /> GEOLOGIC LOG AVELL OWNER <br /> ORIENTATION (Z�:) X VERTICAL —HORIZONTAL —ANGLE —(SPECIFY) Na111e <br /> DRILLPING <br /> !Mallin, -dclless__2300 Clayton Rd. ste. 1 250 <br /> DEPTH FROM METTHODHOD FLUID ..._. <br /> SURFACE DESCRIPTION COnlE-- _ CA 94520 <br /> Ft, to Ft Dr %l Il)r ul(l Ye I rill hl ell ehL 6U1U1 Lte CITY STATE ZIP <br /> �L Addiess 1605 S . E1�EI�oradao1O9treet <br /> Cite Stockton <br /> Count, San Joaquin <br /> -IPI Book 1 67Page 31 Parcel 01 <br /> To,,vnsIllp Range Sec.tioll <br /> I ; <br /> Latitude__ I t NORTH LongltuCle I I WEST <br /> DEG MIN SEC DEG Mitt/ SEC <br /> I , <br /> LOCATION SKETCH -kCTIVITI (.�L) <br /> NORTH _ NEW WELL <br /> ' See attached Site plan. MODIFiCATIONIREPAIR <br /> _ Hespan <br /> I , Other(Specify) <br /> I I <br /> X DESTROY(Descnbe <br /> Procedures and Mall <br /> Under GEOLOGIC LOG) <br /> PLkNNED USES (.�L) <br /> WATER SUPPLY <br /> I i Domestic Puble <br /> o F- Irrigation Industrial <br /> LL <br /> i I <br /> w MONITORING <br /> TEST WELL <br /> CATHODIC PROTECTION <br /> I HEAT EXCHANGE <br /> I I DIRECT PUSH <br /> INJECTION_ <br /> VAPOR EXTRACTION <br /> SPARGING <br /> I I SOUTH REMEDIATION <br /> 111ustratc Ol Dcsc+t6L Drstmice,f WV 11{ram Raurls Liulldnr s <br /> Fenecs RILL ctc rurrl eal a ne 1 LsL rrelditunial pap rf OTHER(SPECIFY) <br /> ncccstul'1 PLE4SE BE 1CCURATE&C031PLET <br /> W-il LEVEL & YIELD OF COMPLETED WELL <br /> r r DEPTH TO FfRST WATER (Ft) BELOW SURFACE <br /> I i DEPTH OF STATIC <br /> WATER LEVEL (Ft)S DATE MEASURED <br /> G ESTIMATED YIELD (GPM)) a TEST -TYPE--- <br /> Tl1T1L fDCPT11 OF 13OR[ C 6S FLet) TEST LENGTH (Hrs} TOTAL DRAWDOWN (Ft) <br /> Tl)T1t W.PT11 OF ( D\[pr CTLD WELL 3- (Feet} * Wal not be repruentarre of a z.,l long-trim yield <br /> DEPTH BORE C#SING IS) DEPTH ANNUL�IR MATERIAL <br /> FROM SURFACE HOLE TYPE( FROM SURFACE TYPE <br /> DIP' r w a MATERIAL f INTERNAL GAUGE= SLOT SIZE CE BEN <br /> ncnesy a 8� j GRADE DIAMETER OR WALL IF ANY MEN TONITE FILL FILTER PACK <br /> Ft o FI m vo LL (Inches) THICKNESS (inches) Ft to FI ( (TYPEISIZE) <br /> f c�. <br /> C 2 D , i2 x <br /> 2 3 yC <br /> I <br /> 3 x San � <br /> L 41f 5 4 <br /> CERTIFIC,TION STITEIIENT <br /> — Geologic Log <br /> I the undersigned certify that this report Is complete and accurate to the best of my knowledge and bekef <br /> Nell Construction Diagram NAME V & w DrillincT <br /> _ Geophysical Logs) (PERSON FIRM OR CORPORATION) (TYPED OR PRINTED) <br /> -J SolrAllChemicalAnalyses PO Box 416 Isletori CA 95641 <br /> Y Other 4 _itj aDDRESS CITY STATE ZIP <br /> -4r7-40'q AODITIONAL INFORMATIO +F IT EWSTS Signed `"�~ 2(�Q LI <br /> �Gkl ;n, REPRES NTATIVE DAT SIGNEIY G Sl IIC€NSE NUMBER <br /> rrrtil I. IIs II r- IF ADIDITIONAL SPACE IS NEEDED USE NEXT CONSECUTIVELY NUAl FORM <br />