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TRIPLICATE STATE OF CALIFORNIA DWR USE ONLY - DO NOT FILL IN <br /> Owner's Copy WELL COMPLETION REPORT —J I I = <br /> Page I of I Refrr m Insnuaion Pumphl" ESTATE WELLNOJSTATION NO. �I <br /> Owner's Well No, 1 - _ No.7536`26` L1� — IL Ll JI -i.L�_�LI <br /> Date Work Begin_08/09/01_ __-_, pnded08/13/01 LATITUDE LONGITUDE <br /> Local Penuit Agency Sart JOaquin CD EHD ___ ______ _ I = == <br /> Penni) No.26974 Permit Date 08/02/01 APNRRS'OTHER <br /> GEOLOGIC LOG WELL OWNER <br /> ORIENTATION(%) --✓- VERTICAL _HDRRONTAL — ANGLE —(SPECIFY) Narne H B Dietz <br /> DRILLING <br /> DEPTH FROM - METHOD ROTARY- - FLUID MUD Mailing Address 33233 S. Koster Rd <br /> SURFACE DESCRIPTION Tracy CA 95376 <br /> FL to FL Lkser11u, a atanal grain. srz. color. em. CITY tYE CATION <br /> STATE ZIP <br /> 0 _ 22 clay Address 33 S Koster t <br /> 22 _ 27_sand/gravel- _—__ Cit,Tracy CA 95304 _ <br /> 27'. clay _ CountySANJOAQUIN <br /> 41 41 41 47clay <br /> sand/gravel APNBook255Page0g0 Parcel 41 <br /> .41- � _ - -- <br /> 47 _ 48 ravel To\ ep Range Section -.._ <br /> - — Q- - — Latituditude <br /> _46 52 day DEG. MIN. SEC. DEG. MIN. SEC. <br /> 52 68 gravel/rocks LOCATIONSKETCHKETCH ACrI\TTY Lr) <br /> 68' 78 Clay NORT -V- NEW WELL <br /> 78 98 gravel/rocks MODIFICATIONIREPAIR <br /> -. - — Deeran <br /> 98 103 clay —Olher(specify) <br /> 103 __ 1_12 gravel/rocks <br /> DESTROY(Descnbeocks <br /> 112. 117 Clay Procedures and Materals <br /> 11T 137 gravel/rules Undef-GEOLOGIC LOG" <br /> 18Y- 152 clay-- PLANNED USES(r) <br /> -- --- - WATER SUPPLY <br /> _ 152_ 159 gravel rocks Domaauc__ PuNro <br /> .� 159 183 -Clay-- - — -- 3 Irrigation — Induslnal <br /> 183 188 gravel MONITORING-- <br /> -_ 186... 193 day --_—.- TEST WELL_- <br /> _ THODIC PROTECTION <br /> 193 197grav_el _ _ HEAT ExCHANGE <br /> 197 223 clay DIRECT PUSH_ <br /> _ 223 22_6 gravel INJECTION- <br /> 226 227,Clay _ VAPOR EXTRACTION _ <br /> - <br /> 227r 230'gravel SPARGING- <br /> - — SOUTH - REMEDIATION _ <br /> 2W7 :W7stick clay--- rlro="TM.'n=°gr'.+K°'='a.'�ol"arl�•RovA=.andmx=. <br /> _ _ _ y Fm�a,M.nc.and anarh a map U.vhfiunwi ppn it OTHER(SPECIFYI-- <br /> _ 287-__3_20 i blue day veins .PLEASE HE ACCURATE & COMPLETE <br /> _ T WATER LEI•'EL&YIELD OF COMPLETED WELL <br /> T DEPTH TO FIRST WATER 50 (FI.)SELOW SURFACE <br /> --- --- - - DEPTH OF STATIPn <br /> WATER LEVEL ✓* (FI.)B DATE MEASURED 06/13/D1 <br /> - ESTIMATED YIELD (GPM)&TEST TYPE <br /> TOTAL Dlil'1'II LAP DURING 320 (Pay) TEST LENGTH - --- <br /> (HIs.)TOTAL DRAWDOYYN _ (FI.) <br /> T(ii'AL DF:P'rIi OF IY)hMLETED WELl.235 _(Fxl) Marnol here rerentalireo «well's ion -lens field. <br /> DEPTH CASING(S) ANNULARMATRRL\L <br /> BORE- <br /> FROM SURFACE HOLE TYPE moi) FROM SURFACE TYPE -- <br /> -- - I DIA. s w n MATERIALI IWERNAL GAUGE SLOT SIZE _ <br /> FI. to FL anchm) ° GRADE DIAMETER ORWALL IF ANY CE- BEN- FILTER PACK <br /> N LL (Inebes) THICKNESS (Inehas) FI. to Ft. MEM TONIT FILL <br /> -- D. 180 12PLASTIC 6 16 0 100 -_ - - <br /> 180' _ 200! _ 12 ✓ PLASTIC 6 160 100 235 <br /> 200 2151 __12 } PLASTIC 6 160 <br /> 12 <br /> 215 235 P7P STIC 6 160 .052 - - <br /> - i -- - <br /> ATTACHMENTS CERTIFICATION STATEMENT <br /> Geologic Log I,the undersigned,m6d,that IN,2po1 Is complete and amurale to the best of my IuroMedge and belief. <br /> Well Construction Diagram NAME_CALWATER DRILLING CO., INC. <br /> _. Geophysical Logls) (PERSON,FIRM,OR CORPORATION)(TYPED OR PRIMED)— <br /> -- SWI(Waler Chemical Analysis 300 S. to d. Turlock CA 55380 <br /> One, _ ADDRESS CITY STATE 2)P <br /> ATTACH AODInONALINFORMAT M.IFITEXISTS. S'gn - --k L. _ 08/17/01 434'218 <br /> WE D ILL R/A RED REPR SENTATIVE DATE SIGNED 0-6/LICENSE NUMBER <br /> DWR MY mw.I V» IF ADDITIONAL SPACE IS NEEDED,USE NEXT CONSECUTIVELY NUMBERED FORM <br />