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.ICATE STATE OF CALIFORNIA W R N Y — D N T F I \ I <br /> Repirements WELL COMPLETI 'nN REPORT <br /> L <br /> Of_ Re/cr In In'te "on mp!'/rr STATE WELL NO.ISTATION NO. <br /> Nel <br /> Begg , 5/15/96"° 475337 �❑ El <br /> egann <br /> I Permit Age � � Health LATITUDE <br /> LONGITUDE <br /> ermit No. Permit DaleAPI I <br /> x <br /> GEOLOGIC LOC _ WELL OWNER <br /> IENTATION (!) VERTICAL _HORIZONTAL _ANGLE (SPECIFY) Name I'Mm—t301Ta <br /> DEPTH FROM DEPTH TO FIRST WATER (FL) BELOW SURFACE: Mailing Addr' <br /> SURFACEDESCRIPTION <br /> Ft. to FL uibc m vial a W,Calor,etc. CITY STATE 21P <br /> WELL LOCATION <br /> Address same <br /> City <br /> County <br /> —297 914 APN Hook Page Parcel <br /> Township Range Section <br /> or <br /> Latitude-------- NORM Longu <br /> ilde WEST ! <br /> DEC.276 iii i elay ' MIN. SEC. DEG. MIN. SEC. <br /> LOCATION SKETCH ACTIVITY (v2:72 2!7!7 ) <br /> NORTH _NEW WELL <br /> 29 r G7 MODIFICATIONIREPAW <br /> DI_Or(SPeelf,) <br /> DESTROY(Describe <br /> — 1� Procetlurea env Melaneb <br /> .AL, JL Una«"GEMOGiCLOG') <br /> a <br /> . -PLANNED USE(S) <br /> 1 3 W (! ) <br /> MONITORING <br /> 335 WATER SUBPLY <br /> y Domestic <br /> Public <br /> IniOetion <br /> _ md.enlel j <br /> .TEST WELL" <br /> CATHODIC PROTEC <br /> SOUTH TION <br /> Illustrate or Describe Distance of Well from LoodonInka — OTHER(SPecily) <br /> such a.R floors,Buildings.Fences,Rivers,err. <br /> PLEASE BE ACCURATE L COMPLETE. <br /> DRILLING mud rocr <br /> METHOD FLUID <br /> WATER LEVEL A YIELD OF COMPLETED WELL <br /> DEPTH OF STATIC <br /> WATER LEVEL (FI.) A DATE MEASURED <br /> ESTIMATED YIELD' (GPM) A TEST TYPE <br /> TOTAL DEPTH OF BORING ( b PEST LENGTH_ (Hrs.) TOTAL DRAWDOWN (Ft.) <br /> TOTAL DEPTH OF COMPLETED WELL (Feel) `May not be representative of a well's long-terns yield. <br /> DEPTH CASING(S)BOHE- DEPTH ANNULAR MATERIAL <br /> FROM SURFACE HOLE RE ( FROM SURFACE TYPE <br /> DIA. <br /> MATERIAL/ INTERNAL GAUGE SLOT SIZE <br /> FI, to FI. GRADE CE <br /> (I MS) DIAMETER OR WALL IF ANY FILTER PACK <br /> T <br /> � c��+ c. _ (IncMs) THICKNESS (Incnea) FI. to FL MEN- IGNITE FILL (TYPE/SIZE) I <br /> 360 11360 380 111! 11 11 t1 <br /> .062 <br /> ATTACHMENTS CERTIFICATION STATEMENT <br /> Geologic Loo I, the undter�lgne ec;ercil�l re OCI Is complete and accurate to the best of my knowledge and belief. <br /> L.fl.LiWa �r V�Cilllt CO., Inc. <br /> Well Construction Diagram NAME <br /> Geophysical Log(s) (PE Rpn FUW:ORjGORgfIBA]l ) (TYPED OR PRINTED) <br /> JVV a-d �1+LVA Turlock, CA. 45340 <br /> Salll Water Chemical Analyses <br /> ADOPESS CITY STATE ZIP <br /> Omer <br /> F <br /> ATTACH ADDITIONAL INFORMATION. �6u'• 5/22/96 434218N. IF IT EXISTS. WEIL DRILLER AULHORIZED REPRESENTATIVE <br /> GALE SIGNED C51 LICENSE NUMBER <br /> WIT IHR REV.7.90 IF ADDITIONAL SPACE IS NEEDED. USE NEXT CONSECUTIVELY NUMBERED FORM <br />