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r <br /> 'The free Adobe Reader may be used to view and comp)Os form. However,software must be purchased to complete, no reuse a saved farm. <br /> File Original with DWR State of California DWR Use Only—Do Not Fin In <br /> Page of Well Completion Report <br /> Refer to Instruction PamplMer <br /> Owner's Well Number EX-1 46329 Stale Well Number/Site Number <br /> Date Work Began 11/17/2014 Date Work Ended 11/11/1 /02 8/201414 <br /> Latitude Lon nude <br /> Local Permit Agency San Joaauin COLntV Environmental Health <br /> Permit Number SR70836 Permit Date 10/22/14 ApNRRs/Other <br /> Geologic Log Well Owner <br /> Orientation OVertical 0Horizontal OAngle Specify Name R.F. Land. Inc. <br /> Drilling Method Auger Dnlling Fluid <br /> Depth from Surface Description Mailing Address 938 Frontage Road <br /> Feet b Feet Describe material, g rain size,color,etc City Ripon State CA Zi <br /> 0 120 Silty clay mix,fine grains Well Location <br /> 20 140 Silts/Sands mix,semi-course Address 938 Frontage Road <br /> 40 65 Fine silt sands City Ripon County San Joaquin <br /> Latitude N Longitude __ �v <br /> Dec. Min. Sec. Dec. Min. Sec. <br /> Datum Dec.Lat. - Dec.Long. <br /> APN Book Page Parcel- <br /> Township —Range— Section <br /> Location Sketch Activit <br /> Sketch must be dawn b hand after form c onrt.d' Q New Well <br /> North O Modification/Repair <br /> O Deepen <br /> O Other— <br /> DEC 18 <br /> 2014 O Destroy <br /> Dube prxedurea aed mavnals <br /> untln'GEOLOGICLOG- <br /> NVIROP Planned Uses <br /> PERMIT/ O water Supply <br /> ❑Domestic ❑Public <br /> 3 w <br /> [Irrigation ❑Industrial <br /> O Cathodic Protection <br /> O Dewatering <br /> O Heat Exchange <br /> O Injection <br /> O Monitoring <br /> O Remediation <br /> O Sparging <br /> South O Test Well <br /> mxualeare�edbeesuavem.,vuAve:,haloes/.rxeg. O Vapor Extraction <br /> tea.ep.am an rn.m.p.Wa .dadolnloaparwrec nn. O' Other <br /> Plaev be eccurab vntl cam late. <br /> ater Level and Yield of Completed Well <br /> Depth to first water (Feet below surface) <br /> Depth to Static <br /> Water Level (Feet) Date Measured <br /> Total Depth of Boring 65 Feet Estimated Yield' (GPM) Test Type <br /> Total Depth of Completed Well 65 Feet Test Length (Hours) Total Dmwdown_(Feet) <br /> *May not be representative of a well's Ion term yield. <br /> Casings Annular Material <br /> Depth from Borehole Wall Outside Screen Slot Size Depth from <br /> Surface Diameter Type Material Thickness Diameter Type if Any Surface FIII Description <br /> Feel to Feet Inches Inches Inches Inches Feet to Feet <br /> 0 40 12 Blank Pvc I Sch 40 16 1 1 0 36 Cement Portland <br /> 40 65 12 Screen PVC Sch 40 16 Slot 0.010 36 MtoniteChips <br /> 38 #8 <br /> Attachments Certification Statement <br /> ❑ Geologic Log I,the undersigned,certify that this report is complete and accurate to the best of my knowledge and belief <br /> 1:1 Well Construction Diagram Name Cascade Drilling L.P. <br /> 1:1 Geophysical Log(s) Person,Fin or Corporation <br /> 3000 D th Streiill West Sacramento CA 95691 <br /> ❑ Soil/Water Chemical Analysescity state Zip <br /> ❑r d Other Site Map Signed � t/ 12/12/2014 938110 <br /> Aaach additional information if it exists. C-57 Licesee water Well Contractor Date Signed C-57 License Number <br /> DWR 188 REV.12006 IF ADDITIONAL SPACE IS NEEDED,USE NEXT CONSECUTIVELY NUMBERED FORM <br />