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1 <br /> 1 <br /> 'The free Adobe Reader may be used to view and comp] form. However,software must be purchased to complete,s nd reuse a saved form. <br /> File Original with DWR State of California <br /> DWR Use Onl —Do Not Fill In <br /> Page of Well Completion Report - <br /> Refer to Insbucfian Pamphlet <br /> Owners Well Number EX-3 No. e0246331 fState Well Number/Site Number <br /> Date Work Began 11/19/2014 Date Work Ended 11/19/2014 LTJ W <br /> Ladtutle Lon`--L ,t� <br /> Local Permit Agency San Joaauin County Environmental H alth <br /> Permit Number 5R70836 Permit Date 10/22/14 APN/TRS/Other <br /> Geologic Log 'Well Owner <br /> Orientation OVerGcal 0Horizontal OAngle Specify Name R.F. Land, Inc. <br /> Drilling Method Auger Drilling Fluid <br /> Depth from surfaceDescription Mailing Address 938 Frontaae Road <br /> Feet to Feet Describe material, rain size,color,etc Cit Ripon State CA Zi <br /> 0 20 Sil clay mix,fine grains Well Location <br /> 20 40 Silty Sand Address 938 Frontage Road <br /> 40 55 Fine sands, mix silts,semi-course City Ripon County San doaguin <br /> Latitude N Longitude <br /> Dep. Min. Sec. Deo_. 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 dmby hand after form is rioted.) p New Well <br /> North <br /> O Modification/Repair <br /> O Deepen <br /> O Other <br /> O Destroy <br /> e�®epmcalurm G'mal¢rsla <br /> uMv'GEGLOGIL LOG' <br /> Planned Uses <br /> O Water Supply <br /> ❑Domestic ❑Public <br /> 3 lu ❑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 /> musenaordescribe dmlance of-1 gam mads,builmmys.fern- O Vapor Extraction <br /> drag.dto.and aeam a map.use additional paper ane«aar, (D Other <br /> Pleeea be eacumb end..I. <br /> Water 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 55 Feel Estimated Yield (GPM) Test Type <br /> Total Depth of Completed Well 55 Feet Test Length (Hours) Total Drawdown_(Feet) <br /> May not be re resentative of a well's long 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 Fill Description <br /> Feel to Feet (inches) Inches Inches Inches Feet to Feet <br /> 0 40 12 Blank PVC SCh 40 6 0 36 Cement Portland <br /> 40 55 12 Screen PVC Sch 40 6 Slot 0.010 36 38 Bentonite <br /> Chips <br /> 38 55 Sand gg <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 /> ❑ Well Construction Diagram Name Cascade Drilling L.P. <br /> ❑ Geophysical Log(s) Person,Firm or Corporation <br /> 3000 Duluth Street West Sacramento CA 95691 <br /> ❑ SollMlater Chemical Analyses Addy-s city state zip <br /> ❑+ Other Site Mao Signed ��,r 12/12/2014 938110 <br /> Attach additional information,if e.ists. r license va erwe Contra t Date Signed C-57 License Number <br /> DWR 188 REV.112006 IF ADDITIONAL SPACE IS NEEDED,USE NEXT CONSECUTIVELY NUMBERED FORM <br />