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`The freeII obe Reader may be used to view and compoµ-4h1s form. However,software must be purchased to eomplete,iW--find reuse a saved form. <br /> File_ Orig hal with DWR State of California ; <br /> " Well Completion Report k ' <br /> Page of Refer to instruction Pamphlet State Well Number/Site Number <br /> Owner's ell Number VW-3 No. e0148209 N Vy <br /> Date We k Began 02/06/2012 Date Work Ended 2/6/2012 ', Latitude Lor, itude <br /> Local Pe mft Agency San Joaquin County Environmental Health 'r <br /> Permit N imber 64190 Permit Date 1118112 i APNITRS! er <br /> 06 ntadion OVertical 0Horizontal OAngle Specify Name Arcadis <br /> Drilling Aeahod A er, Drilling Fluid i <br /> IPPR9Mailing Address 950 Glenn Drive Suite 125 <br /> 3r�6 <br /> w <br /> City Folsom. :# StateChi 95630 <br /> Overdrill 4"well to 45'with 10°Augers and grout <br /> Address 161!2 W Hammer Lane _ <br /> City Stockton d"" San Joequin <br /> Latitude <br /> Dec. Min. se.,�* a# - ?eu. Mtn ySec <br /> Datum I>I D �',ecimal L �Decimal��Long. :? <br /> „may, d".��1 <br /> APN Book P e Parcel, � <br /> TownshipIl: Ra ..n t <br /> O N., WEII �3 <br /> Q Wlific4tionlRepair <br /> O Deepen <br /> bw O Other <br /> ... �.. rc''�r, • DeDeaame Y end mater3Ne <br /> �<.. prpxtlurp <br /> . ` ,rsrder'GE6L061CLQG" <br /> -a O Water Supply <br /> �p ODomestic ❑Public <br /> m <br /> []irrigation ©Industrial <br /> O Cathodic;Protection <br /> Q Dewateting <br /> t (. .. O Heat Exchange. f. <br /> s: .E <br /> O injection' <br /> 0 Monitoring <br /> j <br /> 1:. s,� O Remediation <br /> r. O Sparging <br /> Soudt O Test Wall <br /> v:>_. a ate r:da.ama a;ranm ar+wn barn reea�:aidldlrrys,eerrcea. O Vapor Detraction 1 <br /> addltloneI paps H meamary. O Other <br /> I _;� x .. ., wea.e ne aowrrrte acid .1 <br /> Depth to first vrater ' (Feet below surface) <br /> , u Depth to Static <br /> Water Level li (Feet) Date Measured <br /> Total D pth of BoYRg ,, ? _ Feet Estimated Yield' (GPM) Test Type <br /> 4- <br /> Test Length (Hours) Total Drawdown (Feet) <br /> Total D pth 'Completed Well s=. Feet *May not be re'resentitive of a welt's long term yield. <br /> } <br /> - I <br /> .k. from areholes,.. wall Outside Screen Slat 9iza Depth from <br /> ype * 'tlAaterfal <br /> Su ce bttt� ' Thickness Diameter Type if Any p Surface FIII Description <br /> Feet I Fest Inches°" Inches Inches Inches Feet to Feet <br /> 4�11It <br /> I# <br /> 0 eologic Log I,the undersigned,certify that this report is coliiplete and accurate to the best of mfr knoWbdge and belief <br /> © II Construction Diagram Name Cascade Drillina.L.P. i <br /> Person,Firm or Coryoration <br /> © eophysical Log(s) 2 ircle Rancho Cordova CA 957421 <br /> illWater Chemical Analyses 11 A City state zip <br /> M er Site Mao Signed 03/20/2012 938110 <br /> Attach add' org information N It wrists. C57 Cleansed Weber well Corttrector �; �} Date Signed C-57 License Number <br /> DWR 186 F EV,~2006 IF ADDITIONAL SPACE IS NEEDED,USE NEXT CONSECUTIVELY NUMBERED FORM <br /> i <br /> w <br />