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G 'The free kdobe Reader may be used to view and comple+A+his form. However,saftware must be purchased to comQlate,61--7 and reuse a saved farm. <br /> File Orig nal with DWR _ Slate of California <br /> Page of Well Completion Report 11 <br /> RererrornstrJWWF-amphW I} State Well Number/Site Number <br /> Owner's ell Number AS-3 No. e0148210 NI kvv <br /> Date W Began 02/06/2012 Date work Ended Latitude Lon gitude <br /> Local.Pe it Agency San Joaouin County Environmental HealthiiL <br /> I I 1. _L. I I I I !l _L-- I l <br /> Permit imber 64190 Permit Date 1/18/12 It APN/FRSIOther <br /> i 0 ItitatIon O Vertical O Horizontal OAngle Specify Name Arcadis <br /> Drilling: ethodAuner Drilling Fluid Mailing Address 950 Glenn Drive Suite 125 <br /> COFolsoml State_QA—zi 95630 <br /> Overdrill 2"well to 65'with 8e Augers and grout <br /> Address <br /> city Stockton C` ty San Jo quip <br /> Latitude i tLongitud w <br /> Dep. Min. Sec;f,;'' Min 6K.1 ; <br /> Datum Decimal UW, Declm4g'bng 4 = " <br /> APN Book Ii PageParce <br /> Township T is Se&on <br /> O N�Ir W II , <br /> ' '"b,rth <br /> _W Motlifi tlon/Repair <br /> t j,:0 Deepen <br /> ' 0 Other <br /> Destroy; <br /> .:,. Desatb P edurss and matwials <br /> I '< <br /> wder'GEOLWO LOG, <br /> Ip �. <br /> O Water duppiy <br /> ❑Domestic ❑Public <br /> N" <br /> LU ❑Irrigatibn ❑Industrial <br /> a O Cathodib Protection <br /> r 0 Dewateping <br /> uk Viz: lI 0 Heat E)thange Y <br /> O Injectio'n' . <br /> O Monitoring <br /> O Remediation <br /> O Sparging <br /> x 1{ South O Test W611 <br /> r dem of,eeuhan�an�,cud ,Axa, O Vapor Extraction <br /> dyers,etc.and strath a map.Use edddonal paper M necessary. <br /> Other <br /> _77. FM "accurate and a h te.ii <br /> Depth to first%Vater :i (Feet below surface) <br /> Depth to Static <br /> ,° Water Level (Feet) Date Measured <br /> Total D pth ofiii5g , ' = Feet Estimated Yield" (GPM) Test Type <br /> Total D ptlh o}Completed Well i, Test Length I (Hours) Total Drawdown (Feet) <br /> x Ma not be rB resentative of a well's to term yield. <br /> Feet <br /> � �..1 v�' s'�`��' .��zS s • at'��k'E A Aii '�4YL3 �i-a�`�� i"��t s� <br /> r <br /> De from Borehole wall Outside Screen slot size Depth from <br /> Su ce w irAateal Thickness Diameter Type if Any Surface FIII Description <br /> Feet Feet Inrlie Inches Inches Indies Feet to Feet <br /> I f I <br /> i a <br /> ❑ eotogic Log 1,the undersigned,certify that this report is complete and accurate to the best of my knowledge and belief <br /> 13 11 Construction Diagram Name_Qucade Dril in L.P. <br /> ❑ physical Log(s) 2 me C rcleerson,Firm rc�� � <br /> Rgncho'Cordoya CA 957421 <br /> ❑ oil/Water Chemical Analysesi city Stete l zip <br /> D er Site MaD Signed 03/20/2012 938110 I <br /> Attach sad oral Intomration If It wrists. tensed water wen convex« Date Signed C-57 License Number <br /> DwR 188 EV.V2ooe IF ADDITIONAL SPACE IS NEEDED,USE NEXT CONSECUTIVELY NUMBERED FORM <br /> i <br /> 1 <br />