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t <br /> *The Adobe Reader may be used to view and compl,�s form. However,software must be purchased to (complete,sF -and reuse a saved form. <br /> State of Caldomia <br /> - File Ori nal with DWR ' <br /> Well Completion Report , <br /> Page of Ratrto Instruction pampa t State Well NumbedSite Number <br /> Owner's Welf Number MW-8 No. e0148213 N W <br /> Date W rk Began 02/08/2012 Date work Ended !1 LatitudeLan ltr,da <br /> I <br /> Local Pe rmlt Agency San r+..um Cnadrnnmental Hgalth - — APNITRstoImer <br /> Permit umber 64190 Permit Date 1/18112 <br /> oftntation O Vertical O Horizontal OAngle specify Name Arcadis <br /> Drilling,Method er Drilling Fluid MailingAddress 950 Glenn Drive Suite 125 <br /> T r <br /> City Folsom! } StateCA�i 0 <br /> 9563 <br /> ,. .. -..ww ... ... . .. ....mom` .,;. <br /> Drillout 2"100'well and grout u <br /> Address 161 W Hammer Ian <br /> } I � San Joaquin <br /> City Stockton <br /> Latitude � angdtud _ w <br /> Deq. Min. SZ7 Mtn, <br /> Datum 3 Decimal t d# vi Declmal-gong. <br /> APN Book—. ;IP e_ Parcel M - <br /> Townshi Ii R SAon x <br /> Nelnr Well <br /> 0 Mo diflcatlon/Repair <br /> + <a ' a 0 Deepen <br /> 0 Other <br /> 1& Destroy <br /> esatmateriab <br /> under"GEOLOGIC OG' <br /> '` r,' 0 Water Supply <br /> [ Domestic ❑Public <br /> v "` t. m ❑Irrigation ❑IndustrialLu <br /> ;. 0 Cathodic Protection <br /> 0 Dewatering <br /> 0 Heat Exchange r <br /> 0 Injection <br /> rte , 0 Monitoring <br /> A& > O Remediation <br /> jF 0 Sparging <br /> ;=:q, y> South <br /> 0 Test Well <br /> 7Aim tr a deeame d�etenca at vmn ftm roads,buliarto,fen , Vapor Extraction <br /> man,OW.and a¢edi a map.Use addMW9d papa 0 neossaary. <br /> Pbm be a rata Other <br /> u <br /> ; A s<; Depth to first;water. (Feet below surface) <br /> w <br /> Depth to Static <br /> s= '' Water Level (Feet) Date Measured <br /> Total D pthof 5t#tn9 lk feet Estimated Yield" (GPM) Test Type <br /> z Y -` Test Length I# (Hours) Total Drawdown <br /> Total D pth of�ompleted Well Feet ) (Feet) <br /> *Ma not be re resentative of a well's longterm <br /> 777.75s 5"; <br /> De from Boreholetit ypg y y 'AAaterfiil Wall Outside Screen slot size iDepth fmm <br /> Su cer Thickness Diameter Type If Any Surface FillDescription <br /> Feet Feet Inde Inches Inches Inches Feet to Feel <br /> a=. <br /> 7101 <br /> ologic Log 1,the undersigned,certify that this report is complete and accurate to the best of my knowledge and belief <br /> II Construction Diagram Name Cascade Drilling,L.P. aPerson,Firrm or Corporation <br /> ophysical Logs) 2 mac i I R chdh rdov �. X742 <br /> l/Water Chemical Ana es Aa ry Zip <br /> en Sits MaD Signed 03/20/2012 938110 <br /> Attach adicit lormd Information If It eidsts. [.I' starWell cwdsctor 'I Date Signed C-57 License Number <br /> DN1R 188 EV.112006 IF ADDITIONAL SPACE IS NEEDED,USE NEXT CONSECUTIVELY NUMBERED FORM <br /> i i <br />