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iI end reuse a saved form. <br /> 'rhe f Adobe Reader may be used to view and complete this form. However,software must be purchased to complete,sp ;} <br /> ., <br /> State of California i <br /> ' File Ori incl with DM • <br /> Well Completion Report <br /> Page of ReWtornst 100Pam016t state Wall NumberlSite Number W <br /> Owner's well Number MW-i 3 No- e0148215 <br /> N <br /> Date Work Ended Latitude Longitude <br /> Date W rk Began 02/09/2012 Ii <br /> Local Permit Agency lAalth i APNITRSIOther <br /> . <br /> Permit umber PermitDate 1118112 <br /> Mims- .� <br /> *Ontatlon O Vertical O Horizontal []Angle Specify Name Arcadis <br /> d Au r Drilling Fluid Mailing Address 950 Glenn Drive Suite 125 <br /> C Folsom ' State C_�Zi <br /> � 95630 <br /> Overdriil 2e well to 41'with 8"Au ers&grout <br /> Address v Lane <br /> City Stockton —Cotaraty <br /> San Jo a uin <br /> Latitude longitud' <br /> Deo. Min. 8e Pw. <br /> Datum ll Decimal L Decimal hong <br /> APN Book 'Pagel "Parcela <br /> ,. <br /> TownshlD an <br /> N&Well <br /> ,�Q Mo�ificatianlRepair <br /> .tWO Deepen <br /> O Other <br /> < . Destroy <br /> „. <br /> pasalbe procedures and metertets <br /> .r- - �•. under'GEOLOGIC LOG' <br /> y .. <br /> a r vo O Water Supply <br /> • []Domestic ❑Public <br /> j x <br /> n3 ❑Irrigation ❑industrial <br /> Lo <br /> rx O Cathodic Protection <br /> O Dewatering <br /> L. :°..11 ':i O Heat Exchange ,.,...} <br /> y � <br /> [] injection <br /> q . <br /> r .>. .�, �. .��� O Monitoring <br /> „' ✓ » > O Remediation <br /> O Sparging <br /> R' •u t ', i� South O Test Well <br /> ae.arne'a a otwea rrom roam,aaifts.lanr�. O Vapor Extraction <br /> &M.ate.end Milch a <br /> rmp.uee':admnanel paper Nnacasasry. O Other <br /> Plee.a ea�curmeena p `i+� <br /> r k a Depth to first water ;i (Feel below surface) <br /> Depth to Static <br /> �r Water LevelI (Feet) Date Measured <br /> Total D pth of Bonng � _ ” Feet Estimated Yield" (GPM) Test Type <br /> jL <br /> Total pth oCompleted Well Feet Test Length'} i (Hours) Total Drawdown (Feet) <br /> r rMay not be <br /> reseniative of a well's long term yield. <br /> De kom Borehole + � : Wall Outside Screen slot Size Depth from-, Y€ <br /> 'mype wate6i <br /> Su ce C7i ro r, 44Thickness Diameter Type If Any Surface Fill Description <br /> Feet Feet Inc#ie's' (inches Inches Inches :Feet to Feet <br /> iT <br /> Her>, <br /> ❑ ologic Log I,the undersigned,certify that this report is complete and accurate to the best of my knowledge and belief <br /> © ell Construction Diagram Name Cascade Drillina.L.P._ <br /> Person,Finn prCorporetlon 3 <br /> 13eophysical Log(s) M2 Omec Circle _ �lRarich o Cordova CA 95742 <br /> 0 oiVWater Chemical Analyses -A I, city scare 4P <br /> D er Site Mal) Signed Y1 03/20/2012 938110 <br /> Attach add'onal information d n e�dats. Licensed Water + � - Ij :I Date Signed C-57 License Number <br /> DwR 188 AEV.U2008 IF ADDITIONAL SPACE IS NEEDED,USE NEXT CONSECUTIVELY NUMBERED FORM <br /> i" <br />