Laserfiche WebLink
f <br /> `Tfie free Adobe Reader may be used to view and com Is forth. However,software must be purchased to complete and reuse a saved form. <br /> File Original with DWR State of California IDWR Use Only—Do Not FIII In a -1;"-"'t' <br /> Well Completion Report 111 , , 11111-71 <br /> Page of Refer to Instruction Pamphlet <br /> State Well Number/Site Number <br /> Owner's Well Number M-55A No. e0168533 <br /> Date Work Began 01/13/2013 Date Work Ended 1/13/2013 Latitude Longitude <br /> Local Permit Agency San.lnaauin County Environmental Health <br /> Permit Number 0066244 Permit Date 12/6/12 APNrTRS/other <br /> Geologic Log Well Owner <br /> Orientation O Vertical O Horizontal OAngle Specify Name City of Ripon <br /> Drilling Method Auger Dulling Fluid <br /> Mailing Address 259 N Wilma Ave. <br /> Depth from Surface Description Ci Ripon State CA Zi 95366 <br /> Feet to Feet Describe material rain size,color,etc <br /> 0 40 Clay,stiff,semi-silty Well Location <br /> 40 70 Silty clay mix,fine sands at bottom Address City of Ripon ROW NW corner of First and Locust <br /> City Ripon County San Joaquin <br /> Latitude N Longitude ___W <br /> Dec. Min. Sec. 'Dep. Min. Sec. <br /> Datum Decimal Let. Decimal Long. <br /> APN Book Page Parcel <br /> Township —Range Section <br /> Location Sketch Activity <br /> Sketch must be drawn by hand after form isprinted,) O New Well <br /> North O Modification/Repair <br /> O Deepen <br /> O Other <br /> O Destroy <br /> Dmvibe pm W.—eM melMala <br /> urd.r'GEOLOGIC LOG' <br /> Planned Uses <br /> O Water Supply <br /> NV - « ❑Domestic []Public <br /> ❑Irrigation ❑Industrial <br /> O Cathodic Protection <br /> O Dewatering <br /> O Heat Exchange <br /> O Injection <br /> Q Monitoring <br /> O Remediation <br /> O Sparging <br /> South O Test Well <br /> 11wtamd®ame dwmed. li mm mws,euildi„Os.17 O Vapor Extraction <br /> v�..ac.a,a.rom.m.p.u.e wanwrel p.pa n„a�.n. O Other <br /> l...e n..mrne aee. let.. <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 70 Feet Estimated Yield` (GPM) Test Type <br /> Total Depth of Completed Well 70 Feet Test Length (Hours) Total Drawdown_(Feet) <br /> *May not be representative of a well's long term ield. <br /> Casings Annular Material <br /> Depth from Borehole Type Material Wall Outside Screen Slot Size Depth from <br /> Surface Diameter Thickness Diameter Type if Any Surface Fill Description <br /> Feet tc Feet Inches Inches Inches Inches Feet to Feel <br /> 0 60 8 Blank pvC Sch 40 2 0 56 Cement Portland <br /> 60 70 8 Screen PVC Sch 40 2 slot 0.020 56 158 Bentonite Chips <br /> 58 70 sand #3 <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 DrillinD L.P. <br /> ❑Geophysical Lo Person,Firm or Corporation <br /> 9(s) 3632 Omec Circle, Rancho Cordova CA 95742 <br /> ElSoilMater Chemical Analyses dGy state zp <br /> i <br /> ❑O Other Site Map Signed /) - Q X 01/24/13 938110 <br /> ABach addKonal information it it exists. C-51 Licensee water Wall Ccneaclor Date Signed C-57 License Number <br /> DWR 188 REV.1/2006 IF ADDITIONAL SPACE IS NEEDED,USE NEXr CONSECUTIVELY NUMBERED FORM <br />