Laserfiche WebLink
J ' <br /> 'The free Adobe Reader may be used to view and complete this form. However,software must be purchased to complete,save,and reuse a saved fort. <br /> File Original with DWR Ma:1'11541, State of Califomia DWR Use only-Do Not Fn In <br /> Well Completion ReportI�c, , L I „ I <br /> Page 1 of 1 Refer to Insturion Pempwet State Wail NumbertSde Number <br /> Owner's Well Number No. e0326555 PA 11i t 1 (l N I ,-,, nl <br /> Date Work Began 09/01/2016 Date work Ended 9/13/2016 �— Latitude Lon nude <br /> Local Permit Agency Gan Joanuin C aunty Environmental Health Dept. -L <br /> Permit Number SR0074734 Permit Date 4/20/16 APN/TRSIOther <br /> Geologic Lo <br /> Orientation OVertical O Horizontal OAngle Specify _ <br /> Drilling Method Reverse Rotary Drilling Fluid Water <br /> Depth from Surface Description <br /> Feet to Feet Describe matenal rain size color,etc <br /> 0 1 To Soil Well Location <br /> 1 10 Clay Address Jack Tone Rd-Sout of Mariposa Rd <br /> 10 38 Clay with sand streaks city Stockton County San Joaquin <br /> 38 57 Clay Latitude N Longitude __--N <br /> 57 83 Sand Deo. Min Sec Dep Min sec <br /> 83 89 Clay Datum Dec.Lat. Dec.Long. <br /> 89 105 Sand APN Book 181 Page 170 Parcel 09 <br /> 105 120 Clay Townshl Range Section <br /> 120 127 Sand Location Sketch Activity <br /> 127 133 Clay Sketch must be drarmN� d after form is nted. a New Well <br /> Modification/Repair <br /> 133 160 Sand O Deepen <br /> 160 177 Clay O Other <br /> 177 183 Sand O Des y pr . <br /> ureter-GEOLOGIC LOG' <br /> 183 195 Clay <br /> Planned Uses <br /> 195 205 Sand <br /> 205 223 Clay O Water Supply <br /> ❑Domestic ❑Public <br /> 223 236 Sand )Dirigation Dindustrial <br /> 236 320 Clay3 w <br /> O Cathodic Protection <br /> 320 328 Sand O Dewatering <br /> 328 340 clay O Heat Exchange <br /> 340 370 Sand with clay streaks O Injection <br /> 370 378 Clay O Monitoring <br /> 3O Remediation <br /> 78 403 Sand <br /> O Sparging <br /> 403 410 Clay O Test Well <br /> 410 420 Sand South <br /> O Vapor Extraction <br /> 420 478 Clay with sand streaks m�a�.�em,h.-P uu PA— ter <br /> O Other <br /> Pit—b...—.%andGan <br /> 478 500 Clay <br /> Water Level and Yield of Completed Well <br /> Depth to first water (Feet below surface) <br /> Depth to Static <br /> Water Level 110 (Feet) Date Measured 09/13/2016 <br /> Total Depth of Boring 500 Feet Estimated Yield' 1,971 (GPM) Test Type <br /> Total Depth of Completed Well 480 Feet <br /> Test Length (Hours) Total Drawdown (Feet) <br /> way not be representative of a well's long term yield. <br /> Casings Annular Material <br /> Depth horn BoreholeMaterial Well Outside Screen Slot Size Depth from <br /> Surface Diameter Type Thickness Diameter Type H Any Surface Fill Description <br /> Feet to Feet iamts (Inches) Inches Indies Feet to Feet <br /> 0 310 26 Blank Mad Steel 025 16 0 50 Cement 10.3 Sack <br /> 310 460 26 Ful-Flo Mild Steel .025 16 0.090 0 480 Eimer Pack No.6 Sand pack <br /> 460 480 26 Ful-Flo Mad Steel 025 16 <br /> 0 50 36 Conductor Mild Steel .025 30 <br /> Attachments Certification Statement <br /> I,the undersigned.Certify that this report is complete and accurate to the best of my knowledge and belief <br /> ❑Geologic Log <br /> Name <br /> ❑Weil Construction Diagram Pa:a, F Bros.crpo al <br /> eon <br /> ❑Geophysical Log(s) 1430�La�dRd t �$ 85356 <br /> ❑SoiVWGeoph Si Chemical Analyses acres Cry stay Lp <br /> ❑Other Signed 10-19-16 290813 <br /> Attach additional mforli if It"Mata <br /> icensedwaterwellcovactor Date Signed C-57 License Number <br /> DWR 188 REV I=W IF ADDITIONAL SPACE IS NEEDED,USE NEXT CONSECUTIVELY NUMBERED FORM <br />