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J <br /> ORIGINAL STATE OF CALIFORNIA WR SON v — N T F I <br /> File with DWR WELL COMPLETION REPORT <br /> Page 1 Of 1 Refer to Instruction Pamphlet STATE WELL NO./STATION NO. <br /> Owner's Well No. MW-2 No. e027933 <br /> Date Work Began 7/19/05 Ended 7/19/05g Agency LATITUDE LONGITUDE <br /> Permit A San Joaquin County Department of Environmental Health <br /> APNlTRSroTHER <br /> Permit No. UU42541 Permit Date 6/11U5 <br /> GEOLOGIC LOG WELL OWNER <br /> ORIENTATION (.!:�) _V_(_VERTICAL —HORIZONTAL _ANGLE —(SPECIFY) Name Chevron Environmental M4nnPment <br /> DRIUIIN Fluio g PO Box 6012 <br /> METHODMallin Address <br /> �AF,CREM DESCRIPTION San Ramonr CA 94583 - <br /> FL a FL Describe material, grain size, color, etc. CITYSTATE ZIP <br /> WELL LOCATION <br /> Address 25651 North Highway 99 <br /> 0 83 t Portland 1/11 Cement 'City AcamDO <br /> t County San•l aOUin <br /> APN Book 005Page141 Parcel ?n - <br /> Township Range Section <br /> Latitude t I STH LongitudeWEST <br /> DEG. MIN. SEC. DEQ LUN. SEC. <br /> LOCATION SKETCH ACTIVITY OL) <br /> NORTH NEW WELL <br /> MODIFICATIONIREPAIR <br /> _ Deapen <br /> t <br /> _Ot17er(Specify) <br /> � t <br /> t t DESTROY(Deacdbe <br /> ProceWuae and Matedak <br /> t iMaar-GEOLOGIC LOG-) <br /> PLANNED USES(�) <br /> WATER SUPPLY <br /> _Dotmanc PuMle <br /> Irrigation InaNtrial <br /> N N <br /> MONITORING <br /> 3 TEST WELL_ <br /> CATHODIC PROTECTION <br /> FEAT EXCHANGE_ <br /> t r <br /> DIRECT PUSH <br /> INJECTION <br /> t t VAPOR EXTRACTION— <br /> SPARGING— <br /> SOUTH REMEDIATION <br /> Illustrate or Describe DirtaRce of Well from Roo&,Buildings. OTHER(SPECIFY)— <br /> t t Fences,Rivers,etc.and attach <br /> a u rtddklonal yar if <br /> necessary.PLEASE BE ACCEJ 6 COMPLAr. <br /> I WATER LEVEL & YIELD OF COMPLETED WELL <br /> r t <br /> DEPTH TO FIRST WATER (Ft.)BELOW SURFACE <br /> r t <br /> ' t DEPTH OF STATIC <br /> WATER LEVEL (FL)&DATE MEASURED <br /> r ' ESTIMATED YIELD' (GPM)&TEST TYPE.- <br /> --TOTAL DEPTH OF BORING 83 (Feet) TEST LENGTH (Hrs.)TOTAL DRAWDOWN__(FL) <br /> TOTAL DEPTH OF COMPLETED WELL 83 (Feet) 'May not be representative o a welds long-term yield. <br /> CASING (S) DEPTH ANNULAR MATERIAL <br /> DEPTH FROM SURFACE TYPE <br /> FROM SURFACE HOE- TYPE(_) <br /> DIA. k' MATERIAL/ tNTERNILL GAUGE SLOT SIZE CE. SEN- FILTER PACK <br /> FL to FL (tea) $ GRADE (IrtcMe OR <br /> HICK ESS (Ifid—) FL to Ft.ALL IF ANY MEN'TONITE (KL) (TYPE/SIZE) <br /> 0 t 83 ✓ Portland 1/11 <br /> t <br /> , t <br /> t <br /> t a <br /> t ATTACHMENTS (z�) — CERTIFICATION STATEMENT <br /> 1,the undersigned,certify that this report is complete and accurate to the best of my knowledge and belief. <br /> — Gedogic Lop <br /> — ate#Cow"ction DWWarn NAAeE Gregg Drilling and Testing,Inc. <br /> (PERSON,FIRM,OR CONW1111011) (TYPED OR PRIDED) <br /> — Geophysical Lop(a) <br /> — Satvwa wr Chemk*Analyses 950 Howe Road,Martinez,Q494553 <br /> IP <br /> V otter Site Plan AOOBESS Cm STATE 1 <br /> 65 <br /> ATTACH A00MONAL INFORMATION, IF/T EXISTS. ` +b D 5 CENSE M <br /> A1NE SK;t1E8 C-57 LICENSE IINIafR <br /> own lag REV.11-97 IF ADDITIONAL SPACE IS NEEDED, USE NEXT CONSECUTIVELY NUMBERED FORM <br />