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DWR <br /> ORIGINAL STATE OF CALIFORNIA USE 00 <br /> File with DWRWELL COMPLETION REPORT <br /> Page_Laf1 Refer to Instruction Faniphler STATE WELL NDISTATIDN NO <br /> winees Well No. PSB — No. 749260 ❑ <br /> LATITUDE � LONGITUDE <br /> 4Wte Work Began MARCH 5.2002 _ , Ended MARCH 5 2002 <br /> LDeal Permit Agency SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES-ENV DIV APHITRSIDTHER <br /> Permit No 28981 Permit Date,_ FEBRUARY 22,2002 <br /> GEOLOGIC LOG WELL OWNER � <br /> ORIENTATION (=) ✓VEwrtCAL _HORIZONTAL —ANGLE .(SPECIFY) Name OC <br /> DRILLINGHollow Steam Roster_FLU)D NONl= Mailing Address 8788 ELK GR VE BLVD BU LDIN SU 5 <br /> DEPTH FROM M00 -- A 95 4 <br /> TI <br /> SURFACE DESCRIPTION CITY STATE Zip <br /> R to FL Describe material, grain si_c, color, etc WELL LOCATION <br /> 0 60 , WELL BORING WAS NOT LOGGED OR SAMPLED Address 1SRS PACIFIC AVE. <br /> City—_ STOCKTON-CA <br /> r 1 County SAN JOAQUIN <br /> 1 1 AFN Book Page - Paroel <br /> r 1 Township Range Section <br /> 1NOFITFI WEST <br /> Latitude DES MIN SEC Longitude DE;L MIN sec <br /> LOCATION SKETCH ACTIVITY 00 <br /> t r - •� 1FMIrf1 ` !_.- V NEW WELL <br /> T 5 <br /> MODIFICAT;OMREPAIA <br /> —/ <br /> Deepen <br /> r 1 011ier ISpec11T) <br /> DESTROY(06500e <br /> Proeesurea+nR Atarmals <br /> VIxtar-GEOLOGIC LOS") <br /> PLANNED USES (=) <br /> WATER SUPPLY <br /> av-ss liew"T Domaapc PuOac <br /> r , ` rwnWr s <br /> FoirwL sr.saHIM irrigationDIIduSlnal <br /> r 1 ' IY MONITORING <br /> ■ <br /> a TEST WELL <br /> a <br /> 1 taw+a~ i t Ve4i W Q3� CATHWjc:PROTECTION— <br /> 1 �1 ti f aMC i 1$�� <br /> \s HEAT EXCHANGE <br /> tiNeFti #�� ■P-1A \ DIRECT PUS".� <br /> 1 ' Fartnrr '�i •—Ionia Mis"I� INJECTION— <br /> Slariee MIAs to I W42 1 <br /> 1 iVt e,aleinD♦ ToV"r' VAPOR EXTRACTION <br /> c \ SPARWO <br /> ti YIWa <br /> 1 ' RENFEDIATiDN <br /> 1 rOTHER(SPECIFY) <br /> Renk of Arlwtoo ! <br /> WATER LEVEL lk YIELD OF COMPLETED WELL <br /> r r <br /> DEPTH To FIRST WATER (PL)BELOW SURFACE <br /> r DEPTH OF STATIC <br /> ' 1 WATER LEVEL (FL)8 DATE MEASURED <br /> ESTUATED YIELD• ((IPM)d TEST <br /> TOTAL DEPTH OF BORING 6_. (Feet) TEST LENGTH (Hie)TOTAL DRAVrDOWN (FL) <br /> TOTAL DEPTH OF COMPLETED WELL __0__(Fee4 'My aro`br rrprrsmt"_ Q veffi,Pon -termfield <br /> DEPTH CASING (S) DEPTH ANNULAR MATERIAL <br /> BORE• TYPE(_ FROM SURFACE TYPE <br /> FROM SURFACE HOLE <br /> DIA MATERIAL 1 DIAMETER GAUGE SLOT SIZE ME <br /> 8EN FILTER PACK <br /> lMlclp+) GRADE DIAMETER HI WALL IF ANY ETENT N1TE FILL PE/SIZQ <br /> FL w FL � LL tlr,drae) THICKNESS Andres) FY la t=e (_} (=} I � (TY <br /> 0 , 575 8 ✓ PVC 075 SCh 40 0 , 50 ✓ <br /> 575 r 60 8 ✓ 2 Microsperge 50 1 55 ✓ <br /> 1 55 , 60 ✓ 2/12 Lonestsr <br /> r Send <br /> I <br /> r <br /> r <br /> r ATTACHMENTS (±) CERTIFICA'T'ION STATEI118NT belief <br /> 1.the undersigned certify that this report is complete and accurate to the best of my Wnowtedge and <br /> .� (30010&Log <br /> Well Construction Diagram NAME WOODWARD DRILLING <br /> �9(g) IPERSOK FIRM ON CDRPORA71010 (TYPED OR PRVKD) <br /> .� SoaMralr!r GAernrcal Artalyaes 550 RIVER R AD 1 P O BOX 336 RIO VISTA CA 94`'`71 <br /> Dlhar <br /> AMNESS TY STATE ZIP <br /> 7 <br /> ATrAcrl ADDMIDI AL iuFriamnoAF IF IT EXISTS` R,04Q:A` ^ City <br /> 13,2002 710079 <br /> Signed YrE{l DRILLQRIlED REPRESENTAtIYE DATE SO" E§,7 LICENSE IIUMtIER <br /> D%%R tae KEY )t-gr, IF ADDITIONAL SPACE 15 NEEDED USE NEXT CONSECUTIVELY NUMBERED FORM <br />