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ORIGINAL 17%1'Y 01• ( u It DItNIA w R Y — F I <br /> File will DWF U 'Ar o C 3 <br /> WELL COMPLETION REPORT <br /> Page—of 1 Refer to lttstru,tion Pampblrt STATE WELL NOISTATION NO <br /> Owner r Well Noe97,26,oeq�, 03/28/9° 525334 <br /> b Date Work Began Ended LA7tTl10E LONGITUDE <br /> Lmt -AI Permit Agici <br /> Pt rmll Nor <br /> Permit Date <br /> X GFOLOGIC LOC WELL OWNER <br /> ORIENTATION (!) VERTICAL ^.- HORIZONTAL —ANGLE —(SPECIFY) Namc Moorman ', I,lat_ar SvF;�prrt5, TnC <br /> DEPTH FROM DEPTH TO FIRST WATER (FL) BELOW SURFACE Mailing Address 2120 Wilcox Rd . <br /> SURFACE DESCRIPTION Stockton CA 95215, <br />' Ft to Ft Diercrtbe snate'rtal,gram size,color etc CITY STATE ZIP 1 <br /> WELL LOCATION <br /> 0 ; -- Sdi l Address 19450 Hidden Lakes Lane <br /> 5 ' 35 Clay City Woodbridge <br />' 35 : 45 ; Coarse Sand County San Joaquin <br /> 45 : 55 : Clay APN Book Page Parcel <br /> 55 ! 88 ;Coarse Sand & Gravel Township Range section <br /> 88 100 I. Clay'.Clayor <br /> Latitude + ___ I NORTH Longitude I WEST j <br />' 100 : 110 : Sand Coarse DEQ MIN sec DEG AWN SEC <br /> 110 ' 12$ Gla LOCATION SKETCH ACTIVITY {�) <br /> NORTH X NEW WELL <br /> 128 ' 148 ' SAnd & Gravel & Rock MO[WICATIONIREPAIA <br /> 148 ; 150 : Clay <br /> —ate" , <br /> 150 ; 161 Sand & Gravel & Rock —Oiber(sPOC1110 <br /> 161 ' 225 ; Clay <br /> 225 1228 ! Sand —DESTROY(Dascribo <br /> 228 245 : Clay <br /> PUnder GEEOL06rc Materials <br /> 245 - 251 - Sand ood r PLANNED USES)n <br /> 251 : 325 ; C 1 a 3 to — MOMTORiNQ <br /> WATER SUPPLY <br /> i I <br /> e X Domasbc <br /> - Public <br /> Irriyallon <br /> Industrial <br /> - TEST WELL <br /> SOUTH - CATHODIC PROTEC <br /> TION <br /> ' Illustrate or Describe Distance of Well from Landmarks — OTHER Opacity) <br /> + such as Roads Buildings Fences Rivers etc <br /> PLEASE BE ACCURATE tr COMPLETE <br />' <br /> DRILLING ROTARY <br /> FLUID WATER <br /> WATER LEVEL A YIELD OF COMPLETED WELL <br /> i I DEPTH of sTATIC40 <br /> I I <br /> WATER LEVEL (Ft) & DATE MEASURED <br /> ESTIMATED YIELD' (GPM) & TEST TYPE <br />' TOTAL DEPTH OF BORING 325 (Feet) TEST LENGTH (Hrs) TOTAL DRAWDOWN (Ft) <br /> TOTAL DEPTH OF COMPLETED WELL 265 (Fat) May xot be represeraarme of a well's long-term yield <br />' DEPTH PORE CASING(S) DEPTH ANNULAR MATERIAL <br /> FROM SURFACE HOLE TYpp r FROM SURFACE TYPE <br /> Dl r MATERIAL! INTERNAL GAUGE SLOT 512E FILTER PACK <br /> DIAMETER OR WALL IF ANY CE BEN <br /> Ft to Ft (`+cnas) , QRAOE (inahaa) THICKNESS onehea) Ft to Ft OL TONITE FILL PE/SIZE) <br /> 245 11 PLASTIC 6 160 0 20X <br /> 1 <br /> ATTACHMENTS (:) CERTIFICATIO% STATEMENT <br /> — Geotoan Log I the undersigned certify that this report Is complete and accurate to the best of my knowledge and belief <br /> Well Constructlon Dlaoraim lYAA E(FN WA ' <br />' Geo"yatcsl Log(a) N E01 <br /> i <br /> Soil!Water Chemical Analyses <br /> met CITY STATE lir <br /> ATTACH AVOMONAL WFOFBMATION IF rr Extsrs signed 45=3 zMaehanc- <br /> _04/02/97 F•.AA622 <br />' DRILIEAl DATE SIGrIED C57 LICENSE MJNSER <br /> Dwa IMM HE% 1-91) IF ADDITIONAL SPACE IS NEEDED, USE NEXT CONSECUTIVELY NUMBERED FORM ���� <br />