Laserfiche WebLink
*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 form. <br /> File Original with DWR State of California DWR Use Only-Do Not Filfin <br /> Page 1 of 2 Well Completion Report <br /> Refer to Instruction Pamphlet State Well Number/Site Number _ <br /> Owner's Well Number AMW-13B No. e0084070 I n 1 11 <br /> to Work Began 11/13/2008 Date Work Ended 11/17/2008 Latitude Longitude <br /> cal Permit Agency San Joaquin County <br /> Permit Number SR#0055548 Permit Date 10/22/08 APN/TRS/Other <br /> Geologic Lo Well Uwner <br /> Orientation O Vertical O Horizontal OAngle Specify Name Forward Incorporated <br /> Drilling Method Mud Rotary Drilling Fluid Mud <br /> Depth from Surface Description Mailing Address 9999 S.Austin Road <br /> Feet to, f=eet Describe material,grain size,color,etc City Manteca State CA__Zip 95336 <br /> 0.0 75.0 Not Sampled Well Location <br /> 75.0 76.5 Clayey SILT,stiff,dry,abundant micas, 10 YR 5/4 Address 2500' E of Newcastle Rd.alona NCYCC S. Perimeter Rd. <br /> 76.5 80.0 Clayey SILT City Stockton County San Joaquin <br /> 80.0 81.5 Clayey SILT,with some med.sands,barite bonding Latitude 37 53 15.65 N Longitude -121 11 34.41w <br /> 81.5 85.0 Clayey SILT,with some med.sands,barite bonding Dec. nein. Sec. Dee. Min. Sec. <br /> 85.0 86.5 Clayey SILT,with some med.sands,barite bonding Datum WGS84 Decimal Lat. 37.888 Decimal Long.-121.193 <br /> 86.5 90.0 Silty SAND APN Book 181 Page 150 Parcel 08 <br /> 90.0 90.7 Silty SAND,stiff,slightly moist, rust staining,fine Township 1 North Range 7 East Section 34 <br /> grained, 10 YR 5/4 'Locatiori Sketch Activit <br /> Well <br /> e ,stiff,d New Jske6irnustbedrawn b ihandafterformis printed.,) <br /> 90.7 91.0 Clayey y SILTdry, rust staining, 10 YR 5/4 North O <br /> 91.0 95.0 Clayey SILT O Modification/Repair <br /> O Deepen <br /> 95.0 95.5 SAND, med-coarse grained, loose,wet 5 Y5/2 O Other <br /> 95.5 96.5 SAND,wet,fine grained,5 Y 5/2 with bands 0 Destroy <br /> Describe procedures and materials <br /> 10 YR 5/4 under-GEOLOGIC LOG- <br /> 96.5 100.0 SAND Planno Uses <br /> 100.0 100.9 Silty SAND, moist,fine grained,stiff,abundant O Water Supply <br /> micas, 10 YR 4/4 [:]Domestic El Public <br /> ❑Irrigation ❑Industrial <br /> 0 . 105.0 Silty SAND w <br /> 11005.90 106.5 SAND, moist,fine-med.grained,well graded O Cathodic Protectionn <br /> 10 YR 5/4 O Dewatering <br /> O Heat Exchange <br /> 106.5 110.0 SAND 0Injection <br /> 110.0 111.1 1 SAND,fine-med. grained,moist, multi-colored O Monitoring <br /> 111.1 115.0 SAND O Remediation <br /> 115.0 115.7 Silty CLAY,stiff,dry, micas present, 10 YR 6/2 O Sparging <br /> 115.7 116.5 Clayey SILT,very stiff,rust banding,with micas I SouthO Test Well <br /> Illustrate or describe d"stance of well from roads buildings,fences, O Vapor Extraction <br /> 10 YR 6/2 o-s,etc.and attach a map Use additional paper if necessary O Other <br /> 116.5 120.0 Clayey SILT Please be accurate and Correlate. <br /> 120.0121.3 Clayey SILT,slightly moist,very stiff,micas ater Level and Yield of Completed W611 <br /> present, 10 YR 5/4` Depth to first water N/A (Feet below surface) <br /> Depth to Static <br /> 121.3 125.0 SAND Water Level 65.88 (Feet) Date Measured 12/08/2008 <br /> Total Depth of Boring 140 Feet ***See Estimated Yield* N/A (GPM) Test Type N/A <br /> Total Depth of Completed Well 140 Feet Note at Test Length N/A (Hours)Total Drawdown N/A (Feet) <br /> Bottom *May not be representative of a well's long term yield. <br /> Caisin s Annular Material <br /> Depth from Borehole Type Material wall Outside Screen Slot Size Depth from <br /> Surface Diameter yp Thickness Diameter Type if Any Surface Fill Description <br /> Feet to Feet Inches Inches Inches Inches Feet to Feet <br /> 0 119 8 Blank PVC Sch.80 0.218 2.375 N/A N/A 0 1111.5 Cement Quickrete Concrete <br /> 119 139 8 Screen PVC Sch.80 0.218 2.375 PVC 0.010 111.5 115.67 Bentonite Pei-Plug Bentonite Pellets <br /> 119 139 Sand 2/12 Cemex Lapis Lustre Sand <br /> Attachments <br /> Certification Statement <br /> I]Geologic Log I,the undersigned,certify that this report is complete and accurate to the best of my knowledge and belief <br /> El Well Construction Diagram Name Dave Vasbinder Herst&Associates Inc. <br /> Person,Firm or Corporation <br /> ❑ Geophysical Log(s) 4630 S. Hw 94-North Outer Rd Saint Charles MO 63304 <br /> ❑� Soil/Water Chemical Analysest. Address City State zip <br /> ❑ Other Signed - /-f S-49 636387 <br /> Attach additional information if it exists. C-57 Licensed Water Well Contractor Date Signed C-57 License Number <br /> ***Drilling depth scale begins at one foot above ground surface due to required drilling rig setup. <br />