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<br /> File Original with DW R State of California DWR Use Oni -Do Not Fill In
<br /> Well Completion Report
<br /> Page 1 Of 4 Refer to Instruction Pamphlet
<br /> Owner's Well Number AMW-21 No. e0084068 State Well Number/Site Number
<br /> NI I I I IW
<br /> 18to Work Began 11/04/2008 Date Work Ended 11/12/2008 Latitude Longitude
<br /> cal Permit Agency San Joaquin County
<br /> Permit Number Permit Date 10/22/08 APN/TRS/Other
<br /> Geol2gic Log Well Owner
<br /> Orientation OVertical 0Horizontal OAngle Specify Name Forward Incorporated
<br /> Drilling Method Mud Rotary Drilling Fluid Mud Mailing Address 9999 S.Austin Road
<br /> Depth from'Surface Description Manteca CA 95336
<br /> Feet to Feet Describe material, rain size color,etc Cit State-Zi
<br /> 0.0 1.5 Cultivated black topsoil Well Location
<br /> 1.5 5.0 Silty CLAY Address 650'of Newcastle Rd alona NCYCC S. Perimeter Road
<br /> 5.0 6.1 Silty CLAY,dry,very stiffn barite lenses, 10 YR 5/4 City Stockton County San Joaquin
<br /> 6.1 6.3 SAND,moistn coarse grained,5 YR 4/1 Latitude 37 53 15.64 N Longitude -121 11 2.11 W
<br /> 6.3 10.0 Silty CLAY Dea. Min. Sec. Dec. Min. Sec.
<br /> 10.0 10.9 Silty CLAY,dry,stiff, barite lenses throughout, Datum WGS84 Decimal Lat. 37.888 Decimal Long.-121.200
<br /> 10 YRS 5/4 APN Book 181 Page 150 Parcel 08
<br /> 10.9 11.5 silty CLAY,dry,stiff,b°rite lenses throughout,lo YRS 514,with more abundant barite lenses Township 1 North Range 7 East Section 34
<br /> 15.0 15.5 Clayey SILT,dry,hard, 10 YR 5/4Loca#i�ti.Ske h Acti�iit
<br /> 15.5 15.8 Sity SAND,stiff,slightly moist, 5 YR 3/4 sketchajSusibedrawrsb'handafter form is drited. O New Well
<br /> 15.8 16.5 Sandy CLAY, med.stiff,moist,fine grained, North O Modification/Repair
<br /> Q Deepen
<br /> 10 YR 2/2 O Other
<br /> 16.5 120.0 Sandy CLAY Q Destroy o edu es and materials
<br /> 20.0 20.5 Sandy CLAY under CwLoG C LoC
<br /> 20.5 21.5 Silty CLAY,dry,stiff,barite lenses, 10 YR 5/4 Planned Uses
<br /> 21.5 25.0 Silty CLAY Q Water Supply
<br /> 25.0 26.5 Silty CLAY E]Domestic ❑Public
<br /> to ❑Irrigation ❑Industrial
<br /> 26.5 30.0 Silty CLAY
<br /> O Cathodic Protection
<br /> 30.0 30.5 Clayey SAND,wet,fine-med.grained,10 YR 5/4
<br /> Q Dewatering
<br /> 0.5 31.5 Sandy SILT,dry,stiff,fine-med. grained, 10 YR 7/4 Q Heat Exchange
<br /> 31.5 35.0 Sandy SILT Q Injection
<br /> 35.0 36.1 Silty CLAY,very stiff,dry,oxidized rust bands, O Monitoring
<br /> 5 Y 5/1 Q Remediation
<br /> 36.1 40.0 Clayey SILT O Sparging
<br /> O Test Well
<br /> 40.0 41.3 Clayey SILT,very stiff,dry, mica flakes, 10 YR 5/4 South Q Vapor Extraction
<br /> 41.3 45.0 Clayey SILT 11 ustrate or describe distance of well from roads,buildings,fences.
<br /> rivers,etc.and attach a map.Use additional paper if necessary. Q Other
<br /> 45.0 46.3 Clayey SILT Piaaa°be a"uraleandc°m isle
<br /> 46.3 50.0 Clayey SILT ater Level arid'Yield of Completed We.11:
<br /> 50.0 51.3 Clayey SILT Depth to first water N/A (Feet below surface)
<br /> Depth to Static
<br /> 51.3 155.0 1 Clayey SILT Water Level 62.43 (Feet) Date Measured 12/08/2008
<br /> Total Depth of Boring 176 Feet ***See Estimated Yield* N/A (GPM) Test Type N/A
<br /> Note at Test Length N/A (Hours)Total Drawdown N/A (Feet)
<br /> Total Depth of Completed Well 143 Feet
<br /> Bottom *May not be representative of a well's long term yield.
<br /> Casin a Airinular material
<br /> Type Material Wall Outside Screen Slot Size Depth from
<br /> Depth from Borehole
<br /> Surface Diameter Thickness Diameter Type if Any Surface Fill Description
<br /> Feet to Feet Inches Inches Inches Inches Feet to Feet
<br /> 0 122 8 Blank PVC Sch.80 0.218 2.375 N/A N/A 0 114 Cement Quickrete Concrete
<br /> 122 142 8 Screen PVC Sch.80 0.218 2.375 PVC 0.010 114 118 Bentonite Pel Plug Bentonite Pellets
<br /> 122 142 Sand 2/12 Cemex Lapis Lustre Sand
<br /> Attacflments .:
<br /> Cart flction S#sterrten#`s7 777
<br /> 7.dditional
<br /> gic Log I,the undersigned,certify that this report is complete and accurate to the best of my knowledge and belief
<br /> Construction Diagram Name Dave Vasbinder Herst&Associates Inc
<br /> h SICaI LO S Person,Firm or Corporation
<br /> Y 9( ) 4630S. Hwv 94-N.Outer Road Saint Charles MO 63304
<br /> ater Chemical Analyses `� Addres city State Zp
<br /> Signed l/ (/ )-/S-Ocl 636387
<br /> Atnformation ff 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.
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