|
1
<br /> '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
<br /> DWR Use Only-Do Not Fill In
<br /> ' Page 1 of 6 Well Completion Report
<br /> Rotor to 1naWcdon Pamphlet State Well Number/Site Number
<br /> Owner's Well Number AMW-30 No. e0106293 N W
<br /> Date Work Began 01/18/2010 Date Work Ended 01/22/2010 Latitude Longitude
<br /> ' Local Permit Agency San Joaautn County
<br /> Permit Number SR 0059145 Permit Date 1/12/10 APN/TRS/Other
<br /> Geologic Log Well Owner
<br /> ' Orientation OVertical 0Hod onlal OAngle Specify Name Forward Incoroorated
<br /> Drilling Method M902!!, Drilling Fluid Bentonite mud Mailing Address 9999 South Austin Road
<br /> Depth from Surface Description Manteca
<br /> Feet to Feet Describe material rain size color,etc Cit Stale CAZi 95336
<br /> 0.0 5.0 No sample taken. Well Location
<br /> ' 5.0 6.1 Silty CLAY with trace sand,slight) moist,stiff,low Address 27011 South Austin Road
<br /> plasticity,dark yellowish brown(10YR 4/4). city Ripon County San Joaquin
<br /> 6.1 10.0 Silty CLAY. Latitude 37 53 32.20 N Longitude -121 10 2131 w
<br /> ' 10.0 11.2 Sifty CLAY with trace sand,moist,soft,plastic, Dec. Mon. Sec. Dem Min. Sec.
<br /> dark yellowish brown(10YR 4/6). Datum WAS 84 Decimal Lat. 37.8923 Decimal Long.-121.1745
<br /> 11.2 15.0 Silty CLAY. APN Book 181 Page 16 Parcel 7
<br /> 15.0 15.9 Clayey SAND,moist,subangular,poorly sorted, Townshi IN Ranae 7E Section 35
<br /> '
<br /> very soft,dark yellowish brown(10YR 3/4). Location Sketch Activity
<br /> Sketch must be drawn hand after form is rnded.
<br /> 15.9 20.0 Clayey SAND. North O New Well
<br /> 20.0 20.6 SAND,moist,loose,medium rained,subrounded, O Modification/Repair
<br /> dark grayish brown 10YR 4/2). O Deepen
<br /> ' See attached o other
<br /> 20.6 21.1 Clayey SAND,moist,loose,dark yellovvish brownO Destroy
<br /> Figure 1 nesaft pmradum and matenNa
<br /> (10YR 3/4). Coarse pebbles at bottom of spoon �'GEa
<br /> Well Location Map
<br /> OM LOG,
<br /> and iron staining throughout. Planned Uses
<br /> ' 21.1 25.0 Clayey SAND. O Water Supply
<br /> 25.0 25.3 Clayey SAND,moist,loose,dark yellowish brown , ❑Domestic ❑Public
<br /> (10YR 3/4). 3
<br /> W ❑Irrigation ❑Industrial
<br /> 25.3 26.3 Silty CLAY with trace sand,dry,stiff,low plasticity, O Cathodic Protection
<br /> yellowish brown 10YR 5/4). O Dewatering
<br /> O Heat Exchange
<br /> 26.3 30.0 Silty CLAY.
<br /> O injection
<br /> 30.0 31.5 Sandy CLAY with fine grained sand throughout, U Monitoring
<br /> ' moist,soft,low plasticity,dark yellowish brown O Remediation
<br /> (I OYR 3/6). O Sparging
<br /> 31.5 35.0 Sandy CLAY. south O Test Well
<br /> 35.0 36.3 SiltyCLAY,slightly moist,medium stiff,plastic, uwmateera. a»demn�aWaoranroads,bww„os,,an . O Vapor Extraction
<br /> ' "7 i� rkers,aft.and aeach a map.Use adddnnal paper N necessary Q Other
<br /> reddish brown(5YR 4/3). Poem beaura*41W '"a
<br /> 36.3 40.0 Silty CLAY, Water Level and Yield of Completed Well
<br /> 40.0 41.5 Clayey SILT,dry,soft,iron staining throughout, Depth to first water (Feet below surface)
<br /> ' brown .5YR 4/4). Depth to Static
<br /> Water Level 71.49 (Feet) Date Measured 06/14/2010
<br /> Total Depth of Boring 177 Feet Estimated Yield' (GPM) Test Type
<br /> Total Depth of Completed Well 177 Feet Test Length (Hours)Total Drawdown (Feet)
<br /> 'Ma not be representative of a well's long term Yield.
<br /> ' Casings Annular Material
<br /> Depth from Borehole Wall Outside Screen Slot size Depth from
<br /> Surface Diameter Type Material Thickness Diameter Type if Any Surface Fill Description
<br /> Feet to Feet Inches Inches Inches Inches Feet to Feet
<br /> 0 157 IS Blank I PVC Sch.80 0.375 2.75 0.0 151.2 Cement Portland
<br /> 157 177 8 Screen PVC Sch.80 0.375 2.75 Milted slots 0.010 151.2 154.0 Bentonite Pellets
<br /> 154.0 177.0 Filter Pack W-2112 Sand
<br /> Attachments Certification Statement
<br /> ❑Geologic Log 1,the undersig cedlfi thattlhis report' mplete an aocu ate to the best of my knowledge and belief
<br /> iD Well Construction Diagram Name (fir �J
<br /> ❑Geophysical Log(s) Pe n,F' S CA -/J�y Is
<br /> Q OtSohile alar Chemical Analyses Signed city '�I state 103 39-?
<br /> ' Attach addlbonal Inrortnelion ird excels. C-5T a ossa water weu Convector Date Signed C-57 License Number
<br /> DWR 188 REV.112006 IF ADDITIONAL SPACE IS NEEDED,USE NEXT CONSECUTIVELY NUMBERED FORM
<br />
|