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<br /> ' File Original with DWR State of California DWR Use Only-Do Not Fill In
<br /> Page 3 of 6 Well Completion Report
<br /> Refer to Instruction Pamphlet State Well NumberlSite Number
<br /> Owners Well Number AMW-30 No. e0106293 L I I I TITN-] w
<br /> Date Work Began 01/18/2010 Date Work Ended 01/22/2010 Latitude Lon itude
<br /> ' Local Permit Agency San Joaauin County
<br /> Permit Number SR 0059145 Permit Date 1/12/10 1 APN/TRS/Other
<br /> Geologic Log Well Owner
<br /> ' Orientation OVertical 0Horizontal OAngle Specify Name Forward Incorporated
<br /> Drilling Method Mud Rota Drilling Fluid Bentonite mud Mailing Address 9999 South Austin Road
<br /> Depth from Surface Description
<br /> Feet to Feet Describe material rain size color,etc City Manteca State CA z; 95336
<br /> 76.0 76.5 Sil CLAY,dry,very stiff,not plastic,iron stainina Well Location
<br /> '
<br /> throughout,grayish brown(10YR 5/2). Address 27011 South Austin Road
<br /> 76.5 80.0 Silty CLAY. City_Ripon County San Joaquin
<br /> 80.0 81.5 Silty CLAY,moist,soft,plastic,mica throughout, Latitude 37 53 32-20 N Longitude -121 10 28.31 W
<br /> ' brown 00YR 4/3). Deq. Min. sec. DeQ. Min. sec
<br /> 81.5 85.0 Silty CLAY. Datum WAS 84 Decimal LaL 37.8923 Decimal Long.-121.1745
<br /> 85.0 85.8 Silty CLAY,slightly moist,stiff,not plastic,brown APN Book 181 Page 16 Parcel _7
<br /> 10YR 413. Townshi 1 N Ran a 7E Section 35
<br /> ' 85.8 86.3 SAND,moist,loose,fine to medium grained, Location Sketch Activity
<br /> by poorly sorted,subrounded,yellowish brown skekhmustbedrawnNo�aftertormis ted. CO New Well
<br /> (10YR 5/4). O Modification/Repair
<br /> $6.3 90.0 SAND. O Deepen
<br /> ' See attached o other
<br /> 90.0 90.8 Silty CLAY,slightly moist,stiff,no plasticity,brownO Destroy
<br /> Figure 1 DarnTe procedures uW matedaxs
<br /> (10YR 4/3). Trace fine grained sand throw hout. �'WaOWLOW
<br /> Well Location Map
<br /> Mica and iron staining throughout. Planned Uses
<br /> ' 90.8 91.5 Clayey SILT,moist,loose,soft,dark yellowish O Water Supply
<br /> brown(10YR 4/4). Fine grained sand,mica,and
<br /> ❑Domestic ❑Public
<br /> iron stainingthroughout. w ❑Irrigation [Industrial
<br /> 91.5 95.0 Clayey SILT. O Cathodic Protection
<br /> 95.0 96.5 SAND,moist,loose,fine to coarse rained, oorl O Dewatering
<br /> O Heat Exchange
<br /> sorted,subrounded,mica throughout,dark grayish 9 Y Olnjection
<br /> brown 10YR 4/2). O Monitoring
<br /> ' 96.5 100.0 SAND. O Remediation
<br /> 100.0 101.2 SAND,moist,loose,fine to coarse grained,poor) O Sparging
<br /> sorted,subrounded,mica throughout,dark grayish South O Test Well
<br /> ew.vau w dsocnw a.rcce a"d from mods,bLda rwg.ream, O Vapor Extraction
<br /> ' brown 10YR 412. Contains loose gravel at to of ape,arp.a„d,aaq„a,ap
<br /> Use adMwamlpaper Hneeessery, O Other
<br /> area be aeeureee end
<br /> spoon.
<br /> 101.2 105.0 SAND. Water Level and Yield of Completed Well
<br /> Depth to first water (Feet below surface)
<br /> ' Depth to Static
<br /> Water Level 71.49 (Feel) Date Measured 06/14/2010
<br /> Total Depth of Boring 177 Feel Estimated Yield' (GPM) Test Type
<br /> Total Depth of Completed Well 177 Feet Test Length (Hours)Total Drawdown (Feet)
<br /> *May not be representative of a well's long term 4eld.
<br /> Casings Annular Material
<br /> Depth from Borehole T Malarial Wall Outside Screen Slot Sim Depth from
<br /> Surface Olarnater yl� Thickness Diameter Type if Any Surface FIII Description
<br /> Feet to Feet Inches Inches Inches Inches Feet to Feet
<br /> ' 0 157 18 Blank PVC Sch.so 0.375 2.75 1 0.0 151.2 Cement Portland
<br /> 157 177 8 Screen PVC Sch.80 0.375 2.75 1 Milled Slots 0.010 151.2 154.0 Bentonite Pellets
<br /> 154.0 177.0 Filter Pack #2/12 Sand
<br /> Attachments Certification Statement
<br /> ' 0 Geologic Log 1,the underWd,certify that this rep is comple d urate to the best of my knowledge and belief
<br /> 0 Well Construction Diagram Name
<br /> ❑Geophysit l Log{s) P rson" c b n
<br /> El SoiUWaterChemical Analyses Ad City � ��m0�
<br /> 13Other Signed = � �D 31Q 0
<br /> ' Attach adddronal;nfamabon if d exists. CST Watar Well contractor Date Signed C-57 License Number
<br /> DWR 188 REV.1t2OO6 IF ADDITIONAL SPACE IS NEEDED,USE NEXT CONSECUTIVELY NUMBERED FORM
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