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<br /> ' File Original with DWR State of California DWR Use Only-Do Not Fill In
<br /> Pa2 of 5 Well Completion Report
<br /> Page Rotor to Inarfuchan PwVhfer State Well Number/Site Number
<br /> Owner's Well Number AMW-29 No. e0106872 ���, W
<br /> Date Work Began 01/27/2010 Date Work Ended 02/02/2010 latitude Longitude
<br /> ' Local Permit Agency San Joaquin County
<br /> Permit Number SR 0059146 Permit Date 1112/10 1 ier
<br /> Geologic Log Well Owner
<br /> ' Orientation OVer6cal 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 Slate_CA __Zip 95336
<br /> 35.0 36.5 SILT slightly damp,medium stiff,grayish brown Well Location
<br /> ' (10YR 512). Contains abundant mica with strong Address 27011 South Austin Road
<br /> brown(7.5YR 5/8)iron staining, City Ripon County San Joaquin
<br /> 36.5 40.0 SILT. Latitude 37 53 29.12 N Longitude -121 10 aa.se w
<br /> ' 40.0 40.5 SILT,damp,brittle,medium stiff,brown Dec. Min. Sec. Dea. Min. Sec.
<br /> (10YR 5/3). Contains 10%mica throughout. Datum wGS 84 Decimal Lat. 37.8914 Decimal Long.-121.1791
<br /> 40.5 41.5 SILT,dry,stiff,slight!y plastic,yellowish brown APN Book_181 Page 16 Pard 7
<br /> 10YR 5/6). Contains 10%mica throughout. Township 1N Ra a 7E Section_35
<br /> ' 41.5 45.0 SILT. Location Sketch Activity
<br /> 45.0 46.5 SAND,wet,very dense,coarse grained, (Sketch must be drawn by hand after form is ted. r* New Well
<br /> suban ular to subrounded, ellowish brown North dification/Repair
<br /> Deepen
<br /> (10YR 5/6). Contains 2%fine rained,angular Other
<br /> ravel. See attached stroy
<br /> et"procedures and metensls
<br /> 46.5 50.0 SAND. Figure 1 sr•GEOLOGICLW
<br /> ' 50.0 50.2 CLAY,wet,soft,highly plastic,gray(2.5Y 5/1). Well LOC8tl0n Map Planned Uses
<br /> 50.2 51.0 SILT,dry,stiff,brittle,yellowish brown 10YR 5/6). p Water Supply
<br /> 51.0 51.5 SILT,damp,stiff,brittle,dark yellowish brown ❑Domestic ❑Public
<br /> (10YR4/6). W ❑Imgalion []industrial
<br /> 51.5 55.0 SILT. O Cathodic Protection
<br /> 55.0 56.5 SILT,damp,medium stiff to stiff,slightly plastic, O Dewatering
<br /> O Heat Exchange
<br /> yellowish brown(10YR 5/6). O Injection
<br /> 56.5 60.0 SILT. 0 Monitoring
<br /> ' 60.0 61.5 SILT with trace sand,damp,medium stiff,medium O Remediation
<br /> dense,brittle,yellowish brown 10YR 5/8). O Sparging
<br /> 61.5 65.0 SILT with trace sand. South O Test Well
<br /> 65.0 66.5 SILT with trace sand,damp,medium stiff,mediumIll'"17MB0rdatnbid�"eo(wMftmMeds•b"'"ings,fa^�• O Vapor Extraction
<br /> ' mxs,eto-and dumh a map.Use additional paper d neceaun, 0 Other
<br /> dense,brittle,yellowish brown(10YR 5/8). pNii°'aa°"""d
<br /> 66.5 70.0 SILT with trace sand. Water Level and Yield of Completed-Me-11
<br /> 70.0 71.5 SILT with trace sand,damp,medium stiff,medium Depth to first water (Feet below surface)
<br /> ' dense,brittle,yellowish brown 10YR 5/8 . Depth to Static
<br /> y ( ) Water Level 70.13 (Feet) Date Measured 06/14/2010
<br /> Total Depth of Boring 171.5 Feet Estimated Yield` (GPM) Test Type
<br /> Total Depth of Completed Well 170 Feet Test Length (Hours)Total Drawdown (Feet)
<br /> '
<br /> *May not be re resentative of a well's long term yield.
<br /> CasingsAnnular Material
<br /> Depth from Borehole Type Material Thickness
<br /> Outside Screen Slot Size Depth from
<br /> Surface Diameter Thickness Diameter Type if Any Surface Fill Description
<br /> Feel to Feet Inches Inches Inches Inches Feet to Feet
<br /> 0 150 8 Blank PVC Sch.80 0.375 2.75 1 0.0 1144.0 lCement Portland
<br /> 150 170 8 Screen PVC Sch.80 0.375 2.75 Milled Slots 0.010 144.0 1146.6 Isentonite Pellets
<br /> 146.6 170.0 Filter Pack #2/12 Sand
<br /> Attachments Certification Statement
<br /> ' ❑Geologic Log 1,the undersi rlify At i repo mplele rate to the best of my knowledge and belief
<br /> ❑Well Construction Diagram Name •F m
<br /> ❑Geophysical Log(s) ��-- .cA q5��d
<br /> ❑Soil/Water Chemical Analyses lc
<br /> c slate
<br /> ❑Other Signed tf �. 'D r93&3�
<br /> ' [Attach additional mfomishan d it asasts. CS water well Contractor Date Signed C-57 License Number
<br /> DWR 188 REV.1/20DS IF AODmONAL SPACE IS NEEDED,USE NEXT CONSECUTIVELY NUMBERED FORM
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