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<br /> ' File Original with DWR State of California DWR Use Only-Do Not Fill In
<br /> Well Completion Report
<br /> Page 5 Of 5 Refer to lnsimr6w Pemphler
<br /> Owner's Well Number AMW-29 No. e0106872 State Well Number/Site Number
<br /> Date Work Began 01/27/2010 Date Work Ended 02/02/2010 ��_� I W
<br /> ' latitude Lon nude
<br /> Leal Permit Agency man Joacuin County
<br /> Permit Number SR 0059146 Permit Date 1/12/10 APNlTRS/Other
<br /> Geologic Log Well Owner
<br /> ' Orientation O Vertical O Horizontal OAngle specify Name Forward Incorporated
<br /> Drilling Method Mud Rotag Drilling Fluid Bentonite mud
<br /> Mailing Address 9999 South Austin Road
<br /> Depth from Surface Description
<br /> Feet to Feet Describe material rain size color,etc City Manteca stateCA_2ip 95336
<br /> 135.7 136.5 SAND wet medium to coarse grained,well sorted, Well Location
<br /> ' subrounded,micaceous,grayish brown Address 27011 South Austin Road
<br /> 2.5Y 5/2). Contains coarse,subrounded ravel. City Ripon County San Joaquin
<br /> 136.5 141.0 SAND. Latitude 37 53 29.12 N Longitude -121 10 44.69 w
<br /> 141.0 141.5 SAND,wet,medium to coarse grained,well sorted, DeO. Min. Seo. Dm. Min. Sam
<br /> subrounded,micaceous,grayish brown Datum WGS 84 Decimal Lat.37,8914 Decimal Long.-1211.1791
<br /> (2.5Y 5/2). Contains coarse,subrounded gravel. APN Book 181 Page 16 Parcel 7
<br /> 141.5 145.0 SAND. Township 1N Rance 7E Section 35
<br /> ' 145.0 146.5 SAND,wet,medium to coarse grained,well sorted, Location Sketch Activi
<br /> subrounded,micaceous,grayish brown sketch must be drawn by m atbrform Is ted. . New Well
<br /> No
<br /> (2.5Y 512). O Modification/Repair
<br /> O Deepen
<br /> 146.5 151.0 SAND. See attached O Other
<br /> 151.0 151.5 SAND,wet,medium to coarse grained,well sorted, Figure 1 O Destroy
<br /> Daecnnbe procedures and matmtals
<br /> subrounded,micaceous,grayish brown ondar"GEOLOGIC LOG*
<br /> 2.5Y 542). Contains subrounded ravel.
<br /> Well Location Map planned Uses
<br /> ' 151.5 156.0 SAND. O Water Supply
<br /> 156.0 156.5 SAND,slightly damp,medium to fine grained,well ODomestic ❑Public
<br /> sorted,subrounded,light olive brown 2.5Y 5/3). 3 , ❑Irrigation ❑industrial
<br /> ' 156.5 161.0 SAND. O Cathodic Protection
<br /> O Dewatering
<br /> 161.0 161.5 SAND,slightly damp,medium to fine grained,well O Heat Exchange
<br /> sorted,subrounded,light olive brown(2.5Y 5/3). O Injection
<br /> Quartzite cobble at base of split spoon. U Monitoring
<br /> ' 161.5 171.4 SAND. O Remediation
<br /> 171.4 171.5 CLAY,slightly damp,medium dense,highly O Sparging
<br /> plastic,olive gray(5Y 5/2). South O Test Well
<br /> nwma.«da meedalenmd..taaamob,ardowtomm. O Vapor Extraction
<br /> ' rivers,Mo.and aaacharnap.up ada4aW pegry nawaary, O Other
<br /> Pin"be
<br /> Water Level and Yield of Completed Well
<br /> Depth to first water (Feet below surface)
<br /> ' Depth to Static
<br /> Water Level 70.13 (Feet) Date Measured 06/14/2010
<br /> Total Depth of Boring 171.5 Feet Estimated Yield (GPM) Test Type
<br /> Test Length (Hours)Total Drawdown (Feel)
<br /> Total Depth of Completed Well 170 Feat *May not be representative of a well's long term yield.
<br /> ' Cast Annular Material
<br /> Depth from Borehole Wail Outside Screen Slat Size Depth from
<br /> Surface Diameter Type Material Thickness Diameter Type if Any Surface FIII Description
<br /> Feet to Feel Inches inches Inches inches Feet to Feet
<br /> 0 150 18 Blank PVC Sch.80 0.375 2.75 1 0.0 144.0 cement Portland
<br /> 150 170 8 Screen PVC Sch.80 0.375 2.75 Milled Slots 0A10 144.0 146.6 Bentonite Pellets
<br /> 146.6 170.0 Filter Pack #2/12 Sand
<br /> Attachments Certification Statement
<br /> ' ❑O Geologic Log 1,the undei fi this comp d urate to the best of my knowledge and belief
<br /> 0 Well Construction Diagram Name
<br /> ❑Geophysical Log(s) t� n' I cr q)-- pr.0 /r
<br /> El Soil/Water Chemical Analyses cdy stag I J�v
<br /> ❑Other Signed -�Jz31►o 0'-�t, 7
<br /> ' A eddi6onal.nf.tion if d e.ts. c 6 n and Water well contractor Date Signed C-57 License Number
<br /> DWR 188 REV.1/2006 IF ADDITIONAL SPACE IS NEEDED,USE NEXT CONSECUTIVELY NUMBERED FORM
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