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"The free Adobe Reader maybe used to view and comr '1his form. However,software must be purchased to complete,r "ind-reuse a saved form, <br /> File Original with DWR State of California ; , - <br /> Page 13 of 18 Well Completion Report <br /> Refer to frrstrw*orl Pamphlet State Well NumherlSNe Number <br /> Owner's Well Number MW-13 No. e0150783 N w <br /> Date Work Began 04/11/2012 Date Work Ended 1 Latitude Longitude <br /> Local Permit Agency San Joaau1n County-Enironrnental Health DeoallMent <br /> Permit Number 5502064. Permit Date 2129112 4. APNIrRSIOther <br /> Orientation O Vertical O Horizontal OAngle Specify Name Wight Holdings,Inc. <br /> Drilling Method Auger Drilling Fluid <br /> e ilwu c: Malting <br /> 1.-- CA <br /> i _30 S.Wilson Way <br /> o. <br /> C' State 1 95205 :1, <br /> 0 55 x Overdrill 4 inch well to 55 feet. i 11V1 «, <br /> Address 130 S.Wilson Way <br /> City Stockton C San Jaaguln <br /> Latitude .a Qngltud ,,. <br /> . Deu Min. 5 a ::,r p. pec. <br /> Datum DecimalI �� Decimaj ong t .o <br /> APN Book Pae : Parcel <br /> Township Ra 'on <br /> h1 b aa#teuio`far� <br /> N* <br /> 'iNbrthWell <br /> &p Mti ification/Repair <br /> N t " .0 Deepen <br /> AV O Other <br /> Destroy .. <br /> D] db.prooedu and matefti3 <br /> under'GEOLOGIC LOG' <br /> M <br /> wry * <br /> K a t 0 Water Supply <br /> ©Domestic ❑Public <br /> . ,. , <br /> ❑irrigation [Industrial <br /> O Cathodic Protection <br /> O Dewatering <br /> O Heat Exchange <br /> A ! O Injection' <br /> O Monitoring <br /> 0 Remediation <br /> 4 <br /> T, 4 v O Sparging <br /> South 0 Test Well <br /> 'I�+rsmte or devAbe ounce o—IT 1 o roads,eWldings,rer�ces. ^O^�� Vapor F_7(traCtiDn <br /> rIvem,etc,end attach a map.lige addtdonal paper a neoeaaary. 0 Other .. <br /> k4 ; Please be accurahr and c <br /> fl <br /> Depth <br /> Depth to first water' (Feet below surface) <br /> Depth to Static <br /> nr Water Level (Feet) Date Measured <br /> Total Depth ofp,,,Wi 6 r, Feet Estimated Yield' (GPM) Test Type <br /> Total Depthot^ ompleted Well � ' `" c Feet Test Length (Hours)Total Drawdown (Feet) <br /> ax -Ma not be representative of a well's long term yield. <br /> : <br /> Depth from "''"Borehole "3` �ylatsr I wall. Outside Screen Slot Size Depth from y <br /> h Thickness Diameter <br /> Surface DIa �r Type. if Any Surface Fill Description <br /> Feet to Feet Inches' Inches Inches Inches Feet to Feet <br /> is l <br /> 2 <br /> 7- <br /> DWR <br /> eologic Log I,the undersigned,certify that this report Is complete and accurate to the best of my knowledge and belief <br /> ell Construction Diagram Name Cascade Drilling.L.P. <br /> eophysical LOg(s) Person.Finn orCorporatlon <br /> 3632 Omec Circle .Rancho Cordova CA 95742 <br /> oillWater Chemical Analyses Address city — Stara Zip <br /> ther Site Map Signed 4/26/2012 938110 <br /> nal info ation Ir It a are. - G57 ' need Water ell Con r Date 5i ned C-57.License Number <br /> 18B REV.112D06 IF ADDITIONAL SPACE I5 NEEDED,USE NEXT CONSECUTIVELY NUMBERED FORM <br />