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'The Free Adobe Reader may be used to view and coral" tris form. However,software must be purchased to complete,c' "rand reuse a saved form. <br /> File Original with DWR , <br /> State of California fs <br /> Page :15 of 18 Well Completion Report <br /> Owner's Wel!Number !W-2 Referro rnstWonPamphler State Well NumbedSite Number <br /> No. 00150785 <br /> Date Work Began 04/16/2012 Date Work Ended <br /> LatitudIN <br /> Lon nude <br /> Local Permit Agency-San Joaquin Enviro <br /> Permit Number 15502064 Permit Date 2/29/12 L APNlrRSAher <br /> Orientation OVertical O Horizontal OAngte Specify Name.Wi ht Holdings, Inc. <br /> Drilling Method A er Drilling Fluid <br /> Mailing Address: S.Wilson Way <br /> 5tate— <br /> . C• Stockton CA ri 95205 <br /> 0 55 Overdrill 314 inch well to 55 feet. <br /> Address 130 S:Wil n W <br /> City Stockton a�{y San Joaquin <br /> .:���Jtngitud' <br /> Datumal La(^ " Dedmal hong. <br /> APN Book Page Parcel <br /> Township " an on' <br /> : <br /> NWA-ME <br /> .. n <br /> 'North ` .. O:IN Well <br /> .yO Mobfication/Repair <br /> b O Deepen <br /> O Other <br /> w Destroy <br /> -.s.y, -`; OsxHhe procedures alM marerfats <br /> 'GEOLOGICLOG' <br /> ffa 4. O Water Supply <br /> t ` <br /> , # fid' � 3 []Domestic ©Public <br /> dt ❑Irigation []Industrial <br /> C sILLI <br /> r O Cathodic Protection <br /> -- 4 t "T O Dewatering <br /> O heat Exchange <br /> r4 W.- O injection <br /> �m <br /> O Monitoring <br /> a O Remediation <br /> c ,s O Sparging I <br /> South <br /> O Test Well <br /> -' __� ?✓' d'o«nate ordescnha aistar�ar sea From roads.wllding9.rent,,. O Vapor Extraction <br /> . . _ <br /> rivers,etc.and attach a map.Use addttionet paper 7 necessary. O Other <br /> "- '' Y?°' Plena he eeaau0a mtd tom <br /> Depth to first water (Feet below surface) <br /> Depth to Static <br /> JO <br /> Water Level (Feet) Date Measured <br /> Tota!Depth of Bt'rtng � y5" Feet Estimated Yield` (GPM) Test Type <br /> : ... ) <br /> Total Depth completed Well a Feet <br /> Test Length (Hours) Total Drawdown (Feet) <br /> *Maxnot be representative of a well's longterm lefd. <br /> Depth from j hole SIV * "ffiat;Nal wall Outside Screen Slot Size Depth from <br /> Surface �htar Thickness Diameter TIf <br /> Feet to Feet Inches rF � Inches Inches Type Inches Feet to Feet' Fill Description <br /> 75 <br /> _4ty <br /> �x� ~ <br /> ❑Geologic Log I,the undersigned,Certify that this report is complete and accurate to the best of my knowledge and belief <br /> ❑Well Construction Diagram Name Tin <br /> Peraon,Finn or Corporation <br /> 0 Geophysical Logs) 3632 Omec Cir I RanchoCordova P 95742 <br /> ❑Soil/Water Chemical Analyses Add re s city stagy <br /> 0 Other Site Map Signed3j3fflgZip <br /> 4/26/2012 93$110 <br /> Attach additional information ff it exists. C-57 Licensed kater Well Cifbractor Date Signed C-57 License Number <br /> GWR 188 REV.1121306 IF AMMONAL SPACE IS NEEDED,-LTE NEXT CONSECUTIVELY NUMBERED FORM <br />