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QUADRUPLICATE STATE OF CALIFORNIA DWR USE ONLY — DO NOT FILL IN <br /> For Local Requirements WELL COMPLETION REPORT <br /> Page 1 of 1 Refer to Instruction Pamphlet STATE WELL NO./STATION NO. <br /> Owner's Well No. 95236 NO.e0368091 III , 11:1F11 fill lj1:1 <br /> Date Work Began 8/21/2018 Ended8/22/2018 - LATITUDE LONGITUDE <br /> Local Permit Agency EnvirnnMental HFalth <br /> Permit No. wP0038670 Permit Date 8/16/2018 APWTRS/OTHER <br /> GEOLOGIC LOG WELL OWNER <br /> ORIENTATION(✓) vL VERTICAL —HORIZONTAL —ANGLE —(SPECIFY) Name R St J Dondero <br /> DRILLING ROTARY <br /> DEPTH FROM METHOD FLUID Mud Mailing Address 20480 Cop eropolis Rd <br /> SURFACEDESCRIPTION Linden CA 95236 <br /> Ft. to Ft. Describe material, grain, size, color, etc. CITY STATE ZIP <br /> 0 2 Top Soil Address 2997 N Alpine Rd ELL t.oc'ATK) <br /> 2 10 Sand Stockton CA <br /> 10 49 ClayCity <br /> 49 56 Sand CountySan Joaquin <br /> APN Book Page Parcel <br /> 56 112 Clay Township Range Section <br /> 112 135 Sand and Gravel Latitude I _ 1 l <br /> 135 163 Clay DEG. MIN. SEC. DEG. MIN. SEC. <br /> 163 175 Sand LOCATION SKETCH ACTIVITY (v) <br /> 175 233 Clay <br /> NORTH _31/_ NEW WELL <br /> 233 237 Sand MODIFICATION/REPAIR <br /> —Deepen <br /> 237 243 Clay —other(Specify) <br /> 243 246 Sand <br /> 246 259 Clay — DESTROY <br /> (and Materials <br /> Under"GEOLOGIC LOG' <br /> 259 261 Sand PLANNED USESO <br /> 261 287 Clay WATER SUPPLY <br /> 287 288 Sand W Domestic— Public <br /> 288 290 Clay — Irrigation — Industrial <br /> 290 291 Sand MONITORING— <br /> TEST WELL- <br /> 291 320 Clay ATHODIC PROTECTION- <br /> 320 327 Sand HEAT EXCHANGE- <br /> 327 350 Shale DIRECT PUSH— <br /> INJECTION— <br /> VAPOR EXTRACTION— <br /> SPARGING— <br /> SOUTH <br /> /l/ustrote or Describe Distance of We/1 Jrom Roads, Buildings, REMEDIATION— <br /> Fences,Rivers,etc. and attach a map. Use additional paper if OTHER(SPECIFY)— <br /> necessary. PLEASE BE ACCURATE & COMPLETE. <br /> WATER LEVEL&YIELD OF COMPLETED WELL <br /> DEPTH TO FIRST WATER (Ft.)BELOW SURFACE 1 <br /> DEPTH OF STATIC <br /> WATER LEVEL-126 (Ft.)&DATE MEASURED 8/22/2018 <br /> TOTAL DEPTH OF BORING 350 ESTIMATED YIELD ` (GPM)& TEST TYPE <br /> (Feet) TEST LENGTH—(Hrs.) TOTAL DRAWDOWN (Ft.) <br /> TOTAL DEPTH OF COMPLETED WELL 334 (Feet) May not be representative o a well's lon -term yield. <br /> DEPTH BORE- __ CASING(S) DEPTH ANNULAR MATERIAL <br /> FROM SURFACE HOLE aTYPEL' FROM SURFACE TYPE <br /> DIA. MATERIAL/ INTERNAL GAUGE SLOT SIZE CE- BEN- <br /> (Inches) GRADE DIAMETER OR WALL IF ANY MENT TONIT FILL FILTER PACK <br /> Ft. to Ft. (Inches) THICKNESS (Inches) Ft. to Ft. ✓ (✓) �) (TYPE/SIZE) <br /> 0 314 105/8 PLASTIC 6 200 0 100 <br /> 314 334 .045 100 334 RAVE <br /> I <br /> ATTACHMENTS (4) CERTIFICATION STATEMENT <br /> — Geologic Log I,the undersigned,certify that this report is complete and accurate to the best of my Itnowledge and belief. <br /> — Well Construction Diagram NAME MASELLIS DRILLING INC <br /> — Geophysical Log(s) (PERSON,FIRM,OR CORPORATION) (TYPED OR PRINTED) <br /> — Soil/Water Chemical Analysis 119 Albers Rd Modesto CA 9 357 <br /> — Other ADDRESSCITY STATE ZIP <br /> ATTACH ADDITIONAL INFORMATION,IF IT EXISTS. Signed `zl_4009/11/18 668622 <br /> 11 WELL DRILLER/AUTHORIZED REPRESENTATIVE DATE SIGNED C-57 LICENSE NUMBER <br /> DWR 188 REV,11-97 IF ADDITIONAL SPACE IS NEEDED,USE NEXT CONSECUTIVELY NUMBERED FORM <br />