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State of California <br /> Well Completion Report <br /> Form DWR 188 Submitted 12/5/2019 <br /> WCR2019-017200 <br /> Owner's Well Number Date Work Began 11/25/2019 Date Work Ended 11/26/2019 <br /> Local Permit Agency San Joaquin County Environmental Health Department <br /> Secondary Permit Agency Permit Number 40325 Permit Date 11/21/2019 <br /> Well Owner(must remain confidential pursuant to Water Code 13752) Former Use <br /> Name Henry VanderBosch Activity Destroy <br /> Mailing Address 232 Milgeo Ave. Former Use Water Supply <br /> City Ripon State CA Zip 95366 <br /> Well Location <br /> Address 232 Milgeo AVE APN 261-200-05 <br /> City Ripon Zip 95366 County San Joaquin <br /> Township 02S <br /> Latitude 37 44 46.5061 N Longitude -121 7 19.0059 W Range 08 E <br /> Section 20 <br /> Deg. Min. Sec. Deg. Min. Sec. Baseline Meridian Mount Diablo <br /> Dec.Lat. 37.7462517 Dec.Long. -121.1219461 Ground Surface Elevation <br /> Vertical Datum Horizontal Datum WGS84 Elevation Accuracy <br /> Location Accuracy Location Determination Method Elevation Determination Method <br /> Borehole Information Water Level and Yield of Completed Well <br /> Orientation Vertical Specify Depth to first water (Feet below surface) <br /> Drilling Method Drilling Fluid Depth to Static <br /> Water Level (Feet) Date Measured <br /> Total Depth of Boring Feet Estimated Yield* (GPM) Test Type <br /> Test Length (Hours) Total Drawdown (feet) <br /> Total Depth of Completed Well 100 Feet *May not be representative of a well's long term yield. <br /> Destruction Details: <br /> Pulled existing pump,pumped 10.3 sack cement mix from bottom to the top,mushroom cap on top. <br /> Other Observations: <br /> Form DWR 188 rev. 12/19/2017 Page J_of 2 <br />