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State of California <br /> Well Completion Report <br /> Form DWR 188 Submitted 10/14/2020 <br /> WCR2020-014573 <br /> Owner's Well Number Date Work Began 09/04/2020 Date Work Ended 09/04/2020 <br /> Local Perm,t Agency San Joaquin County Environmental Health Department <br /> Secondary Permit Agency Permit Number WP0041153 Permit Date 08/25/2020 <br /> Well Owner(must remain confidential pursuant to Water Code 13752) Former Use <br /> Name KAREN VIEIRA Activity Destroy <br /> Mailing Address 16896 ELSHOLZ RD Former Use Water Supply <br /> City RIPON State CA Zip 95366 <br /> Well Location <br /> Address 18007 S ARBOREAL WAY APN 245-050-170 <br /> City RIPON Zip 95366 County San Joaquin Township <br /> Latitude 37 47 49.2252 N Longitude -121 5 45.5748 W Range <br /> Section <br /> Deg. Min. Sec. Deg. Min. Sec. <br /> Baseline Meridian <br /> Dec.Lat. 37.797007 Dec.Long. -121.095993 Ground Surface Elevation 76 <br /> Vertical Datum Horizontal Datum WGS84 Elevation Accuracy Unknown <br /> Location Accuracy Unknown Location Determination Method GPS Elevation Determination Method Digital Aerial Photo <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 63 (Feet) Date Measured 09/04/2020 <br /> Total Depth of Boring Feet Estimated Yield' (GPM) Test Type <br /> Test Length (Hours) Total Drawdown (feet) <br /> Total Depth of Completed Well 65 Feet *May not be representative of a well's long term yield. <br /> Destruction Details: <br /> 8V WELL DESTRUCTION FILLED WITH BENTONITE AND COMPLETED WITH 3'MUSHROOM CAP <br /> Other Observations: <br /> INSPECTED BY:COUNTYINSPECTOR-09.04.2020 <br /> _. to": INI E® <br /> ENTAL VICALj1-1 <br /> ENv��Rr�iSERV10Es <br /> Form DWR 188 rev. 12/19/2017 Page 1 of 2 <br />